Concussions in Ice Hockey - Moving Toward Objective Diagnoses and Point-of-care Treatment: A Review

Effects of Creatine Supplementation on Brain Function and Health

While the vast majority of research involving creatine supplementation has focused on skeletal muscle, there is a small body of accumulating research that has focused on creatine and the brain. Preliminary studies indicate that creatine supplementation (and guanidinoacetic acid; GAA) has the ability to increase brain creatine content in humans. Furthermore, creatine has shown some promise for attenuating symptoms of concussion, mild traumatic brain injury and depression but its effect on neurodegenerative diseases appears to be lacking. The purpose of this narrative review is to summarize the current body of research pertaining to creatine supplementation on total creatine and phophorylcreatine (PCr) content, explore GAA as an alternative or adjunct to creatine supplementation on brain creatine uptake, assess the impact of creatine on cognition with a focus on sleep deprivation, discuss the effects of creatine supplementation on a variety of neurological and mental health conditions, and outline recent advances on creatine supplementation as a neuroprotective supplement following traumatic brain injury or concussion.

REDUCING THE SPORTS INJURY THROUGH FUNCTION MOVEMENT BIOLOGICAL IMAGE DATA SCREENING

ABSTRACT Introduction Among the many cases of sports injuries, the incidence of musculoskeletal injuries remains high. After a musculoskeletal injury occurs, athletes often need to suspend training and undergo rehabilitation. A suitable sport mode requires athletes to have sufficient joint range of motion, core stability, and balance ability in different positions to complete various complex movements in training and competition. Objective The paper analyzes the impact of warm-up exercises before the test on the test results of functional sports biological image data screening ( FMS TM ) and provides references for unifying test conditions, checking the reliability of FMS TM repeated tests, and discussing the comparability of the research results. Methods The paper used the same password and process to test 12 young male volleyball professional athletes without warm-up and warm-up. The two-dimensional motion analysis system Dartfish Pursuit 8.0 was used to analyze the video data recorded by the two cameras simultaneously. Results In the two tests before and after, the hurdle step score (1.75±0.62 vs. 2.42±0.52) and the total score (13.50±2.20 vs. 16.42±2.15) were significantly higher than those without the warm-up test (P<0.01). Besides, in squats (1.58±0.67 vs. 1.92±0.67), straight lunges (2.00±0.43 vs. 2.50±0.52), active straight leg lifts (1.50±0.67 vs. 2.00±0.60), rotation stability (1.42) ±0.52 vs. 1.92±0.29) showed a significant increase in the score (P<0.05). Conclusions Warm-up exercises before the test can improve the test results. This abnormal movement pattern observed only by visual inspection may not truly reflect the “dysfunction” of the movement. In the case of ignoring the pre-test warm-up factors, feedback on sports performance and formulating training strategies, this conclusion of predicting injury risk and evaluating training effects may have specific limitations in its reference value. Level of evidence II; Therapeutic studies - investigation of treatment results.

Brain Vital Signs in Elite Ice Hockey: Towards Characterizing Objective and Specific Neurophysiological Reference Values for Concussion Management

Background: Prior concussion studies have shown that objective neurophysiological measures are sensitive to detecting concussive and subconcussive impairments in youth ice-hockey. These studies monitored brain vital signs at rink-side using a within-subjects design to demonstrate significant changes from pre-season baseline scans. However, practical clinical implementation must overcome inherent challenges related to any dependence on a baseline. This requires establishing the start of normative reference data sets.

Methods: The current study collected specific reference data for N = 58 elite, youth, male ice-hockey players and compared these with a general reference dataset from N = 135 of males and females across the lifespan. The elite hockey players were recruited to a select training camp through CAA Hockey, a management agency for players drafted to leagues such as the National Hockey League (NHL). The statistical analysis included a test-retest comparison to establish reliability, and a multivariate analysis of covariance to evaluate differences in brain vital signs between groups with age as a covariate.

Findings: Test-retest assessments for brain vital signs evoked potentials showed moderate-to-good reliability (Cronbach’s Alpha > 0.7, Intraclass correlation coefficient > 0.5) in five out of six measures. The multivariate analysis of covariance showed no overall effect for group (p = 0.105), and a significant effect of age as a covariate was observed (p < 0.001). Adjusting for the effect of age, a significant difference was observed in the measure of N100 latency (p = 0.022) between elite hockey players and the heterogeneous control group.

Interpretation: The findings support the concept that normative physiological data can be used in brain vital signs evaluation in athletes, and should additionally be stratified for age, skill level, and experience. These can be combined with general norms and/or individual baseline assessments where appropriate and/or possible. The current results allow for brain vital sign evaluation independent of baseline assessment, therefore enabling objective neurophysiological evaluation of concussion management and cognitive performance optimization in ice-hockey.