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Second Round Abstract Submissions
11) Risk Reduction/Prevention
11.21 Evaluating the protective effect of mouthguard use for concussion in youth ice hockey
  1. Ash T Kolstad1,2,3,4,
  2. Paul H Eliason1,2,3,4,
  3. Jean-Michel Galarneau1,2,
  4. Amanda M Black1,2,3,4,5,
  5. Brent E Hagel1,2,3,5,6,7,
  6. Carolyn A Emery1,2,3,4,5,6,7,8
  1. 1Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary,, Calgary, Canada
  2. 2Integrated Concussion Research Program, University of Calgary, Calgary, Canada
  3. 3Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Canada
  4. 4Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
  5. 5O’Brien Institute for Public Health, University of Calgary, Calgary, Canada
  6. 6Departments of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
  7. 7Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
  8. 8MCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada

Abstract

Objective To evaluate the association between mouthguard use and concussion rates in youth ice hockey players (ages 11–18).

Design Prospective cohort.

Setting Calgary and Edmonton (Canada).

Participants Over 5 seasons, 3,330 youth ice hockey players (males and females; 5,356 player-seasons) participated.

Assessment of Risk Factors At baseline, participants reported wearing (always/sometimes) or not wearing (never) a mouthguard. Other covariables included participant weight, age group (U13/U15/U18), concussion history (yes/no), position (forward/defense/goalie), and body checking policy (allowed/disallowed). Participation in games/practices (hours) and injury occurrence (concussion and non-concussion) were recorded.

Outcome The outcome of interest was suspected/diagnosed concussions each season (concussion definition – 5th International Sport Concussion Consensus). Non-concussion injuries included those with missed participation (time-loss) and/or required medical attention, and were validated by a study therapist.

Results Complete-case multivariable mixed-effects negative binomial regression (3,953 player-seasons; 360 player-concussions; 240,008.9 player-hours) adjusted for weight, age group, concussion history, position, body checking policy, and clustered by team was used to estimate incidence rates and incidence rate ratios (IRR). Mouthguard wearers had a 35% lower concussion rate (IRR=0.65, 95%CI:0.49–0.85). A similarly constructed multivariable model examined the rate of any non-concussion injury (below the neck) by mouthguard use status to assess potential confounding of injury rates by protective equipment-related factors. There were no significant differences in the rate of non-concussion injuries (n=370 player non-concussion injuries) by mouthguard use status (IRR=0.96, 95%CI: 0.72–1.29).

Conclusions Wearing a mouthguard was associated with significantly lower concussion rates. The results of our study have implications for mouthguard policies in youth ice hockey.

https://doi.org/10.1136/bjsports-2023-concussion.379

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