Use double quotes to find documents that include the exact phrase: "aerodynamic AND testing"

The purpose of this project was to explore issues surrounding segregated sport for people with impairments and to address the question of whether or not segregated sport perpetuates inequity (Fay & Wolff, 2009). The specific objectives included: (1) Identifying the drawback and benefits of participation in segregated athlete training programs taking place in different settings; (2) To understand how the nature of these programs and the settings in which they take place inform participants’ conceptualizations of disability and inclusion; and (3) To contribute knowledge to more inclusive sport policies and practices. Conclusions drawn from the findings of this work highlight the value of segregated programming for athletes with impairments and the importance of legitimate choice and access to alternative settings (i.e., integrated and segregated) that are experienced as inclusive. In essence, these findings challenge the notion that segregated sport should be a stepping stone to integrated sport. Furthermore, segregated sport can be experienced as inclusive. These findings challenge a hierarchical vision of inclusion and athlete development. Recognition and valuing of different pathways through sport is required.

Nancy Spencer-Cavaliere presents at SCRI Conference
Research methods

This research consisted of a case study supported by interpretive description and was comprised of participants in two training programs for athletes with impairments. Interpretive description is an approach used to address a practical issue and to gain an understanding of the patterns and relationships within a phenomenon (Thorne, 2016). The training programs were run through a centre specializing in disability and physical activity. Participants in both programs competed in a range of sports (e.g., para-athletics, swimming, sledge hockey, goal ball, dragon boat racing) and were supported by coaches and trainers with impairment and parasport specific knowledge. However, one of the programs, which focused on developing athletes was run out of the centre within a segregated activity environment comprised of only athletes with impairments. The other program, which focused on high performance athletes, took place within an integrated environment where athletes from outside of parasport also trained. Data collection consisted of participant observation, field notes and reflexive journaling over a period of several months in both training environments. Semi-structured interviews were then conducted with the participants followed by reflective note taking. The interviews were transcribed. Analysis was guided by an attempt to answer the questions, “What is happening here?” and “What am I learning about this?” (Thorne, Kirkham, & MacDonald-Emes, 1997, p. 174).

Research results
Photo Scott Grant/Canadian Paralympic Committee

The key findings highlight the opportunities athletes experienced as a result of the nature of the training programs and the settings within which they occurred. Although a few drawbacks to the programs were identified, the athletes in both settings overwhelmingly focused on how the programs and settings met their needs, contributed to their positive views of self, and created a sense of community. The findings were captured in three themes. The first theme, Legitimate Access, was articulated within the segregated setting as a safe environment comprised of accessible equipment and knowledgeable staff, which maximized independence. In this way, the segregated setting eliminated barriers commonly experienced in other settings, which supported athletes’ focus on training. Within the integrated setting, legitimate access translated to well designed and intense training programs and expert coaching knowledge, which afforded the possibility of attaining high performance training goals. Within both settings, the second theme, (Re)Discovering the Athlete, highlighted the internal struggle participants experienced in their identification with the role of athlete. Within the segregated setting, it was the encouragement of other athletes in the program, trainers, and coaches who helped to facilitate an athletic view of self and increases in self-confidence. Within the integrated setting, athletic identity appeared to be largely supported by the nature of the integrated environment, which did not separate athletes based on impairment, but rather brought all athletes (with and without impairment) together on the basis of their commitment to high performance sport. This appeared to reinforce study participants’ positive views of self, as athletes. The final theme of Diversity Valued within the segregated setting was described by athletes as having their individual needs, due to impairment, being met, but that these were valued differences, rather than markers of disability. The integrated environment was described as a humanizing setting where stereotypes about (dis)ability and sport performance could be challenged. Across both settings athletes articulated experiencing a strong sense of inclusion and personal value. Based on these findings, it appears that different sport streams, both integrated and segregated, can meet the individual needs of athletes and be experienced in positive ways that support athlete development and valuing of differences. These findings challenge the notion that segregated programs and environments necessarily perpetuate inequity. At the same time, the contextual nature of these programs and history associated with forced segregation and marginalization of people with impairments must remain at the forefront of future recommendations for possible pathways through sport and attempts to level the playing field.

