Safe-Play Knowledge, Aggression, and Head-Impact Biomechanics in Adolescent Ice Hockey Players.

CONTEXT: Addressing safe-play knowledge and player aggression could potentially improve ice hockey sport safety. OBJECTIVES: To compare (1) safe-play knowledge and aggression between male and female adolescent ice hockey players and (2) head-impact frequency and severity between players with high and low levels of safe-play knowledge and aggression during practices and games. DESIGN: Cohort study. SETTING: On field. PATIENTS OR OTHER PARTICIPANTS: Forty-one male (n = 29) and female (n = 12) adolescent ice hockey players. INTERVENTION(S): Players completed the Safe Play Questionnaire (0 = less knowledge, 7 = most knowledge) and Competitive Aggressiveness and Anger Scale (12 = less aggressive, 60 = most aggressive) at midseason. Aggressive penalty minutes were recorded throughout the season. The Head Impact Telemetry System was used to capture head-impact frequency and severity (linear acceleration [g], rotational acceleration [rad/s(2)], Head Impact Technology severity profile) at practices and games. MAIN OUTCOME MEASURE(S): One-way analyses of variance were used to compare safe play knowledge and aggression between sexes. Players were categorized as having high or low safe-play knowledge and aggression using a median split. A 2 × 2 mixed-model analysis of variance was used to compare head-impact frequency, and random-intercept general linear models were used to compare head-impact severity between groups (high, low) and event types (practice, game). RESULTS: Boys (5.8 of 7 total; 95% confidence interval [CI] = 5.3, 6.3) had a trend toward better safe-play knowledge compared with girls (4.9 of 7 total; 95% CI = 3.9, 5.9; F1,36 = 3.40, P = .073). Less aggressive male players sustained significantly lower head rotational accelerations during practices (1512.8 rad/s (2) , 95% CI = 1397.3, 1637.6 rad/s(2)) versus games (1754.8 rad/s (2) , 95% CI = 1623.9, 1896.2 rad/s(2)) and versus high-aggression players during practices (1773.5 rad/s (2) , 95% CI = 1607.9, 1956.3 rad/s (2) ; F1,26 = 6.04, P = .021). CONCLUSIONS: Coaches and sports medicine professionals should ensure that athletes of all levels, ages, and sexes have full knowledge of safe play and should consider aggression interventions for reducing head-impact severity among aggressive players during practice.

NCAA concussion education in ice hockey: an ineffective mandate.

BACKGROUND/AIM: Despite concussion education being increasingly mandated by states and sports leagues, there has been limited evaluation of what education is in fact effective. The National Collegiate Athletic Association (NCAA) currently mandates that institutions provide concussion education, without specifying content or delivery. The present study evaluated the effectiveness of this general mandate, as enacted for male collegiate ice hockey teams within one conference of competition. METHODS: In a prospective cohort design, 146 players from 6 male collegiate ice hockey teams in one Division 1 conference completed written surveys before and after receiving their institution-determined concussion education. Knowledge, attitudes, perceived norms and behavioural intention were assessed using validated measures. Education content and delivery was assessed by open-ended responses and consultation with team athletic trainers. RESULTS: All teams received concussion education material; however, content and delivery varied. Rates of material recall differed by delivery format. Considering all teams together, there were no significant improvements in knowledge and only a very small decrease in intention to continue playing while experiencing symptoms of a concussion. Pre-education and post-education, there were significant between-team differences in attitudes towards concussion reporting and behavioural intention. CONCLUSIONS: The NCAA's general education mandate was divergently enacted; it did not significantly change the constructs of interest nor did it mitigate the pre-education team differences in these constructs. Existing educational materials should be evaluated, theory and evidence-driven materials developed, and mandates extended to, at a minimum, recommend materials found to be effective in changing concussion-reporting behaviour.

Effectiveness of an educational video on concussion knowledge in minor league hockey players: a cluster randomised controlled trial.

BACKGROUND: With the heightened awareness of concussions in all sports, the development and implementation of effective prevention strategies are necessary. Education has been advocated as an effective injury prevention intervention. PURPOSE: To examine the effectiveness of the 'Smart Hockey: More Safety, More Fun' video on knowledge transfer among minor league hockey players. STUDY DESIGN: Cluster-randomised controlled trial. METHODS: A total of 267 participants from two age divisions and competitive levels were assigned to either a video or no-video group. The video was shown (or not shown) to the entire team as a result of random assignment. To evaluate the effectiveness of the educational video, questionnaires specific to concussion knowledge and players' attitudes and behaviours were completed. RESULTS: There was a significant increase in the players' concussion knowledge scores immediately following exposure to the video (F(1,103)=27.00, p<0.001). However, concussion knowledge at 2 months was not significantly different between the video and no-video groups, after controlling for prior knowledge level, age and competitive level (F(1,115)=0.41, p=0.523). Similarly, players' attitudes and behaviour scores at 2 months did not differ between groups (F(1,115)=0.41, p=0.507). CONCLUSIONS: We were able to show that a single viewing of an educational video in hockey could immediately improve knowledge about concussion but that this effect was transient and lost at 2-month follow-up. Future prevention endeavours in hockey and other sports should attempt to incorporate strategies and modalities to enhance knowledge retention.

