Citation

Emery CA, Kang J, Shrier I, Goulet C, Hagel BE, Benson B, Nettel-Aguirre A, McAllister J, Meeuwisse W. CMAJ 2011; 183(11): 1249-1256.

Copyright

(Copyright © 2011, Canadian Medical Association)

DOI

10.1503/cmaj.101540

PMID

21690221

PMCID

PMC3153513

Abstract

Background: In a previous prospective study, the risk of concussion and all injury was more than threefold higher among Pee Wee ice hockey players (ages 11-12 years) in a league that allows body-checking than among those in a league that does not. We examined whether two years of body-checking experience in Pee Wee influenced the risk of concussion and other injury among players in a Bantam league (ages 13-14) compared with Bantam players introduced to body-checking for the first time at age 13. Methods: We conducted a prospective cohort study involving hockey players aged 13-14 years in the top 30% of divisions of play in their leagues. Sixty-eight teams from the province of Alberta (n = 995), whose players had two years of body-checking experience in Pee Wee, and 62 teams from the province of Quebec (n = 976), whose players had no body-checking experience in Pee Wee, participated. We estimated incidence rate ratios (IRRs) for injury and for concussion. Results: There were 272 injuries (51 concussions) among the Bantam hockey players who had body-checking experience in Pee Wee and 244 injuries (49 concussions) among those without such experience. The adjusted IRRs for game-related injuries and concussion overall be tween players with body-checking experience in Pee Wee and those without it were as follows: injury overall 0.85 (95% confidence interval [CI] 0.63 to 1.16); concussion overall 0.84 (95% CI 0.48 to 1.48); and injury resulting in more than seven days of time loss (i.e., time between injury and return to play) 0.67 (95% CI 0.46 to 0.99). The unadjusted IRR for concussion resulting in more than 10 days of time loss was 0.60 (95% CI 0.26 to 1.41). Interpretation The risk of injury resulting in more than seven days of time loss from play was reduced by 33% among Bantam hockey players in a league where body-checking was allowed two years earlier in Pee Wee compared with Bantam players introduced to body-checking for the first time at age 13. In light of the increased risk of concussion and other injury among Pee Wee players in a league where body-checking is permitted, policy regarding the age at which hockey players are introduced to body-checking requires further consideration.

Language: en