Emerging Concussion Assessments Baseline Performance In Ice Hockey Players Across Age Groups

The 6th Concussion in Sport and SCAT-6 introduced emerging assessments for concussions including near point of convergence (NPC), single (ST-TG) and dual task tandem-gait (DT-TG). While these assessments have strong supporting evidence in collegiate student-athletes, there is limited evidence in children and adolescent athletes. PURPOSE: To determine if age affects performance on the emerging assessments. METHODS: We enrolled male hockey players under 12 years old (“children”, n=22, age=10.6 1.3), 13-18 (“adolescents”, n=52, age=14.8 1.3) and collegiate (“student-athletes”, n=35, age=19.7 1.2) who completed a concussion baseline assessment including the NPC, ST-TG and DT-TG protocol. Each assessment was performed consistent with established and published approaches. The primary outcome measures were the mean for three trials for NPC, and the mean time of the four trials of ST-TG and DT-TG. A one-way ANOVA compared group (children, adolescent, or collegiate student athlete) on the mean for NPC, ST-TG, and DT-TG, with post hoc on significant main effects and Cohen d effect sizes reported. RESULTS: There was a significant main effect for group for mean NPC ( = 0.085, p = 0.013), children (2.5 0.4 cm) performed worse than collegiate athletes (1.2 0.4 cm, p=0.035, d=3.0) and adolescents (0.9 0.29 cm, p=0.004, d=4.3). There was a main effect for group for mean ST-TG time ( = 0.357, p < 0.001), whereby children (16.9 0.8 sec) performed worse than college (9.9 0.7 sec, p<0.001, d=9.6) and adolescents (11.4 0.5 sec, p<0.001, d=8.5). There was also a main effect for group for mean DT-TG time ( = 0.224, p < 0.001) whereby children (22.3 1.4 sec) performed worse than collegiate athletes (12.9 1.2 sec, p<0.035, d=7.2) and adolescents (16.6 0.9 sec, p=0.004, d=4.8) and adolescents performed worse than collegiate athletes (p=0.013, d=3.5). CONCLUSION: Clear age-related differences are present for these emerging assessments suggesting that age-specific normative values are required for appropriate for concussion management in the event baseline tests are not available for clinicians. These findings suggest that there is an improved performance with aging for both ST-TG and DT-TG, but no differences between adolescents and collegiate athletes for NPC.