Policy implications

A major emphasis in Canadian Sport Policy (CSP) when addressing the participation of people with impairments are the values of inclusion and accessibility and the Inclusive policy principle which states that, “Sport programs are accessible and equitable and reflect the full breadth of interests, motivations, objectives, abilities, and the diversity of Canadian society” (p.3). The findings of this research reinforce the importance of this policy but also offer suggestions for how to expand the interpretation of the ways in which sport programs can be equitable and how this can be actualized. Through the offering and valuing of diverse training environments and programs (e.g., segregated, integrated, reverse integrated) choice can be afforded. Resisting a model of sport that is primarily integration focused and hierarchical in nature broadens the participation possibilities not only for people with impairments but for all people to take part in sport. Policies and practices that value different pathways and sport streams may have greater potential to ultimately be more inclusive. Ensuring there is an equitable distribution of resources to support these different pathways is critical. Likewise, ensuring legitimate access to a range of valued possibilities, essentially a diverse fields of dreams, is essential.

Next steps
Photo by Matthew Murnaghan/Canadian Paralympic Committee

Future directions include:

  1. actualizing the concept of equity within sport models that attend to the importance of choice, and
  2. challenging the binary of segregation and integration within sport policies and practices.

A critical future research direction involves the examination of current sport programs to identify specific practices that lead to inclusion, support choice, and offer diversity.

Key stakeholders and benefits

In addition to disability specific organizations and the Canadian Paralympic Committee, the following provincial organization with emphasis on parasport may benefit from the findings. Importantly organizations who support recreational to high performance sport should be included.

Sample of Potential Organizations: Paralympic Sports Association, ParaSport Ontario, Sport Nova Scotia, Saskatchewan Sport, SportAbility BC, Sport Manitoba, ParaSport and Recreation PEI, Recreation Newfoundland & Labrador, Active Living Alliance for Canadians with a Disability.

2017 Sport Canada Research Initiative Conference (Knowledge Transfer Paper)

Investigators: Nancy Spencer-Cavaliere, Lisa Tink, & Kirsti Van Dornick, University of Alberta

SCRI Conference presentation video

Relative age effects (RAEs) are developmental advantages experienced by those born in the early months of the year relative to an age-defined cut-off date (Barnsley et al., 1985). In sport and educational settings, RAEs tend to endure, resulting in an accumulated advantage that could affect youths’ overall development (Murray, 2003). This research program investigated the accumulated advantage of RAEs amongst Canadian male adolescent ice hockey players at different competitive levels (i.e., house league and travel) in hopes of: a) assessing the leadership behaviours and other developmental outcomes (e.g., personal & social skills, goal setting) among Canadian hockey players within the context of RAEs, and; b) comparing the attributes of relatively younger and older hockey players.

Jess Dixon presents at 2017 SCRI Conference

Despite significantly more travel players being born in the early months of the selection year than the latter months, no significant differences in leadership behaviours or other developmental outcomes were found among travel or house league players based on birth quartile. Moreover, there were no significant interactions between birth quartile and competitive level on these outcomes. These results should be comforting to sport administrators, particularly in light of published reports of how RAEs are impacting developmental outcomes among youth in alternative settings, such as education (e.g., Cobley et al., 2009; Dhuey & Lipscomb, 2008). To the extent that participation in hockey is providing adolescent males with equal opportunities to develop skills that are valued in the workplace (Kuhn & Weinberger, 2005), this achievement is worthy of celebration.

Research methods

Adolescent male travel and house league ice hockey players were recruited at tournaments across Ontario to complete an online survey that evoked general demographic information, including date of birth, along with their responses to the Leadership Scale for Sport (LSS; Chelladurai & Saleh, 1980) and the Youth Experience Survey for Sport (YES-S; MacDonald et al., 2012). The LSS measures five dimensions of leadership, while the YES-S examines five dimensions of youth development: personal and social skills, initiative, goal setting, cognitive skills, and negative experiences. Both scales demonstrated adequate model fit and reliability in previous research involving adolescent athletes.

To determine if an RAE was present within these samples, we grouped athletes into birth quartiles using the December 31st cut-off date prescribed by Hockey Canada. Athletes born in January, February, and March were placed in quartile one (Q1), while quartile two (Q2) consisted of those born in April, May and June, and so forth. Chi-square goodness of fit tests were performed to determine if the birthdate distributions of the male travel and house league hockey players differed significantly from what we would expect among midget-aged players (15-17 years) within the Ontario Hockey Federation (Hancock et al., 2013) and the general Canadian population. Effect sizes were calculated using Cramér’s phi and, when necessary, standardized residuals for the significant chi-square values were calculated post-hoc to identify which quartiles differed significantly from the expected birth distributions.

