The goal of this study is to evaluate the effects of SM/NM training in ice hockey players. The specific questions include: 1) typical performance on sensorimotor and neuromuscular (SM/NM) tests 2) evaluate SM/NM training on ice hockey skills performance and SM/NM tests, 3) evaluate SM/NM control to prevent concussions and injuries Participants will: Consent and complete a series of SM/NM tests. Participate in their typical training for 4 weeks. Repeat the SM/NM tests. Participate in SM/NM training for 4 weeks as part of their off season training program. Repeat the SM/NM tests and on ice skills testing. Record any injuries and concussions that they sustain over the next season. Repeat the SM/NM tests and on ice skills tests at the start of the 2025 off season training (estimated May - July of 2025).
Rationale: While sensorimotor function is recognized as an important aspect of growth and development, little is known about specific changes in sensorimotor control with sport specific training. Similarly, the relationship between sensorimotor control and sport-specific performance is not yet well understood. Specific rehabilitation exercises have been shown to improve sensorimotor control, many of which are context specific and may also prevent injury and/or concussion. The effect of age on these outcomes and the relationship between training sensorimotor control and age is also not well understood. Thus, evaluation of sensorimotor control outcomes across ages, the effects of sensorimotor training on sensorimotor control and performance is needed and may inform changes to recommendations for sport-specific training. Ultimately, understanding the effect of training specific sensorimotor systems (which is not a part of typical sport training environments) will inform multiple areas of sport including: 1) Sport-specific performance 2) typical development of SM/NM function, 3) the effect of SM/NM training on SM/NM measures and ice hockey specific physical performance and 4) injury and concussion prevention strategies. Therefore, the objectives of this study are to: 1. Describe age and sex specific typical scores on sensorimotor and neuromuscular (proprioception, movement related, balance, vision, divided attention) and ice hockey specific physical performance measures over one off season of training. 2. Evaluate the effects of a sensorimotor training program on ice hockey skills performance. 3. Evaluate sensorimotor control as a means to improve safety in sport: 1. Evaluate the effect of SM/NM training on concussion and injury risk. 2. Evaluate the effect of previous concussion and injury on sensorimotor function. 4. Evaluate the effect of SM/NM training on performance of 1) system specific outcomes and 2) sport specific measures in ice hockey players.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
250
Sensorimotor and neuromuscular training exercises aimed at training the cervical spine neuromuscular control, vestibular system and oculomotor system in addition to ice hockey specific training the incorporates higher level integrated functional activities of these integrated systems. This will be performed at the same frequency as their typical training - four days per week in the gym, one day of yoga or recovery as well as on ice sessions.
Typical training for ice hockey players off season
Concussion Rehabilitation Laboratory
Calgary, Alberta, Canada
RECRUITINGCraniocervical flexion
mmHg, the ability of the participant to perform a craniovertebral flexion task in a controlled way and maintain the position for a minimum of 3 seconds.
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
Dynamic Visual Acuity
logMAR, Represents the ability of the patient to see clearly with head motion as per Schneider et al 2019=8
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
Vestibular Ocular Motor Screen (VOMS)
Symptom provocation on tests of vestibulo ocular and oculomotor function, rated on a scale of 0-10 where 0=no symptoms and 10= the worse imaginable, Mucha et al 2014
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
Advanced Functional Gait Assessment
/48, 16 tests of dynamic balance each rated on a scale of 0-3 with 0 repress unable to complete the task and 3 is able to perfectly complete the task.
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
Transition Agility Skate
Seconds, Outcome of the transition agility skate on the Hockey Canada skills test
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
Cervical spine range of motion
1=full range of motion, 0=limited range of motion
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
Anterolateral flexion strength
kilograms (kg), average of three trials in a rotated position to either the right or left and defined according to the position of the head
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
cervical flexor endurance test
Seconds, the length of time the participant can lift the head in craniovertebral flexion
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
cervical flexion rotation test
1=positive, 0=negative, a measure of upper cervical spine dysfunction with a positive test suggesting cervicogenic headache, limited range of motion in full flexion by \>20 degrees, measured to the right and left
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
head perturbation test
0-8/8; ability of the individual to maintain their head in a neutral position when an external force of 5lbs is applied
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
Head thrust test
Positive = 1, Negative =0, Ability of the eyes to maintain a fixed position on a target with rapid head motion
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
Numeric Pain Rating Scale (NPRS) Headache
Headache 0-10 where 0=no symptoms and 10=worst symptom imaginable
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
Numeric Dizziness Rating Scale (NDRS) Dizziness
dizziness 0-10 where 0=no symptoms and 10=worst symptom imaginable
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
Numeric Pain Rating Scale (NPRS) Neck pain
neck pain 0-10 where 0=no symptoms and 10=worst symptom imaginable
Time frame: 0 weeks, 4 weeks, 8 weeks each year, up to 2 years
Concussion
Defined as per the Amsterdam International Consensus on Concussion in Sport
Time frame: yearly, up to 2 years
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