Effect of Routine Sport Participation on Short-Term Clinical Neurological Outcomes: A Comparison of Non-Contact, Contact, and Collision Sport Athletes.

OBJECTIVES: To compare pre-season to post-season changes on a battery of clinical neurological outcome measures between non-contact, contact, and collision sport athletes over multiple seasons of play. METHODS: 244 high school and collegiate athletes participating in multiple non-contact, contact, and collision sports completed standardized annual pre-season and post-season assessments over 1-4 years. Pre/post-season changes in 10 outcome measures assessing concussion symptoms, neurocognitive performance, and balance were compared between the groups using linear mixed models. RESULTS: Small, but statistically significant overall pre/post-season change differences were present between the groups for Axon computerized neurocognitive test processing speed, attention, and working memory speed scores (Axon-PS, Axon-Att, Axon-WMS), as well as Balance Error Scoring System (BESS) total score. Small seasonal declines not exceeding reliable-change thresholds were observed in the collision sport group relative to the contact and non-contact groups for Axon-PS and Axon-Att scores. The collision and contact sport groups demonstrated less pre-/post-season improvement than the non-contact sport group for Axon-WMA and BESS, with less BESS improvement also observed in the collision sport group relative to the contact sport group. Overall, longitudinal performance on all 10 outcome measures remained stable in all 3 groups over 4 years. CONCLUSION: Our findings do not necessarily support the notion that participation in sports associated with exposure to repetitive head impacts has clinically meaningful cumulative effects over the course of a season, nor over four consecutive seasons in high school and collegiate athletes.

Ability of preseason body composition and physical fitness to predict the risk of injury in male collegiate hockey players.

BACKGROUND: Injuries in collegiate ice hockey can result in significant time lost from play. The identification of modifiable risk factors relating to a player's physical fitness allows the development of focused training and injury prevention programs targeted at reducing these risks. PURPOSE: To determine the ability of preseason fitness outcomes to predict in-season on-ice injury in male collegiate ice hockey players. STUDY DESIGN: Prognostic cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Athlete demographics, percentage body fat, aerobic capacity (300-m shuttle run; 1-, 1.5-, 5-mile run), and strength assessment (sit-ups, push-ups, grip strength, bench press, Olympic cleans, squats) data were collected at the beginning of 8 successive seasons for 1 male collegiate ice hockey team. Hockey-related injury data and player-level practice/game athlete exposure (AE) data were also prospectively collected. Seventy-nine players participated (203 player-years). Injury was defined as any event that resulted in the athlete being unable to participate in 1 or more practices or games following the event. Multivariable logistic regression was performed to determine the ability of the independent variables to predict the occurrence of on-ice injury. RESULTS: There were 132 injuries (mean, 16.5 per year) in 55 athletes. The overall injury rate was 4.4 injuries per 1000 AEs. Forwards suffered 68% of the injuries. Seventy percent of injuries occurred during games with equal distribution between the 3 periods. The mean number of days lost due to injury was 7.8 ± 13.8 (range, 1-127 days). The most common mechanism of injury was contact with another player (54%). The odds of injury in a forward was 1.9 times (95% CI, 1.1-3.4) that of a defenseman and 3 times (95% CI, 1.2-7.7) that of a goalie. The odds of injury if the player's body mass index (BMI) was ≥25 kg/m(2) was 2.1 times (95% CI, 1.1-3.8) that of a player with a BMI <25 kg/m(2). The odds ratios for bench press, maximum sit-ups, and Olympic cleans were statistically significant but close to 1.0, and therefore the clinical relevance is unknown. CONCLUSION: Forwards have higher odds of injury relative to other player positions. BMI was predictive of on-ice injury. Aerobic fitness and maximum strength outcomes were not strongly predictive of on-ice injury.

Incidence and injury characteristics of medial collateral ligament injuries in male collegiate ice hockey players.

BACKGROUND: Medial collateral ligament (MCL) injuries are the second most common injury resulting in player lost time in elite-level ice hockey. PURPOSE: To determine the incidence and injury characteristics of knee MCL sprain in male collegiate ice hockey players. STUDY DESIGN: Case control. METHODS: Athlete exposure data demographics, mechanism of injury, player position, time of injury occurrence (game vs practice), grade of MCL sprain, concomitant injuries, and lost time for cases were extracted from a computerized injury database of 8 college hockey seasons at 1 university. MCL injury rates were calculated. Injury characteristics were descriptively summarized. Simple linear regression was utilized to determine the relationship between the grade of MCL injury and player lost time. RESULTS: There were 13 MCL injuries in 10 players. The overall incidence rate was 0.44 injuries per 1000 athlete exposures. Two players suffered reinjuries. Defensemen and forwards were equally represented. Contact with another player or the ice was the mechanism of injury in 77% of players. Grade 2 injuries were most common. The grade of injury predicted time lost from play (P < 0.01). CONCLUSION AND CLINICAL RELEVANCE: The lost time relates directly to the severity of injury.

Heat- and cold-induced injuries in athletes: evaluation and management.

Both extreme heat and cold can be challenging for athletes during training and competition. One role of the team physician is to educate coaches and athletes on the risks of exposure to these conditions and how to best prevent and manage their adverse effects. Heat illness varies in degree from mild to severe, with the most severe forms being potentially fatal. Cold exposure can result in systemic effects and peripheral injury to the extremities.