scholarly journals Acromioclavicular Joint Injuries in Professional Ice Hockey Players: Epidemiologic and MRI Findings and Association With Return to Play

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096447
Author(s):  
Lawrence M. White ◽  
Jonathan Ehmann ◽  
Robert R. Bleakney ◽  
Anthony M. Griffin ◽  
John Theodoropoulos
Keyword(s):  
Acromioclavicular Joint ◽  
Ice Hockey ◽  
Return To Play ◽  
Low Grade ◽  
Mri Findings ◽  
Grade 5 ◽  
Significant Difference ◽  
Hockey Players ◽  
Mri Scans ◽  
Grade 3

Background: Acromioclavicular joint (ACJ) injuries are common in ice hockey players and are traditionally evaluated with conventional radiography, which has recognized limitations in the accurate characterization of the spectrum of soft tissue injuries and severity/grade of injury sustained. Purpose: To evaluate the epidemiologic, clinical, and magnetic resonance imaging (MRI) findings in professional ice hockey players who have sustained acute ACJ injuries. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review was performed of professional National Hockey League (NHL) players referred for MRI evaluation of acute ACJ injuries. All MRI scans were assessed for status of the ACJ, ligamentous stabilizers, and surrounding musculature. MRI-based overall grade of ACJ injury (modified Rockwood grade 1-6) was assigned to each case. Data regarding mechanism of injury, player handedness, clinical features, and return to play were evaluated. Results: Overall, 24 MRI examinations of acute ACJ injuries (23 patients; mean age, 24 years) were reviewed. We found that 50% of injuries were sustained during the first period of play, and in 75% of cases, injuries involved the same side as player shooting handedness. Analysis of MRI scans revealed 29% (7/24) grade 1 ACJ injuries, 46% (11/24) grade 2 injuries, 21% (5/24) grade 3 injuries, and 4% (1/24) grade 5 injuries. Trapezius muscle strains were seen in 79% and deltoid muscle strain in 50% of cases. Nonoperative management was used for 23 injuries; 1 patient (grade 5 injury) underwent acute reconstructive surgery. All players successfully returned to professional NHL competition. Excluding cases with additional injuries or surgery (n = 3) or convalescence extending into the offseason (n = 3), we found that the mean return to play was 21.4 days (7.2 games missed). No statistically significant difference was observed in return to play between nonoperatively treated grade 3 injuries (mean, 28.3 days) and grade 1 or 2 injuries (mean, 20.1 days). However, grade 3 injuries were associated with a greater number of NHL scheduled games missed (mean, 12.7) compared with lower grade injuries (mean, 6.1) ( P = .027). Conclusion: The spectrum of pathology and grading of acute ACJ injuries sustained in professional ice hockey can be accurately assessed with MRI; the majority of injuries observed in this study were low grade (grades 1 and 2). Although grade 3 injuries were associated with a greater number of games missed, similar return-to-play results were observed between nonoperatively treated grade 3 and grade 1 or 2 ACJ injuries.

scholarly journals A Current Concepts Review of Clavicle Injuries in Ice Hockey From Sternoclavicular to Acromioclavicular Joint

2020 ◽  
Vol 8 (9) ◽  
pp. 232596712095141
Author(s):  
Eugene S. Jang ◽  
Caroline N. Park ◽  
William N. Levine ◽  
Charles A. Popkin
Keyword(s):  
Upper Extremity ◽  
Acromioclavicular Joint ◽  
Significant Proportion ◽  
Sternoclavicular Joint ◽  
Ice Hockey ◽  
Return To Play ◽  
Joint Injuries ◽  
Joint Dislocations ◽  
Hockey Players ◽  
Clavicle Fractures

