Title: 177 Primary prevention of sport-related concussion in youth ice hockey: a pilot randomized controlled trial
Abstract: <h3>Background</h3> Neuromuscular and sensorimotor training may reduce the risk of concussion. <h3>Objective</h3> To evaluate the feasibility and efficacy of a concussion prevention neuromuscular training program in youth ice hockey. <h3>Design</h3> Pilot cluster-randomized controlled trial. <h3>Setting</h3> Canadian ice hockey. <h3>Patients (or Participants)</h3> Youth ice hockey players (ages 13–17). <h3>Interventions (or Assessment of Risk Factors)</h3> A study physiotherapist visited teams weekly for six weeks. Both study groups received standard concussion education and previously validated concussion surveillance.<b> I</b>ntervention teams completed a progressive neuromuscular and sensorimotor training program (10–20 minutes per session) (including aerobic, balance, strength, agility, adaptation, cervical spine strength and dividing attention), on- and off-ice. Control teams completed their typical warm-up. <h3>Main Outcome Measurements</h3> Recruitment, completion, retention rates, time and safety were used to evaluate feasibility. Sport-related concussion was defined using the 5<sup>th</sup> Consensus Statement on Concussion in Sport. <h3>Results</h3> Eight teams [n=118 players; 83 males, 35 females] consented to participate. All control teams and 3/4 of the intervention teams completed all 6 sessions [median 85 days (range 42–102)]. No adverse events were reported. There were 6 concussions in the intervention group (n=65) and 4 in the control group (n=53). Exploratory univariate Poisson regression analysis adjusted for cluster by team revealed no difference in concussion risk between groups [incidence rate ratio (IRR)=0.99 concussions/100 players/season (95%CI; 0.28–3.48). For males alone, there was also no difference in IRR [IRR<sub>males</sub>=0.37 (95%CI; 0.068–1.94)]. Both female teams were allocated to the intervention group. <h3>Conclusions</h3> The implementation of a neuromuscular and sensorimotor training program with youth ice hockey teams was feasible and safe. Future evaluation in a larger sample over a longer training period to examine the effects of neuromuscular and sensorimotor training strategies on the risk of concussion in youth ice hockey players, including consideration of sex and age group is warranted.