Incidence of Concussions in Elite Female Water Polo: A Retrospective Analysis.

OBJECTIVE: Current evidence for concussions is mixed in water polo players. Surveys suggest rates as high as 36%, whereas surveillance studies at international competitions often fail to report them at all. The goal of this study was to examine the incidence of concussions in elite female water polo players from surveillance tools implemented longitudinally. DESIGN: Retrospective chart analysis of 10 years spanning between 2012 and 2022. SETTING: National teams or professional sports. PARTICIPANTS: Female players from the Canadian senior national water polo teams that participated in international competitions and trained more than 10 hours per week in a competitive environment. ASSESSMENT OF RISK FACTORS: Included player position, recurrence, and time loss before full return to play. MAIN OUTCOME MEASURES: Prevalence of concussion diagnosis. RESULTS: Forty-three concussions were identified over the 10 years observed at a median count of 3 concussions per year. Cumulative days lost spanned between 25 and 348 days per team*year. Altogether, this produced a median rate of 14.3 injuries per 100 player*years. Goalkeepers in the sample suffered the highest rates of concussion (25.8%), compared with players in other positions (22.8% of centers and 16.7% of drivers). CONCLUSIONS: This study found evidence for prevalence of concussions in elite female water polo players. Improved guidelines preceded a significant reduction in time loss after the year 2017. This adds to a body of knowledge suggesting that improved surveillance methods are needed to detect and care for concussions in this population.

A New In-Skates Balance Error Scoring System for Ice Hockey Players.

OBJECTIVE: Evaluate a new in-skates balance error scoring system (SBESS) for ice hockey players wearing their equipment. DESIGN: Prospective, randomized, single blinded study. SETTING: Sport Medicine Clinic. PARTICIPANTS: Eighty university hockey players. INTERVENTION: A control group performed the SBESS assessment at rest on 2 separate occasions and an experimental group performed the assessment at rest and after exertion. The SBESS consists of maintaining different stances on ice skates for 20 seconds each, while wearing full equipment (no stick, gloves and helmet) and standing on a hard rubber surface. Three independent reviewers scored the video recorded assessments. MAIN OUTCOMES MEASURES: Primary outcome was the number of balance errors and the secondary outcome was the number of falls. RESULTS: The control group's median SBESS scores were 2 and 3 on the first and second attempts at rest, respectively. The experimental group's median SBESS scores were 2 at rest and 2 after exertion. There was no fatigue effect and no athletes fell while performing the test. Of the 4 stances tested, the tandem stance had the highest variability in error scores between athletes and when repeated by the same athlete. The intraclass correlation coefficient (ICC) for interrater reliability was above 0.82, and the intrarater reliability ICC was above 0.86 for all SBESS scores. There was no concordance between the SBESS and the modified BESS. CONCLUSIONS: The SBESS, omitting the tandem stance, is a safe and reproducible sideline balance assessment of ice hockey players wearing full equipment.