Clavicle injuries are common in ice hockey, and a number of high-profile fractures and dislocations have occurred in elite hockey players in recent years. Acromioclavicular joint injuries, clavicle fractures, and sternoclavicular joint injuries are some of the most frequent hockey-related injuries treated by orthopaedic surgeons, and familiarity with the management of these injuries and sport-specific considerations for treatment and recovery are critical. Injuries involving the clavicle can sometimes be life-threatening, and subtle findings on physical examination and radiographic studies can have profound implications for treatment. The recent literature pertinent to the diagnosis and treatment of clavicle-related injuries in ice hockey players was reviewed and compiled into a clinical commentary. For ice hockey players, the upper extremity was traditionally considered a relatively well-protected area. However, given the evolution of the game and its protective equipment, the upper extremity now accounts for the majority of youth ice hockey injuries, of which clavicle injuries comprise a significant proportion. Acromioclavicular joint injuries are the most common injury in this population, followed closely by clavicle fractures. Sternoclavicular joint injuries are rare but can be associated with serious complications. The treatment of these injuries often differs between athletes and the general population, and surgical indications continue to evolve in both groups. Although the evidence regarding clavicle injuries is ever-increasing and the treatment of these injuries remains controversial, clavicle injuries are increasingly common in ice hockey players. Rule and equipment changes, most notably the increased use of flexible boards and glass, have been shown to significantly decrease the risk of clavicle injuries. We also recommend compulsory use of shoulder pads, even at a recreational level, as well as continued enforcement and evolution of rules aimed at reducing the rate of clavicle injuries. Future research should focus on equipment design changes directed toward clavicle injury prevention, standardized return-to-play protocols, and studies weighing the risks and benefits of nonoperative management of controversial injuries, such as type III acromioclavicular joint dislocations and diaphyseal clavicle fractures.

An Investigation into the Relationship between Ice Hockey Participation and Delinquency

1985 ◽  
Vol 2 (4) ◽  
pp. 281-298 ◽  
Author(s):  
Jeffrey Segrave ◽  
Claude Moreau ◽  
Douglas N. Hastad
Keyword(s):  
Physical Violence ◽  
Ice Hockey ◽  
Self Report ◽  
Differential Association ◽  
Minor League ◽  
Significant Difference ◽  
Hockey Players ◽  
The Relationship

The purpose of this study was to investigate the relationship between participation in minor league Canadian ice hockey and delinquency. Specifically, the study sought to compare the extent of delinquency among ice hockey players and nonathletes, and to examine the relationship between ice hockey participation and delinquency on the basis of a group of sociopsychological variables. The sample of ice hockey players was taken from the Montreal midget minor ice hockey league (15 to 16 years of age) and was further subdivided into local, inter-city, and provincial players. Delinquency was classified by type of offense, namely drugs, theft, physical violence, and vandalism. Data were obtained from anonymous, self-report questionnaires. The results indicated no significant difference in total delinquency between ice hockey players and nonathletes. However, when delinquency was categorized by type, ice hockey players reported more delinquency of a physically violent nature than nonathletes. The results also showed a differential association between a variety of sociopsychological variables and delinquency among ice hockey players and nonathletes

Return to play after an initial or recurrent concussion in a prospective study of physician-observed junior ice hockey concussions: implications for return to play after a concussion

2010 ◽  
Vol 29 (5) ◽  
pp. E5 ◽  
Author(s):  
Paul Sean Echlin ◽  
Charles H. Tator ◽  
Michael D. Cusimano ◽  
Robert C. Cantu ◽  
Jack E. Taunton ◽  
...  
Keyword(s):  
Clinical Evaluation ◽  
Consensus Statement ◽  
Assessment Tool ◽  
Ice Hockey ◽  
Return To Play ◽  
Cognitive Test ◽  
Time Interval ◽  
Test Results ◽  
Hockey Players ◽  
The Mean