Finally, we performed multivariate analysis of variance (MANOVA) tests to determine if scores on the sub-scales of the LSS and YES-S differed because of birth quartile. Through these analyses, we attempted to discern how relative age may influence the leadership behaviours and development of male adolescent hockey players. When necessary, and to account for correlations among dependent variables in the LSS and YES-S, we employed relative weight analyses to discern where significant differences were located.

Research results

Consistent with previous research (e.g., Hancock et al., 2013; Montelpare et al., 2000), we found no evidence of a RAE among the male adolescent house league hockey players that we surveyed (n = 453). Although our MANOVA results revealed significant multivariate differences between quartiles of birth on the LSS dimensions, post-hoc tests indicated that the relative weights were not statistically significant. Therefore, quartile of birth was not significantly different for any of the LSS dimensions. Similarly, we found no significant multivariate differences between quartiles of birth on the five YES-S dimensions.

On the contrary, we found a significant difference between the birth distribution of travel players (n = 259) and what we would expect to find in the general population, with significantly more players born in Q1 and significantly fewer players born in Q4. These results are also consistent with previous research (e.g., Barnsley & Thompson, 1988; Hancock et al., 2013). Despite evidence of a RAE among travel players, no significant multivariate differences were found between quartiles of birth on dimensions of the LSS or YES-S. Finally, there were no interactions between birth quartile and competitive level on the dimensions of the LSS or YES-S.

Caution should be exercised when generalizing these results, or lack thereof. Firstly, the vast majority of our sample was born and participated in hockey in Ontario, making it difficult to generalize our results to other geographic regions or sports. Secondly, as with any self-reported survey, it is difficult to ensure participants answered questions about their experiences in sport thoughtfully and honestly. Finally, our results may be somewhat skewed because athletes who had negative experiences in hockey may have already dropped out of the sport. This is noteworthy given that other researchers have found relatively younger athletes dropping out of sport due to their negative experiences prior to or during adolescence (e.g., Helsen et al., 1998; Lemez et al., 2014).

Policy implications

To our knowledge, this is the first series of studies to examine the relationship between relative age and leadership behaviour and other developmental outcomes within sport. While Dhuey and Lipscomb (2008) found relatively younger adolescent students acquire fewer leadership experiences prior to graduation, our results demonstrate that leadership behaviours and other developmental outcomes among adolescent male travel and house league ice hockey players are not influenced by relative age or competitive level. These contrasting results may stem from coaches and other sport administrators developing these qualities in all of their athletes, regardless of their relative ages. Determining that travel and house league hockey players are not being (dis)advantaged in terms of their leadership behaviours or other developmental outcomes because of their relative ages can help guide future research and inform professional practice. To the extent that participation in hockey is providing equal opportunities to develop skills that are valued in the workplace (Kuhn & Weinberger, 2005), our null results are worthy of celebration. In the future, Ontario parents, teachers, and other relevant stakeholders should consider promoting hockey to children as a method to facilitate positive youth development and leadership behaviour, given that relative age plays no discriminating role in achieving these outcomes.

Next steps

Despite the null findings in this study, we believe relative age ought to be considered in other studies exploring positive youth development within sport to provide a more comprehensive analysis of other potential influences on youth sporting experiences. In particular, we recommend the replication of this study with samples drawn from other sports, other competitive levels, as well as from female athletes, where RAE patterns are more equivocal (e.g., Wattie et al., 2007; Weir et al., 2010).

Key stakeholders and benefits

A list of sport organizations, governments (units, branches or sectors) and/or groups that may benefit from the findings and describe those benefits here.

2017 Sport Canada Research Initiative Conference (Knowledge Transfer Summary)

Investigators: Jess C. Dixon, University of Windsor; Sean M. Horton, University of Windsor; Patricia L. Weir, University of Windsor; Joe Baker, York University; Stephen P. Cobley, The University of Sydney

SCRI Conference presentation video.

Participation in sport can be an integral, rewarding component of life. However, sport concussions can too easily derail the benefit of both competitive and casual exercise—instances that can be avoided through proper education and preventative measures. Sport is especially advantageous for adolescents. Those who participate in sport during this period often build better social skills, develop confidence and create a strong foundation for lifelong health. Unfortunately, it is this very age group that is most vulnerable to concussions. 64-percent of the time, children between the ages of 10 to 18 who visit the emergency room do so because of sports and recreational activities. Of this group, a staggering 39% are diagnosed with concussions, and a further 24% are possible concussions. To further demonstrate the issue, concussions have grown in prevalence by 40% from 2004 to 2014 in the sports of football, soccer and hockey.

