Did Implementation of the Zero-Tolerance for Head Contact Rule Change the Risk of Concussion and Injury in Youth Hockey Players in Alberta?

Authors

  • Maciej Krolikowski 1) Sport Injury Prevention Research Centre, Faculty of Kinesiology University of Calgary, Calgary, Alberta, Canada

Keywords:

concussion, injury, ice hockey, youth, policy

Abstract

Background: Ice hockey is a popular winter sport in Canada. Concussion accounts for the greatest proportion of all injuries in youth ice hockey. Research has informed policy change enforcing the no head contact rule in all leagues in Canada in 2011.

Objective: To determine if the risk of game-related concussion and other injury differ for Pee Wee (ages 11-12) and Bantam (ages 13-14) players following a 2011 rule implementation compared to players in similar divisions prior to the rule change.

Design: Historical cohort study.

Setting: Ice hockey rinks.

Participants: Historical cohort included Pee Wee (most elite 70%, 2007/08) (n=891) and Bantam (most elite 30%, 2008/09) (n=378) players before the rule change and Pee Wee (2011/12) (n=588) and Bantam (2011/12) (n=244) players in the same levels of play after the policy change.

Assessment of Risk Factors: Exposure of ice hockey teams before and after a “zero tolerance for head contact” rule enforcement policy change. Risk factors include position, and previous injury/concussion.

Main Outcome Measurements: Suspected concussions were identified by a team designate (Pee Wee) or team therapist (Bantam) and referred to a sport medicine physician. Hockey injuries included those requiring medical attention and/or time loss.

Results: The risk of game concussion increased in both age cohorts in the season following implementation of the zero-tolerance for  head contact rule (Rule 6.5) in 2011 compared to players in similar age groups and divisions prior to implementation (Pee Wee concussion IRR = 1.96 [95% CI; 1.29-2.98] and Bantam concussion IRR = 2.61 [95% CI; 1.28-5.35]). The risk of other injury (excluding concussion) did not change in the Bantam level (Bantam other injury IRR = 0.99 [95% CI; 0.62-1.63]).

Conclusions: The “zero tolerance for head contact or head checks” rule did not reduce game-related concussion risk in Pee Wee or Bantam ice hockey players. This study will inform future research examining mechanism of injury leading to concussions in youth ice hockey.

References

1. Hockey Canada. Hockey Canada Minor Hockey web site. Available at: http://www.hockeycanada.ca/en-ca/Corporate/About/Basics.aspx. Accessed May 6th, 2013

2. Emery, C., Meeuwisse, W. (2006). Injury rates, risk factors, and mechanisms of injury in minor hockey. AJSM, 34:1960-1969.

3. Helly KD, Lissel HL, Rowe BH, et al. (2001) Sport and recreation-related head injuries treated in the emergency department. CJSM, 11:77-81.

4. Hockey Canada. Hockey Canada Minor Hockey web site. Available at: httip://www.hockeycanada.ca/en-ca/news/2011-GN-018-en. Accessed May 6th, 2013

5. Benson BW, McIntosh AS, Maddocks D, Herring SA, Raftery M & Dvorak J (2013). What are the most effective risk-reduction strategies in sport concussion? BJSM, 47: 321-326

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Published

2014-07-31

Issue

Vol. 4 (2014)

Section

Extended Abstracts

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