Safe-Play Knowledge, Aggression, and Head-Impact Biomechanics in Adolescent Ice Hockey Players.
BACKGROUND
Addressing safe-play knowledge and player aggression could potentially improve ice hockey sport safety.


OBJECTIVE
To compare (1) safe-play knowledge and aggression between male and female adolescent ice hockey players and (2) head-impact frequency and severity between players with high and low levels of safe-play knowledge and aggression during practices and games.


METHODS
Cohort study.


METHODS
On field.


METHODS
Forty-one male (n = 29) and female (n = 12) adolescent ice hockey players.


METHODS
Players completed the Safe Play Questionnaire (0 = less knowledge, 7 = most knowledge) and Competitive Aggressiveness and Anger Scale (12 = less aggressive, 60 = most aggressive) at midseason. Aggressive penalty minutes were recorded throughout the season. The Head Impact Telemetry System was used to capture head-impact frequency and severity (linear acceleration [g], rotational acceleration [rad/s(2)], Head Impact Technology severity profile) at practices and games.


METHODS
One-way analyses of variance were used to compare safe play knowledge and aggression between sexes. Players were categorized as having high or low safe-play knowledge and aggression using a median split. A 2 × 2 mixed-model analysis of variance was used to compare head-impact frequency, and random-intercept general linear models were used to compare head-impact severity between groups (high, low) and event types (practice, game).


RESULTS
Boys (5.8 of 7 total; 95% confidence interval [CI] = 5.3, 6.3) had a trend toward better safe-play knowledge compared with girls (4.9 of 7 total; 95% CI = 3.9, 5.9; F1,36 = 3.40, P = .073). Less aggressive male players sustained significantly lower head rotational accelerations during practices (1512.8 rad/s (2) , 95% CI = 1397.3, 1637.6 rad/s(2)) versus games (1754.8 rad/s (2) , 95% CI = 1623.9, 1896.2 rad/s(2)) and versus high-aggression players during practices (1773.5 rad/s (2) , 95% CI = 1607.9, 1956.3 rad/s (2) ; F1,26 = 6.04, P = .021).


CONCLUSIONS
Coaches and sports medicine professionals should ensure that athletes of all levels, ages, and sexes have full knowledge of safe play and should consider aggression interventions for reducing head-impact severity among aggressive players during practice.
Department of Kinesiology and Concussion Research Laboratory, University of Georgia, Athens.
Julianne D
JD
Schmidt
Carolina Family Practice and Sports Medicine - A Duke Health Clinic, Cary, NC.
Alice F
AF
Pierce
Department of Exercise and Sport Science, Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center, and Injury Prevention Research Center, University of North Carolina at Chapel Hill.
Kevin M
KM
Guskiewicz
Department of Exercise and Sport Science, Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center, and Injury Prevention Research Center, University of North Carolina at Chapel Hill.
Johna K
JK
Register-Mihalik
Department of Kinesiology, California State University at Fullerton.
Derek N
DN
Pamukoff
Department of Exercise and Sport Science, Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center, and Injury Prevention Research Center, University of North Carolina at Chapel Hill.
Jason P
JP
Mihalik
D000293:Adolescent; D000374:Aggression / Q000523:psychology*; D000067449:Anger Management Therapy / Q000379:methods; D056352:Athletes / Q000523:psychology; D001265:Athletic Injuries / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D001696:Biomechanical Phenomena; D001924:Brain Concussion / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D015331:Cohort Studies; D006259:Craniocerebral Trauma / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006260:Head Protective Devices; D006688:Hockey / Q000193:education / Q000523:psychology; D006801:Humans; D008297:Male; D017751:Safety Management / Q000379:methods*; D012737:Sex Factors; D013663:Teaching; D015599:Trauma Severity Indices
adolescent sports; concussions; head trauma; mild traumatic brain injuries