Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada.
Br J Sports Med. 2023 May;57(10):571-577. doi: 10.1136/bjsports-2022-105585. Epub 2023 Mar 14.
To compare the incidence rates and odds of concussion between youth ice hockey players based on mouthguard use and helmet age.
Within a 5-year longitudinal cohort (2013/2014 to 2017/2018) of male and female ice hockey players (ages 11-18; n=3330 players) in Alberta (Canada), we analysed the relationship of equipment and concussion in both a prospective cohort and nested case (concussion) control (acute musculoskeletal injury) approach. The prospective cohort included baseline assessments documenting reported mouthguard use (yes/sometimes, no use), helmet age (newer/<2 years old, older/≥2 years old) and important covariables (weight, level of play, position of play, concussion history, body checking policy), with weekly player participation throughout the season. The nested case-control component used injury reports to document equipment (mouthguard use, helmet age) and other information (eg, mechanism and type of injury) for the injury event. Multivariable mixed effects negative binomial regression (prospective cohort, incidence rate ratios (IRRs)) and multivariable mixed effects logistic regression (nested case-control, odds ratios (OR)) examined the association between equipment and concussion.
Players who reported wearing a mouthguard had a 28% lower concussion rate (IRR=0.72, 95% CI 0.56 to 0.93) and 57% lower odds of concussion (OR=0.43, 95% CI 0.27 to 0.70) compared with non-wearers. There were no associations in the concussion rate (IRR=0.94, 95% CI 0.75 to 1.15) and odds (OR=1.16, 95% CI 0.73 to 1.86) between newer and older helmets.
Wearing a mouthguard was associated with a lower concussion rate and odds. Policy mandating use should be considered in youth ice hockey. More research is needed to identify other helmet characteristics (eg, quality, fit) that could lower concussion risk.
比较基于护齿器使用和头盔年龄的青年冰球运动员脑震荡发生率和几率。
在一个为期 5 年的纵向队列（2013/2014 年至 2017/2018 年）中，研究了加拿大艾伯塔省（Alberta）男性和女性冰球运动员（年龄 11-18 岁；n=3330 名运动员）中设备与脑震荡之间的关系，该队列研究采用前瞻性队列和嵌套病例（急性肌肉骨骼损伤）对照（急性肌肉骨骼损伤）方法进行分析。前瞻性队列纳入了基线评估，记录了报告的护齿器使用情况（是/有时，否使用）、头盔年龄（新的/＜2 年，旧的/≥2 年）和重要协变量（体重、比赛级别、比赛位置、脑震荡史、身体检查政策），并在整个赛季每周记录运动员的参与情况。嵌套病例对照部分使用损伤报告记录损伤事件中的设备（护齿器使用、头盔年龄）和其他信息（例如，损伤机制和类型）。多变量混合效应负二项回归（前瞻性队列，发病率比（IRR））和多变量混合效应逻辑回归（嵌套病例对照，比值比（OR））用于检查设备与脑震荡之间的关联。
与不佩戴者相比，报告佩戴护齿器的运动员脑震荡发生率降低 28%（IRR=0.72，95%CI 0.56 至 0.93），脑震荡几率降低 57%（OR=0.43，95%CI 0.27 至 0.70）。新旧头盔之间的脑震荡发生率（IRR=0.94，95%CI 0.75 至 1.15）和几率（OR=1.16，95%CI 0.73 至 1.86）均无关联。
佩戴护齿器与脑震荡发生率和几率降低有关。应考虑在青年冰球运动中制定使用护齿器的政策。需要进一步研究以确定其他可能降低脑震荡风险的头盔特征（例如，质量、适配性）。