Governor General’s Conference on Concussions in Sport “We Can Do Better”

Driven by his  strong desire for Canadian youth to play safe and continue to get involved in sport and physical activity, the Governor General spent a full day in December 2016 hosting a conference with former professional athletes, Olympic and Paralympic athletes, the medical community, and the sport community at large, discussing concussions in sport and how we can do better for Canadian youth to play safe and continue to get involved in sport and physical activity. The recording of the day’s sessions can be accessed through the CPAC broadcast of the Conference on Concussions in Sport. The Minister of Sport and Person’s with a Disability and the Governor General also spoke with the online community, hosted by the Sport Information Resource Centre (SIRC), to gather thoughts on concussion from Canadians from coast to coast to coast.

Let’s Talk About Concussions – Ottawa Spring Summit 2017

While the Ottawa Sport Council has always encouraged sport participation, it has also worked to make the community sport landscape a safer space for all participants by facilitating learning opportunities—and there is compelling evidence that concussion education can decrease occurrences and minimize the impact of concussions in sport. Inspired by the Governor’s General’s Concussion Conference, the Ottawa Sport Council, in partnership with SIRC, hosted the 2017 SPRING Ottawa Sport Summit, Let’s Talk about Concussions to further the dialogue. The objective of the 2017 Ottawa Summit was to advance the dialogue around the growing prevalence of concussions in sports through a series of presentations, and round table discussions. It also provided participants with the opportunity to network with peers who face many of the same challenges. Participants were encouraged to take a few minutes to watch this Concussion Management video which provided a good introduction to the Summit discussion.

The goal for the summit was not only to advance the dialogue around the growing prevalence of concussions in sport, but to highlight the latest research in this rapidly changing field and share learnings from the perspective of a parent, a coach and an athlete. The curriculum was delivered through keynote, panel speakers and roundtable discussions.

Summit speakers included:

Dr. Andrée-Anne Ledoux spoke to the group in order to set the stage around:

A copy of Dr. Ledoux’s very informative keynote presentation is available for consultation.

Learning Resource from the Ottawa Concussion Summit

In order to ensure the educational material is available to all members of Ottawa Community Sport Organizations, and thus provide a capacity increase to an audience beyond the Ottawa Sport Summit participants, a video eLearning module was developed from the presentations and panel discussions.

Concussion continues to be a very hot topic in sport these days. In fact, the Governor General spent a full day in December 2016 hosting a conference with former professional athletes, Olympic and Paralympic athletes, the medical community, and the sport community at large, discussing concussions in sport and how we can do better for Canadian youth to play safe and continue to get involved in sport and physical activity. The recording of the day’s sessions can be accessed through the CPAC broadcast of the Conference on Concussions in Sport.

What do we need to know about concussions?

A concussion is an injury that is caused by the brain being shaken around inside the skull after a hit, bump or blow to the head, or a sudden jerking of the head or neck when the body is hit. There is a misconception that you have to be knocked out to sustain a concussion, when in fact any contact to the head or body that causes rapid head movement can cause a concussion.

Common symptoms may include (but aren’t limited to): headache, dizziness, being in a daze, nausea, sensitivity to light/noise, confusion, memory problems, and/or loss of consciousness. Any athlete who is suspected to have a concussion should be removed from play and seen by a medical professional. Treatment of concussion may take some time and will include medical treatment, rest and a gradual progression of returning to school/work and to physical activities. Athletes should be symptom free before returning to activity.

SIRC resources on Concussion:

After Concussion: Student-athletes Return-to-Learn (Blog)

Need to Know Facts about Concussions (Blog)

Concussion Resources page

Apps on Concussion Education/Awareness

The best defence is to keep yourself knowledgeable about head impacts and concussions. There are many resources out there that can help educate and promote awareness. The following apps are great Canadian resources that can help athletes, parents, teachers, coaches and the public at large better understand concussions and their impacts on daily life.

Created by Parachute, Concussion Ed is designed to give Canadians free access to critical concussion resources. This free mobile app was primarily developed for youth, parents and educators, but covers concussions throughout different scenarios for a wide audience. Available in English and French, Concussion Ed is organized into Prevent, Recognize, Manage and Track.

Parachute worked under the guidance of its Expert Advisory Committee and with selected members from the Canadian Concussion Collaborative to select relevant, evidence-based material for Concussion Ed. The development of Concussion Ed was supported by the Public Health Agency of Canada.

