Effect of Repetitive Head Impacts in Collegiate Ice Hockey on a Multifaceted Concussion Test Battery

OBJECTIVE: To investigate the effects of a collegiate ice hockey season and the repetitive head impacts (RHI) experienced on the neurologic health using a multifaceted assessment battery. DESIGN: Cross-sectional. SETTING: Research laboratory. PARTICIPANTS: Thirty-six male collegiate club ice hockey players. INDEPENDENT VARIABLES: Time (preseason, midseason, postseason) and head impact measures (number of impacts, mean linear acceleration). MAIN OUTCOME MEASURES: Athletes wore Smart Impact Monitor (SIM-G) accelerometers throughout 1 season and completed testing at preseason, midseason, and postseason. The battery included a 22-item graded symptom checklist, Standardized Assessment of Concussion, Balance Error Scoring System, Trails A & B, King-Devick, Near Point Convergence, Clinical Reaction Time, Tandem Gait (single- and dual-task), and computerized neurocognitive testing (ImPACT). RESULTS: There was a significant main effect of time, with improved performance, on the Standardized Assessment of Concussion ( F(2, 70) = 4.43, P = 0.015), Trails A ( F(2, 67) = 7.16, P = 0.002), Trails B ( F(2,71) = 5.19, P = 0.008), King-Devick ( F(2, 72) = 4.31, P = 0.017), Clinical Reaction Time ( F(2, 69) = 4.54, P = 0.014), ImPACT Verbal Memory ( F(2, 76) = 3.82, P = 0.026), and Tandem Gait (ST: F(2, 76) = 6.11, P = 0.003; DT: F(2, 78) = 4.65, P = 0.012). Multiple regression analyses identified an association between the overall head impact model and Visual Motor score (R 2 = 0.354, F(2, 29) = 3.698, P = 0.016), whereby increased head kinematics corresponded to higher (better) Visual Motor performance. CONCLUSIONS: A season of collegiate ice hockey RHI did not negatively affect multifaceted clinical assessments. Additional investigation is warranted to determine the effect of RHI sustained during collegiate hockey participation later in life.