Object The authors investigated return-to-play duration for initial and recurrent concussion in the same season in 2 teams of junior (16–21-year-old) ice hockey players during a regular season. Methods The authors conducted a prospective cohort study during 1 junior regular season (2009–2010) of 67 male fourth-tier ice hockey players (mean age 18.2 ± 1.2 years [SD], range 16–21 years) from 2 teams. Prior to the start of the season, every player underwent baseline assessments that were determined using the Sideline Concussion Assessment Tool 2 (SCAT2) and the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). The study protocol also required players who entered the study during the season to complete a baseline SCAT2 and ImPACT. If the protocol was not followed, the postinjury test results of a player without true baseline test results were compared with previously established age- and sex-matched group normative levels. Each game was directly observed by a physician and at least 1 neutral nonphysician observer. Players suspected of suffering a concussion were evaluated by the physician during the game. If a concussion was diagnosed, the player underwent clinical evaluation at the physician's office within 24 hours. The return-to-play decision was based on clinical evaluation guided by the Zurich return-to-play protocol (contained in the consensus statement of international expert opinion at the 3rd International Conference on Concussion in Sport held in Zurich, November 2008). This clinical evaluation and return-to-play protocol was augmented by the 2 tests (SCAT2 and ImPACT) also recommended by the Zurich consensus statement, for which baseline values had been obtained. Results Seventeen players sustained a physician-observed or self-reported, physician-diagnosed concussion during a physician-observed ice hockey game. The mean clinical return-to-play duration (in 15 cases) was 12.8 ± 7.02 days (median 10 days, range 7–29 days); the mean number of physician office visits by players who suffered a concussion (15 cases) was 2.1 ± 1.29 (median 1.5 visits). Five of the 17 players who sustained a concussion also suffered a recurrent or second concussion. One of the 5 individuals who suffered a repeat concussion sustained his initial concussion in a regular season game that was not observed by a physician, and as a result this single case was not included in the total of 21 concussions. This initial concussion of the player was identified during baseline testing 2 days after the injury and was subsequently medically diagnosed and treated. The mean interval between the first and second concussions in these 5 players was 78.6 ± 39.8 days (median 82 days), and the mean time between the return-to-play date of the first and second concussions was 61.8 ± 39.7 days (median 60 days). Conclusions The mean rates of return to play for single and recurrent concussions were higher than rates cited in recent studies involving sport concussions. The time interval between the first and second concussions was also greater than previously cited. This difference may be the result of the methodology of direct independent physician observation, diagnosis, and adherence to the Zurich return-to-play protocol.

scholarly journals Hockey Concussion Education Project, Part 1. Susceptibility-weighted imaging study in male and female ice hockey players over a single season

2014 ◽  
Vol 120 (4) ◽  
pp. 864-872 ◽  
Author(s):  
Karl G. Helmer ◽  
Ofer Pasternak ◽  
Eli Fredman ◽  
Ronny I. Preciado ◽  
Inga K. Koerte ◽  
...  
Keyword(s):  
Ice Hockey ◽  
Susceptibility Weighted Imaging ◽  
Male And Female ◽  
Time Points ◽  
Significant Difference ◽  
Hockey Players ◽  
Changes Over Time ◽  
Male Subjects ◽  
Over Time ◽  
Female Subjects

Object Concussion, or mild traumatic brain injury (mTBI), is a commonly occurring sports-related injury, especially in contact sports such as hockey. Cerebral microbleeds (CMBs), which appear as small, hypointense lesions on T2*-weighted images, can result from TBI. The authors use susceptibility-weighted imaging (SWI) to automatically detect small hypointensities that may be subtle signs of chronic and acute damage due to both subconcussive and concussive injury. The goal was to investigate how the burden of these hypointensities changes over time, over a playing season, and postconcussion, in comparison with subjects who did not suffer a medically observed and diagnosed concussion. Methods Images were obtained in 45 university-level adult male and female ice hockey players before and after a single Canadian Interuniversity Sports season. In addition, 11 subjects (5 men and 6 women) underwent imaging at 72 hours, 2 weeks, and 2 months after concussion. To identify subtle changes in brain tissue and potential CMBs, nonvessel clusters of hypointensities on SWI were automatically identified, and a hypointensity burden index was calculated for all subjects at the beginning of the season (BOS), the end of the season (EOS), and at postconcussion time points (where applicable). Results A statistically significant increase in the hypointensity burden, relative to the BOS, was observed for male subjects with concussions at the 2-week postconcussion time point. A smaller, nonsignificant rise in the burden for female subjects with concussions was also observed within the same time period. There were no significant changes in burden for nonconcussed subjects of either sex between the BOS and EOS time points. However, there was a statistically significant difference in the burden between male and female subjects in the nonconcussed group at both the BOS and EOS time points, with males having a higher burden. Conclusions This method extends the utility of SWI from the enhancement and detection of larger (> 5 mm) CMBs, which are often observed in more severe cases of TBI, to cases involving smaller lesions in which visual detection of injury is difficult. The hypointensity burden metric proposed here shows statistically significant changes over time in the male subjects. A smaller, nonsignificant increase in the burden metric was observed in the female subjects.

