Individual-level determinants and clinical outcomes of head impact exposure in youth hockey

项目概要/摘要： 冰球是一种高受伤率的碰撞/接触运动。身体检查，运动员故意 与对手碰撞以获得冰球的控制权是男孩和男子比赛的关键组成部分 曲棍球虽然女子曲棍球不允许进行身体检查，但它仍然被认为是一项身体接触的运动; 男女曲棍球运动员患脑震荡的比例相当。最近的证据表明 即使没有临床诊断的脑震荡， 导致大脑微观结构和认知功能的改变。姿势控制的评估已经被用于 以帮助诊断脑震荡，有证据表明，这种评估是足够敏感，以检测 亚临床损伤迄今为止，没有研究评估个人水平的表现（运动员技能）作为一个决定因素 头部受到撞击未来的干预措施可以针对技能发展，以提高体育安全， 特别是在青年一级。然而，头部撞击暴露的准确量化及其与 在干预前，有必要与个人表现指标和临床姿势控制缺陷进行共享 可以实现。本研究的目的是使用一个口承式感测器来量测头部撞击 暴露在男性和女性青年曲棍球运动员，并评估累积之间的关系 暴露、个体表现指标和姿势控制缺陷。研究小组在本提案中确定， 在量化青少年运动中的头部撞击暴露和评估临床结果方面有着广泛的历史。一 为顺利完成以下工作，已制定了一项完善的研究和指导计划 目标。在目标1中，32名男孩和32名女孩的青年曲棍球运动员将完成赛季前和赛季后的评估 冰上曲棍球表演。青年运动员将配备一个定制的喉舌传感器， 赛季所有冰上训练都将被记录和审查，以确定头部撞击的特征。我们将 量化每次影响的频率和程度。在目标2中，装备了仪器的青年运动员将接受 季节前后姿势控制评估。从术前到术后姿势控制措施的变化 赛季将评估与冰上头部撞击暴露和青年运动员表现指标的相关性。 这项研究的成功完成将阐明以前未描述的头部撞击之间的关系， 暴露、青年运动员表现指标和姿势控制缺陷。未来的干预研究可以利用 本研究旨在设计旨在提高青少年运动员表现的策略，以减少暴露， 转动可以减少姿势控制缺陷。这项研究最终可以作为一个早期的进步 政策变化，这将提高青少年曲棍球的安全性，并减轻脑损伤或功能障碍的风险。 损伤

Project Summary/Abstract: Ice hockey is a collision/contact sport with a high rate of injury. Body checking, where an athlete intentionally collides with an opponent to gain possession of the puck is a critical component of play in boys’ and men’s hockey. Although body checking is not allowed in women’s and girls’ hockey, it is still considered a contact sport; male and female hockey athletes share comparable rates of concussion. Recent evidence suggests that exposure to subconcussive head impacts, even in the absence of clinically-diagnosed concussion is sufficient to cause alterations in brain microstructure and cognitive function. Assessments of postural control have been used to aid diagnosis of concussion, and evidence suggest that such assessments are sensitive enough to detect subclinical injury. To date, no studies have evaluated individual-level performance (athlete skill) as a determinant of head impact exposure. Future interventions could target skill development in an effort to improve sport safety, particularly at the youth level. However, accurate quantification of head impact exposure and the relationship it shares with individual performance metrics and clinical postural control deficits is necessary before interventions can be implemented. The objective of this study is to use a mouthpiece-sensor for measurement of head impact exposure in male and female youth hockey athletes and evaluate the relationships between cumulative exposure, individual performance metrics, and postural control deficits. The study team identified in this proposal has extensive history in quantifying head impact exposure in youth sports and in evaluating clinical outcomes. A well-developed research and mentorship plan has been prepared for the successful completion of the following aims. In Aim 1, 32 boys’ and 32 girls’ youth hockey athletes will complete a pre- and post-season assessment of ice hockey performance. Youth athletes will be instrumented with a custom mouthpiece sensor to wear during the season. All on-ice sessions will be recorded and reviewed to identify characteristics of head impacts. We will quantify impact frequency and magnitude for each impact. In Aim 2, instrumented youth athletes will undergo a pre- and post-season postural control assessment. Changes in postural control measures from pre- to post- season will be evaluated for correlation with on-ice head impact exposure and youth athlete performance metrics. Successful completion of this research will elucidate previously undescribed relationships between head impact exposure, youth athlete performance metrics, and postural control deficits. Future intervention studies can utilize this research to design strategies aimed at improving youth athlete performance to reduce exposure, which in turn may decrease postural control deficits. This research could ultimately serve as an early advancement towards policy change that will improve youth hockey safety and mitigate risk of brain injury or functional impairment.