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Journal Article

Citation

Gaudiani MA, Castle JP, Wolterink TD, Sprys-Tellner TJ, Haan JW, Sean Lynch T. Orthop. J. Sports Med. 2024; 12(4): e23259671241231757.

Copyright

(Copyright © 2024, American Orthopaedic Society for Sports Medicine, Publisher SAGE Publishing)

DOI

10.1177/23259671241231757

PMID

38665385

PMCID

PMC11044774

Abstract

BACKGROUND: An updated National Hockey League (NHL) concussion protocol (NHLCP) was established in the 2016-2017 season to mitigate the negative outcomes of sport-related concussions. However, few studies on the effects of implementing the NHLCP have been performed.

PURPOSE: To define concussion incidence and investigate differences in NHL player performance after a concussion during periods before and after NHLCP implementation and assess the financial impact on NHL teams associated with NHLCP implementation. STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: This was a retrospective review of NHL players who sustained a concussion before (2000-2001 to 2015-2016 seasons) and after (2016-2017 to 2020-2021 seasons) implementing the NHLCP (pre-NHLCP and post-NHLCP groups). For each group, multiple performance metrics-including 30 days, 1 season, and 3 seasons before and after concussion-were compared for both groups. Return to play, total concussion cost, and association of return to play with cost were investigated using regression analysis.

RESULTS: A total of 452 players (423 skaters, 29 goalies) sustained concussions during the study period, including 331 players (315 skaters, 16 goalies) in the pre-NHLCP group and 121 players (108 skaters, 13 goalies) in the post-NHLCP group. For both groups, no significant differences in standard performance were observed during the 30-day and 1-season periods before and after concussion. The mean return to play was significantly higher in the pre-NHLCP group than in the post-NHLCP group (20.1 vs 15.7 days; P =.022). The mean adjusted player salary was not different between groups; nonetheless, the mean adjusted replacement player salary was significantly higher in the post-NHLCP group ($744,505 vs $896,942; P =.032). The mean cost of time missed did not differ between groups. The mean return to play time significantly decreased over the entire study period (R(2) = 0.33; P =.005), and the mean return to play time was positively associated with cost R(2) = 0.215; P =.030).

CONCLUSION: Concussion incidence did not change after implementation of the updated NHLCP; nonetheless, players had significantly less missed time from injury after protocol implementation. Changes in player performance 30 days and 1 year before and after concussion injury were not different before and after NHLCP implementation. No differences were found in the financial cost of concussions between the pre- and post-NHLCP groups, and missed time was significantly correlated with mean cost from missed time.


Language: en

Keywords

concussion; concussion protocol; National Hockey League; sport performance

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