Risk of Head Injury Associated with Distinct Head Impact Events in Elite Women's Hockey

Abstract

Head injuries are a major health concern for sport participants as 90% of emergency department visits for sport-related brain injuries are concussion related (Canadian Institute for Health Information, 2016). Recently, reports have shown a higher incidence of sport-related concussion in female athletes compared to males (Agel et al., 2007). Few studies have described the events by which concussions occur in women’s hockey (Delaney et al., 2014, Brainard et al., 2012; Wilcox et al., 2014), however a biomechanical analysis of the risk of concussion has not yet been conducted. Therefore, the purpose of this study was to identify the riskiest concussive events in elite women’s hockey and characterize these events through reconstructions to identify the associated levels of peak linear and angular acceleration and strain from finite element analysis. 44 head impact events were gathered from elite women’s hockey game video and analyzed for impact event, location and velocity. In total, 27 distinct events based on impact event, location and velocity were reconstructed using a hybrid III headform and various testing setups to obtain dynamic response and brain tissue response. A three-way Multivariate Analysis of Variance (MANOVA) was conducted to determine the influence of event, location and velocity. The results of this study show that head-to-ice impacts resulted in significantly higher responses compared to shoulder-to-head collisions and head-to boards impacts however, shoulder and boards impacts were more frequent. All events produced responses comparable to proposed concussion threshold values (Zhang et al., 2004). This research demonstrates the importance of considering the event, the impact characteristics, the magnitude of response, and the frequency of these impacts when attempting to capture the short and long term risks of brain trauma in women’s hockey.