The value of computerised neurocognitive testing at medical clearance to return to play following a sport-related concussion in youth ice hockey players

2017 ◽  
Vol 51 (11) ◽  
pp. A58.3-A59
Author(s):  
Amanda M Black ◽  
Brian L Brooks ◽  
Regan S McLeod ◽  
Luz Palacios-Derflingher ◽  
Kathryn J Schneider ◽  
...  
Keyword(s):  
Ice Hockey ◽  
Return To Play ◽  
Neurocognitive Testing ◽  
Medical Clearance ◽  
Hockey Players

scholarly journals The Impact of Blastocyst Grade on Singleton Birthweight in Fresh Transplanted Cycles

2021 ◽  
Author(s):  
Qiongyao Shi ◽  
Senlin Shi ◽  
Wenyan Song ◽  
Feifei Zhao ◽  
Haixia Jin ◽  
...  
Keyword(s):  
Birth Weight ◽  
Live Birth ◽  
Cell Mass ◽  
The Other ◽  
Low Grade ◽  
High Grade ◽  
Significant Difference ◽  
Group A ◽  
Grade 3 ◽  
The Impact

Abstract Background: A retrospectively cohort study was performed to compare the birth weight of different blastocyst grades in fresh transplantation cycle and explore the related factors affecting the birth weight. Methods: The 1301 fresh cycles of single blastocyst transplantation and single live birth profile were analyzed,four groups were divided according to the grade of transplanted blastocyst. There are 170 cycles in group A with AA blastocyst grade, 312 cycles in group B with AB/BA blastocyst grade, 559 cycles in group C with BB/CA/AC blastocyst grade and 260 cycles in group D with BC/CB blastocyst grade. Comparison were made among four groups of birth weight, general conditions, fertilization rate, embryo rate, cleavage rate and D5,D6 blastocyst formation rate and other laboratory indicators. And then comparison were performed among the birth weight of different groups which were divided by the degree of blastocyst expansion, and the classification of inner cell mass(ICM) and the trophectoderm(TE). Results: The study shows that the birth weight of group A is significantly higher than that of the other three groups (P < 0.05). And the high quality embryo rate and blastocyst rate of group A are significantly higher than those of the other three groups (P < 0.05). What’s more, the clinical pregnancy rate, implantation rate and live birth rate of high grade blastocyst are higher, but there are no significant difference in abortion rate. The birth weight of the degree of blastocyst expansion in grade 3 and below is significantly lower than that of those with grade 3 and above (P < 0.05). The birth weight of grade A of ICM is significantly higher than that of grade B (P < 0.05). The birth weight of grade B of TE is significantly heavier than that of grade C (P < 0.05). Conclusions: Our results indicate that high grade blastocyst transplantation can achieve better pregnancy outcome. Different blastocyst grades affect birth weight, and low grade blastocyst transplantation is associated with a single birth weight loss.

Divided Visual Attention Performance of Ice Hockey Players with History of Concussion

2018 ◽  
pp. 121-127
Keyword(s):  
Visual Attention ◽  
Peripheral Vision ◽  
Ice Hockey ◽  
Orientation Discrimination ◽  
White Background ◽  
Response Accuracy ◽  
Attention Task ◽  
Significant Difference ◽  
Hockey Players ◽  
History Of

Background: A significant part of successful athletic performance is the use of peripheral vision. A divide visual attention task with a central and peripheral target was used to assess athletes with and without a history of concussion. The research suggests that both groups had the same response accuracy in the task performance. The purpose of this research was to determine if peripheral visual attention is impacted in ice hockey players who have had a history of one or more self reported concussion. Methods: Orientation discrimination accuracy of a pair of Landolt type block “C” targets was measured using a divided covert attention task on 22 collegiate level men’s ice hockey players. Stimuli were presented simultaneously at central fixation and at one of 40 peripheral locations against a bright white background for two stimulus durations (150ms and 15ms). Block “C” targets were presented at one of 4 orientations (up, down, left and right) and randomized for central and peripheral locations. Results: Overall there was a statistically significant difference in the performance at 150ms and 15ms stimuli durations; athletes had a larger area of correct responses with the 150ms stimulus duration. Athletes performed better in the horizontal meridian compared to the vertical meridian for both stimulus durations. Conclusion: The divided visual attention test results for a cohort of university level men’s ice hockey players shows a decline in area of correct responses with shorter stimulus durations. There was no difference in response accuracy between those with a history of a concussion compared to those without a previous concussion.

