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Evaluation of a Medically Supervised Concussion Protocol for Youth Hockey in Canada

  • Michael J. Ellis (a1) (a2) (a3) (a4) (a5) (a6), Jeff Leiter (a1) (a4) (a6) (a7), Dean M. Cordingley (a4) (a6) (a7), Karen Reimer (a4) (a6) (a8), James Koenig (a4) (a6) (a9) and Kelly F. Russell (a2) (a5) (a6)...

Abstract

Objectives: The objective of this study was to evaluate the feasibility and implementation of a standardized medically supervised concussion protocol established between a city-wide AAA hockey league and a multi-disciplinary concussion program. Methods: We conducted a retrospective review of injury surveillance, clinical and healthcare utilization data from all athletes evaluated and managed through the Winnipeg AAA Hockey concussion protocol during the 2016-2017 season. We also conducted post-season email surveys of head coaches and parents responsible for athletes who competed in the same season. Results: During the 2016-2017 season, 28 athletes were evaluated through the medically supervised concussion protocol, with two athletes undergoing evaluation for repeat injuries (a total of 30 suspected injuries and consultations). In all, 96.7% of the athletes managed through the concussion protocol were captured by the league-designated Concussion Protocol Coordinator and 100% of eligible athletes underwent complete medical follow-up and clearance to return to full hockey activities. Although 90% of responding head coaches and 91% of parents were aware of the concussion protocol, survey results suggest that some athletes who sustained suspected concussions were not managed through the protocol. Head coaches and parents also indicated that athlete education and communication between medical and sport stakeholders were other elements of the concussion protocol that could be improved. Conclusion: Successful implementation of a medically supervised concussion protocol for youth hockey requires clear communication between sport stakeholders and timely access to multi-disciplinary experts in traumatic brain and spine injuries. Standardized concussion protocols for youth sports may benefit from periodic evaluations by sport stakeholders and incorporation of national guideline best practices and resources.

Évaluation d’un protocole de gestion des commotions cérébrales destiné à des jeunes hockeyeurs canadiens et encadré médicalement. Objectifs: Évaluer la faisabilité et la mise en œuvre d’un protocole standardisé de gestion des commotions cérébrales établi entre une ligue de hockey de calibre AAA à l’échelle d’une ville et un programme multidisciplinaire de gestion des commotions cérébrales. Méthodes: Nous avons mené une analyse rétrospective des données liées à tous les athlètes évalués et pris en charge dans le cadre du protocole de gestion des commotions cérébrales adopté par la ville de Winnipeg pour son calibre AAA, et ce, durant la saison 2016-2017. Mentionnons que ces données se rapportaient spécifiquement au suivi des blessures signalées ainsi qu’aux soins cliniques prodigués. À la fin de la saison, nous avons aussi effectué un sondage par courriel ciblant les entraîneurs et les parents responsables des jeunes athlètes ayant compétitionné. Résultats: Durant la saison 2016–2017, 28 athlètes ont été évalués dans le cadre du protocole de gestion des commotions cérébrales. Deux athlètes ont également été soumis à une évaluation en raison de blessures à répétition, ce qui a donné un total de 30 individus, chez qui l’on soupçonnait des lésions, ayant consulté. Dans l’ensemble, 96,7 % des athlètes visés par ce protocole ont été dépistés par le coordonnateur de la ligue ayant été nommé pour en assurer le suivi. De plus, 100 % des athlètes admissibles ont bénéficié d’un suivi médical complet et ont recommencé à jouer au hockey, sans contre-indications, moyennant une autorisation. Bien que 90 % des entraîneurs-chefs et 91 % des parents ayant répondu au sondage étaient au courant de l’existence de ce protocole, nos résultats suggèrent néanmoins que certains athlètes chez qui l’on suspectait une commotion cérébrale n’ont pas été pris en charge dans le cadre du protocole. Ces mêmes entraîneurs-chefs et ces mêmes parents ont aussi indiqué que la sensibilisation des athlètes, de même que la communication établie avec les intervenants médicaux et sportifs, sont d’autres aspects du protocole qui pourraient être améliorés. Conclusions: La mise en œuvre réussie de protocoles de gestion des commotions cérébrales destinés à de jeunes hockeyeurs et encadrés médicalement exige une bonne communication entre les parties prenantes du monde du sport ainsi qu’un accès en temps opportun à des équipes multidisciplinaires spécialisées dans les lésions traumatiques cérébrales et dans celles affectant la colonne vertébrale. On pourrait même ajouter que les protocoles standardisés de ce type visant l’ensemble des sports pratiqués par les jeunes pourraient bénéficier d’évaluations périodiques conduites par les intervenants sportifs et de l’adoption de lignes directrices nationales fondées sur les meilleures pratiques en vigueur.

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Copyright

Corresponding author

Correspondence to: Dr. Michael J. Ellis, Pan Am Clinic, Pan Am Concussion Program, 75 Poseidon Bay, Winnipeg, MB, Canada R3M 3E4. Email: mellis3@panamclinic.com

References

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