Effectiveness of interventions to reduce aggression and injuries among ice hockey players: a systematic review.

BACKGROUND: The increasing incidence of injuries related to playing ice hockey is an important public health issue. We conducted a systematic review to evaluate the effectiveness of interventions designed to reduce injuries related to aggressive acts in ice hockey. METHODS: We identified relevant articles by searching electronic databases from their inception through July 2012, by using Internet search engines, and by manually searching sports medicine journals, the book series Safety in Ice Hockey and reference lists of included articles. We included studies that evaluated interventions to reduce aggression-related injuries and reported ratings of aggressive behaviour or rates of penalties or injuries. RESULTS: We identified 18 eligible studies. Most involved players in minor hockey leagues. Of 13 studies that evaluated changes in mandatory rules intended to lessen aggression (most commonly the restriction of body-checking), 11 observed a reduction in penalty or injury rates associated with rule changes, and 9 of these showed a statistically significant decrease. The mean number of penalties decreased by 1.2-5.9 per game, and injury rates decreased 3- to 12-fold. All 3 studies of educational interventions showed a reduction in penalty rates, but they were not powered or designed to show a change in injury rates. In 2 studies of cognitive behavioural interventions, reductions in aggressive behaviours were observed. INTERPRETATION: Changes to mandatory rules were associated with reductions in penalties for aggressive acts and in injuries related to aggression among ice hockey players. Effects of educational and cognitive behavioural interventions on injury rates are less clear. Well-designed studies of multifaceted strategies that combine such approaches are required.

Trajectories of affective states in adolescent hockey players: turning point and motivational antecedents.

This study examined longitudinal trajectories of positive and negative affective states with a sample of 265 adolescent elite hockey players followed across 3 measurement points during the 1st 11 weeks of a season. Latent class growth modeling, incorporating a time-varying covariate and a series of predictors assessed at the onset of the season, was used to chart out distinct longitudinal trajectories of affective states. Results provided evidence for 3 trajectories of positive affect and 3 trajectories of negative affect. Two of these trajectories were deflected by team selection, a seasonal turning point occurring after the 1st measurement point. Furthermore, the trajectories of positive and negative affective states were predicted by theoretically driven predictors assessed at the start of the season (i.e., self-determination, need satisfaction, athletic identity, and school identity). These results contribute to a better understanding of the motivational, social, and identity-related processes associated with the distinct affective trajectories of athletes participating in elite sport during adolescence.

The influence of gender-related beliefs and conceptions of ability on women learning the hockey wrist shot.

The purpose of this study was to determine the influence of beliefs about gender appropriateness and conceptions of ability on perceived and actual competene and patterns of behavior during practice of the hockey wrist shot. Sixty-eight undergraduate women formed four treatment conditions based on their beliefs about gender appropriateness and conceptions of ability. Four teachers taught across the treatment conditions for a total of 16 learning groups. Data were collected through a three-part questionnaire and from audio-video taping of the entire episode to ascertain the paticipants' competency beliefs, effort, and performance. Gender appropriateness impacted the participants' perceptions of competence and actual performance in the study, while beliefs about conceptions of ability did not produce a significant difference. This study reaffirms that educators must work diligently to combat the stereotypical beliefs many hold with respect to the gender appropriateness of physical activities.

Development of a hockey-specific, skate-treadmill VO2 max protocol.

The purpose of this study was to investigate a protocol for the determination of VO2 max utilizing a motor-driven skate treadmill (ST). On separate days, 6 male hockey players completed a ST and a cycle ergometer (BK) VO2 max protocol. The results showed no significant difference between the ST and BK protocols for relative (60.4 +/- 5.09 vs. 59.0 +/- 8.31 ml.kg-1.min-1) and absolute VO2 max values (4.51 +/- 0.50 vs. 4.39 +/- 0.59 L.min-1), respectively. Significantly higher HR max was recorded during the ST protocol (202.3 +/- 4.27 vs. 200.7 +/- 4.55 b.min-1) (p < 0.05). Peak VE and VT were nonsignificant between the two conditions. However, peak f was higher for the ST protocol (63.0 +/- 7.56 vs. 60.2 +/- 7.76 breath.min-1) (p < 0.05). Although the physiological response to both protocols was similar, the ST protocol replicates a hockey stride, which may provide more applicable information for the development of training programs.

