What we’ve learned so far about concussion reporting and education in the GTHL

Researchers at the Holland Bloorview Concussion Centre are already seeing positive trends in education and reporting in the GTHL after one year with the new concussion policy. Implemented prior to the 2016-17 season, the collaborative effort has started to measure the impact of changes in understanding and awareness of symptoms and treatment methods, as both organizations strive to make minor hockey safer.

The impact of initial key findings has already exceeded expectations by those in the field of pediatric concussion and has garnered attention from across the country. The GTHL saw significant improvements in concussion awareness and reporting in 2016-17 compared to previous seasons. A positive shift in coaches’ and trainers’ concussion knowledge, attitudes and intended practices also was noted by the research team. These changes were reported via research surveys administered before and after mandatory concussion education sessions for GTHL bench staff.

The research team also has begun to explore the number of concussion injuries that have been reported in the GTHL, before and after implementation of the policy.

Data collection over the next five years of the partnership will help shed light on changes in concussion knowledge and concussion injuries over time. More research also will provide a better understanding of trends in concussion reporting in the GTHL, leading to improved strategies for the prevention, identification and management of concussions. This partnership also will assist in developing concussion programming and protocol to improve education for coaches, trainers, parents and players.

Call to action

This collaboration between the GTHL and researchers at the Holland Bloorview Concussion Centre will continue to rely on participation from everyone involved in minor hockey. Together we can improve knowledge, identification, reporting and management of concussion in the minor hockey community. This policy, educational and research initiatives would not have been possible without the dedicated trainers, coaches, parents and players of the GTHL – because of your effort, we are very proud that other sports organizations are looking to the GTHL for guidance on how to better support their players, and to replicate this early success.

Improvements in concussion reporting across the league

Reporting and proper treatment are two areas that have seen significant jumps since the implementation of the new concussion policy.

235% increase in suspected concussions reported

What does this mean?

Concussions are often underreported. This increase in suspected concussions reported suggests that more robust education and policy implementation in the GTHL is leading to behavior change in concussion reporting.

300% increase in players receiving physician clearance prior to returning to full contact play

Why is physician clearance important before return to play?

It is critical to ensure players have fully recovered from a concussion before returning to full-contact play to reduce the risk of re-injury that could result in a more serious brain injury.

What does this mean?

Players with a concussion are now following protocols that state the need for a physician diagnosis, the completion of a gradual return-to-play protocol and medical clearance from physicians before returning to game play.

Suspected concussions are seeking medical assessment by physicians

Why is physician diagnosis important?

A concussion is a clinical diagnosis, so medical assessment is necessary to rule out more serious forms of brain injury, spine injuries and other neurological conditions that can present with concussion-like symptoms. In the first season with the new policy, five in seven suspected concussions reported by coaches and trainers were diagnosed as concussions by a physician.

What does this mean?

Players with suspected concussion are seeking appropriate medical assessment – with full support from coaches and trainers – to determine if a concussion has been sustained.

Education leads to positive shift in knowledge, attitudes and intended practices

Last season, 1,200 GTHL coaches and trainers received mandatory in-person concussion education from the Holland Bloorview Concussion Centre. Of those who attended, 939 participated in a research study that used a survey, completed before and after the concussion education, to measure changes in concussion knowledge, attitudes, and intended practices.

Mandatory education improved knowledge to recognize concussion signs and symptoms

There was a significant increase in knowledge of concussion symptoms among GTHL coaches and trainers after training sessions, with the average score for recognition of emotional symptoms increasing from 58% to 94%. Furthermore, 97% of trainers and 89% of coaches stated that they had the knowledge to recognize the symptoms of concussions in one of their players.

Mandatory concussion education improved coaches’ and trainers’ knowledge, attitudes, and practices towards concussion recovery

The percentage of coaches and trainers who indicated that they have the knowledge to properly manage a player’s return to play after a concussion increased from 49% and 65%, respectively, before education to 79% and 88%, respectively, after education. Additionally, there was a 23% increase in trainers believing they had the knowledge to manage a player’s return and a 30% increase for coaches.

TAKE HOME POINTS

• Reporting suspected concussions is critical. It will help make minor hockey safer and support our understanding of concussions among minor hockey players.
• Providing regular and relevant education will continue to be critical for coaches, trainers, parents and players.
• These research studies conducted as part of this collaboration between the GTHL and the Holland Bloorview Concussion Centre will be published in scientific journals in the near future and be shared internationally to improve the safety of minor hockey players around the world.

TIPS FOR THE SEASON

• Know the signs of concussion symptoms and ensure your child sees a physician if a concussion is suspected.
• Familiarize yourself with the GTHL Concussion Policy gthlcanada.com/gthl-concussion-policy and report suspected concussions.
• Speak to your coach or trainer if you feel more education is needed at the parent and player level – Holland Bloorview may be able to come and speak with your team.