Navigating the Ice: Establishing Pre-Concussion Baselines in Ice-Hockey Players for Gait Assessment Utilizing Inertial Measurement Units

Abstract

Introduction Ice hockey can lead to high-energy collisions and traumas and is a sport with high risk of concussion (Ornon et al., 2020). Concussions represent 2–14% of all hockey injuries (Izraelski, 2014). Sports-related concussions (SRC) sustained in professional ice hockey are a common in-competition injury leading to highly individual return to sport that can be associated with symptoms lasting days to months (Höllerer et al., 2023). Following SRC there is an increased risk of subsequent concussion and musculoskeletal injury upon return to play, however, assessments that can detect subclinical changes in function following a concussion are lacking (Dunne et al., 2023). A COSMIN systematic review suggests gait-based assessments using inertial measurement units to capture pre-concussion baseline scores (Dunne et al., 2023). This study measured pre-season pre-concussion gait data in Swiss National League Ice hockey players. Baseline scores will be compared with measures from players sustaining in-season SRC.

Methods Temporal and spatial gait parameters were measured with the Physilog (https://www.physilog.com/ , Lausanne, Switzerland) movement sensors. The sensors were fixed to the shoes for flat overground gait analysis. Over a 20-30 m walkway, participants performed a single-task (ST) walking condition (preferred gait speed) and a dual-task (DT) walking condition, i.e., preferred gait speed whilst counting backwards. Application of the dual-task paradigm aimed at quantifying the automaticity of movement (Soulard et al., 2021). The focus of this study was on gait speed, cadence (+ cv%), and stride length (+ cv%) (Dunne et al., 2023).

Results Thirteen male National League players from SC Rapperswil-Jona Lakers, 21.9 ± 3.1 years, 182.5 ± 5.9 cm height, 83.3 ± 7.6 kg body weight performed a pre-season gait analysis. The players sustained 1.5 ± 1.4 [range 0 – 3] concussions in the past. ST/DT walking revealed a walking speed of 1.3 ± 0.14/1.12 ± 0.14 m/s; step length 0.72 ± 0.09/0.67 ± 0.07 m; step length coefficient of variation (cv, %) 5.4 ± 1.9/5.6 ± 1.4 %; cadence 106.7 ± 5.1/100.5 ± 5.7 steps/min; cadence cv 2.8 ± 1/2.9 ± 0.9 %.

Discussion/Conclusion Our results will shed light on the reliability and validity of using inertial measurements in the context of concussion management. Practitioners can use this resource at their disposal to help make informed decisions regarding concussion management.

References

Dunne, L. A. M., et al. (2023). Validity and reliability of methods to assess movement deficiencies following concussion: A COSMIN systematic review. Sports Medicine - Open, 9, 76. https://doi.org/10.1186/s40798-023-00625-0

Höllerer, D., et al. (2023). Injury incidence, outcomes, and return to competition times after sports-related concussions during one professional ice hockey season: A prospective cohort study. Healthcare, 11, 3153. https://doi.org/10.3390/healthcare11243153

Izraelski, J. (2014). Concussions in the NHL: A narrative review of the literature. Journal of the Canadian Chiropractic Association, 58(4), 346–352.

Ornon, G., et al. (2020). Epidemiology of injuries in professional ice hockey: A prospective study over seven years. Journal of Experimental Orthopaedics, 7, 87. https://doi.org/10.1186/s40634-020-00300-3

Soulard, J., et al. (2021). Spatio-temporal gait parameters obtained from foot-worn inertial sensors are reliable in healthy adults in single- and dual-task conditions. Scientific Reports, 11, 10229. https://doi.org/10.1038/s41598-021-88794-4