Bone mineral density and body composition of the United States Olympic women's field hockey team.

OBJECTIVE: To evaluate total bone mineral density (BMD) and body composition (% fat) in world class women field hockey players, members of the 1996 United States Olympic team. METHODS: Whole body BMD (g/cm2) and relative body fatness (% fat) were assessed by dual energy x ray absorptiometry using a Lunar DPX-L unit with software version 1.3z. Body composition was also estimated by hydrostatic weighing and the sum of seven skinfolds. RESULTS: Mean (SD) BMD was 1.253 (0.048) g/cm2 which is 113.2 (4.0)% of age and weight adjusted norms. Estimates of body composition from the three methods were similar (statistically non-significant): 16.1 (4.4)% fat from dual energy x ray absorptiometry, 17.6 (3.2)% from hydrostatic weighing, and 16.9 (2.6)% from the sum of seven skinfolds. Mean fat free mass was approximately 50 kg. CONCLUSIONS: The mean whole body BMD value for members of the 1996 United States Olympic women's field hockey team is one of the highest reported for any women's sports team. Moreover, the mean fat free mass per unit height was quite high and % fat was low. In this group of world class sportswomen, low % fat was not associated with low BMD.

Predictors of injury in ice hockey players. A multivariate, multidisciplinary approach.

Eighty-six male high school ice hockey players participated in this prospective study to determine both the incidence of injury in high school ice hockey and the influence of physical, situational, and psychosocial factors. Physical factors included height, weight, vision, previous injuries, musculoskeletal abnormalities, and injuries present at the time of screening evaluations. Situational factors examined were level of participation, playing time, player position, and games versus practices. Psychosocial factors such as confidence, stress, social support, positive states of mind, and mood states were also examined to determine their influences on injury. Twenty-seven injuries occurred during the 1994 to 1995 season. As hypothesized, the overall incidence of injury in high school hockey games (34.4 per 1000 player-game hours) was less than the incidence of injury in Junior A hockey (96.1 per 1000 player-game hours) and was more than previously reported for Bantam youth hockey (10.9 per 1000 player-game hours). Injuries occurred more often in games than in practices, usually as a result of collisions. Physical factors such as player position and previous injuries did not significantly predict injuries, but players in the high playing time group were more likely to be injured. Psychosocial factors of low vigor and high fatigue as measured by the Incredibly Short Profile of Mood States (ISPOMS) significantly predicted high school ice hockey injuries.

Applied physiology of ice hockey.

Today's elite hockey players are physically bigger and have improved levels of physiological fitness when compared with their predecessors. Correspondingly, previous ice hockey studies that have become widely referenced may have little relevance to current players and the way the game is presently played. A great need exists to apply exercise science to the game of ice hockey. Although much has been written about the physiology of ice hockey, there is little information based on well controlled studies. Particularly, there is a paucity of knowledge concerning optimal training schedules, training specificity, recovery profiles and seasonal detraining. Moreover, the reports that do exist have attempted to make comparisons across all levels of skill and talent. Thus, fundamental questions remain as to actual physiological exercise response and specialised training programmes for ice hockey players, particularly at the elite level. There is a demand for new properly designed experiments to find answers pertaining to the appropriate training methods for today's ice hockey players. Future research directions should consider the relationships between performance and such variables as neuromuscular skills, strength, power, peripheral adaptations, travel, hydration, detraining and sport-specific training programmes. Incidence and severity of injury among ice hockey players in relation to fatigue and fitness must also be investigated. Much of the information currently used in ice hockey will remain speculative and anecdotal until these studies are conducted.

[Socialization on the role of the coach in minor league hockey]. / La socialisation vers le rôle d'entraîneur en hockey mineur.

The purpose of this study was to examine the effectiveness of the socialization model developed by Kenyon and McPherson (1973) to determine the degree of socialization of minor league hockey coaches. A questionnaire was administered to 333 current coaches and 175 former coaches from the Quebec City area. Results showed that the coaches' perception of their competence, the degree of watching professional hockey as a spectator, the material factors, and the influence of the peer group were positively associated with their degree of socialization; however, the influence of their own children on the decision to be a coach was negatively associated with their degree of socialization. Results also show that less than 30% of the variance was explained by the model. Different research strategies are suggested in order to better investigate the phenomenon.