Objectives To compare rates of injury and concussion among U-15 (ages 13–14 years) ice hockey players playing in leagues allowing body checking, but who have a varying number of years of body checking experience.
Methods This 5-year longitudinal cohort included U-15 ice hockey players playing in leagues where policy allowed body checking. Years of body checking experience were classified based on national/local body checking policy. All ice hockey game-related injuries were identified using a validated injury surveillance methodology. Players with a suspected concussion were referred to a study sport medicine physician. Multiple multilevel Poisson regression analysis was performed, adjusting for important covariates and a random effect at a team level (offset by game exposure hours), to estimate injury and concussion incidence rate ratios (IRRs).
Results In total, 1647 players participated, contributing 1842 player-seasons (195 players participating in two seasons). Relative to no body checking experience, no significant differences were found in the adjusted IRRs for game-related injury for players with 1 year (IRR=1.06; 95% CI: 0.77 to 1.45) or 2+ years (IRR=1.16; 95% CI: 0.74 to 1.84) body checking experience. Similarly, no differences were found in the rates of concussion for players with 1 year (IRR=0.92; 95% CI: 0.59 to 1.42) or 2+ years (IRR=0.69; 95% CI: 0.38 to 1.25) body checking experience.
Conclusions Among ice hockey players aged 13–14 years participating in leagues permitting body checking, the adjusted rates of all injury and concussion were not significantly different between those that had body checking experience and those that did not. Based on these findings, no association was found between body checking experience and rates of injury or concussion specifically in adolescent ice hockey.
- athletic injuries
- brain concussion
- child health
- sporting injuries
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.
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Contributors PE, BEH, LP-D, AMB and CE contributed to the study proposal development. PE, BEH, LP-D, VWKV, AMB and CE contributed to the data collection, entry and data cleaning. PE, BEH, LP-D, VWKV, SB and CE contributed to the data analysis and interpretation of study results. SB, MM and CL contributed to all aspects of data collection at study sites outside of Calgary. CE and BEH contributed to acquisition of funding, study design and led all aspects of the cohort. All authors critically reviewed and edited the manuscript before submission. CE is the study gurantor.
Funding The funding for this study was provided by Alberta Innovates Health Solutions (Collaborative Research and Innovation Opportunities Programme Grant # 3685), the Canadian Institutes of Health Research (Institute of Neuroscience, Mental Health and Addictions Grant #293332) and the Hotchkiss Brain Institute (University of Calgary).
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Hockey Canada, BC Hockey, Hockey Calgary, and Hockey Edmonton were involved as knowledge brokers in contributing to approval of study design, study recruitment, injury surveillance methods, support of safety designate role and dissemination of research findings within the hockey community. The research questions and outcome measures were developed and informed by the priorities, experience, and preferences of Hockey Canada, BC Hockey, Hockey Calgary and Hockey Edmonton. Hockey players, parents, coaches and administrators in Hockey Canada, BC Hockey, Hockey Calgary, Airdrie Minor Hockey, and Hockey Edmonton were dedicated to the collection of weekly exposure data, identification of a player with a suspected concussion, and supporting communication with the research team for injury follow-up. A knowledge broker from Hockey Canada and Hockey Calgary informed the methods and time commitment for study participation by players and parents and safety designates.
Provenance and peer review Not commissioned; externally peer reviewed.
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