Lexicale rijkdom, frequentielagen en tekstmoeilijkheid

2016 ◽  
Vol 5 (1) ◽  
pp. 18-33
Author(s):  
Anne Vermeer
Keyword(s):  
Text Comprehension ◽  
Low Frequency ◽  
Receptive Vocabulary ◽  
Effect Sizes ◽  
Vocabulary Skills ◽  
Grade 5 ◽  
Significant Difference ◽  
Show Evidence ◽  
Recent Developments ◽  
Grade 3

In line with recent developments in both language acquisition and text comprehension studies, it is argued that more reliable and valid lexical richness measures can be obtained by including frequency class information. To that end, texts written by 452 elementary school children (L1/L2) in grades 3–6 were investigated. In order to find out whether a frequency class based lexical measure is more valid than type/token based measures, the central question to be answered was whether with increasing vocabulary skills from grades 3 to 6 (measured by standardized vocabulary tests), the number of low frequency words in children’s writings increased, and whether L2-children with lower vocabulary skills used relatively more high frequency words than their L1-peers. The results show a gradually growing number of low frequency words: children in grade 3 use more words belonging to the 1,000–5,000 word frequency range; in grades 4/5 more from the 5,000–12,500 range; and in grade 6 more from the 12,500-plus range. L2-children in all grades use relatively more words from the first frequency class (the first 1,000 lemmas) than their L1-peers. The effect sizes, however, with eta2 ranging from .09 to .02 between grades, and from eta2 = .01 to nonsignificant between L1/L2, were lower than those of the standardized productive and receptive vocabulary tests (eta2 = .26-.35 resp. between grades, eta2 = .34-.23 resp. between L1/L2), and also lower than the effect sizes for the number of different types in the texts (eta2 = .23 between grades, and .01 between NT1/NT2). The TTR shows only a significant difference in the wrong direction (grade 6 outperforming grade 5). The frequency class based lexical measure MLR discriminates significantly both between the grades and between L1/L2, but the effect sizes are low (eta2 = .05 between grades, and eta2 = .02 between L1/L2). These outcomes show evidence that a frequency class based lexical measure as the MLR is more valid than a type/token based measure such as the TTR.

scholarly journals Canadian Minor Hockey Participants’ Knowledge about Concussion

2009 ◽  
Vol 36 (03) ◽  
pp. 315-320 ◽  
Author(s):  
Michael D. Cusimano ◽  
Mary L. Chipman ◽  
Richard Volpe ◽  
Peter Donnelly
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Physical Therapy ◽  
Ice Hockey ◽  
Return To Play ◽  
Educational Strategies ◽  
Greater Toronto Area ◽  
Minor League ◽  
Hockey Players ◽  
The Usa

Abstract:Background and Objectives:In Canada and the USA, ice hockey is a cause of traumatic brain injury. Post-concussive symptoms are the most important feature of the diagnosis of concussion in sports and it is recommended that athletes not return to play while still symptomatic. Lack of knowledge of concussions could therefore be one of the main detriments to concussion prevention in hockey. The purpose of this research is to describe what minor league hockey players, coaches, parents and trainers know about concussion and its management.Methods:A questionnaire to assess concussion knowledge and return to play guidelines was developed and administered to players at different competitive levels (n = 267), coaches, trainers and parents (total adults n = 142) from the Greater Toronto Area.Results:Although a majority of adults and players could identify mechanisms responsible for concussion, about one-quarter of adults and about a quarter to a half of children could not recall any symptoms or recalled only one symptom of a concussion. A significant number of players and some adults did not know what a concussion was or how it occurred. Almost half of the players and a fifth of the adults incorrectly stated that concussion was treated with medication or physical therapy. Nearly one quarter of all players did not know if an athlete experiencing symptoms of concussion should continue playing.Conclusions:This study demonstrated that a significant number of people held misconceptions about concussion in hockey which could lead to serious health consequences and creates a need for better preventive and educational strategies.

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