The Coaching Association of Canada (CAC) is committed to ensuring all sport organization partners and coaches have access to concussion awareness resources. With funding from the Public Health Agency of Canada’s Active and Safe Initiative, and in collaboration with the Canadian Centre for Ethics in Sport, Hockey Canada, and Parachute Canada, the CAC created the award-winning Making Head Way eLearning series.

These FREE Making Head Way modules educate coaches, parents, athletes, teachers, and officials on concussion prevention, signs and symptoms, management, and internationally recognized return to play protocol. The Making Head Way series was developed in consultation with medical experts Dr. Jamie Kissick, Dr. Mark Aubry, and Dr. Charles Tator and is available for small or large-scale use immediately via coach.ca. Information regarding identifying and managing concussions is constantly evolving. The CAC is committed to ensuring that our Making Headway eLearning modules are current and reflect the latest research in the area of concussion management. Proof of completion of these NCCP Professional Development modules is available publicly through the CAC’s national database upon successful completion. To date, the Making Head Way eLearning modules have been completed mo re than 22,800 times. Get Concussion Smart Today!

Hockey Canada has worked hard to eliminate head contact from the game, preventing concussions and keeping players on the ice. For us, keeping players safe is just as important as teaching players to skate, pass and shoot. To help in the prevention of concussions, Hockey Canada has created a concussion app, giving players, parents, coaches and volunteers instant access to concussion symptoms and information on how to manage a concussion.

The Hockey Canada Concussion Awareness app is a great tool for parents, coaches, trainers, players, administrators and anyone interested in learning about the prevention, recognition and response to concussion injury, including responsible return-to-play protocol.

The Hockey Canada Concussion Awareness app for kids is a great tool for parents to teach young players how to prevent concussions through respect and playing by the rules. The app explains important concussion information in an easy-to-follow manner for young players and contains an interactive game around respect starring Puckster, the official mascot of Hockey Canada. Download the app and help keep our game safe!

Developed through the BC Injury Research and Prevention Unit, the Concussion Awareness Training Tool (CATT) includes three toolkits providing training in the recognition, treatment and management of concussion for: 1) Medical Professionals; (2) Parents, Players, and Coaches; and (3) School Professionals.

CATT is free, accessible and regularly updated with evidence-based information and resources. Each toolkit includes a self-paced learning module as well as tailored resources relevant to the specific audience.

A concussion is a common head injury, also known as a Mild Traumatic Brain Injury (MTBI). It is an injury that is caused by the brain being shaken around inside the skull after a direct blow to the head, or a sudden jerking of the head or neck when the body is hit. There is a misconception that you have to be knocked out to sustain a concussion, when in fact any contact to the head or body that causes rapid head movement can cause a concussion.

Symptoms of a Concussion**:

An athlete who has had one concussion is more likely to have another than an athlete who hasn’t been concussed

– Hard Facts about Concussions, Ithaca College

 Recovering from a Concussion

Resources

Concussion is a topic that affects everyone in sport in some way whether you are a coach, athlete, trainer, physician, or director. If you wish to read more information on concussion prevention, symptoms, or recovery there are a lot of resources available to the sport community.

Here are a few links to get you started:

**This is not intended to be a comprehensive list, anyone that is suspected to have a concussion should always be seen by a medical professional.

Concussion is one of those topics in sport that has been increasing in prevalence over the last few years. It is most likely that concussion injuries have existed for a long time, however, the awareness of their symptoms, presentation and management have been largely hidden from the mainstream. High profile athletes who have shared their experience of concussion have helped to create a groundswell of awareness around the seriousness of concussion’s short term and long term effects on individuals, their sporting career and their everyday life. Researchers and medical professionals continue to study this phenomena to better understand concussion and recommend treatment and management practices. In October 2016 the Concussion in Sport Group reconvened for their 5th International Conference on Concussion in Sport and published in April, the 2017 Concussion in Sport Group (CSIG) consensus statement. The stated intention of the consensus document is to develop further conceptual understanding of sport-related concussion (SRC) and is meant for physicians and healthcare providers caring for athletes at all levels (recreational, elite, or professional).

While the full version of the consensus statement as well as the accompanying systematic reviews should be consulted for full understanding of the suggestions for clinical practice, some of the key points of this version of the consensus statement that have changed from the previous versions can be summarized as follows:

  • Recognize and Remove – One of the most important factors for anyone involved in sport is supporting athlete health by erring on the side of caution, by recognizing (coaches, teammates, parents, support staff, etc.) situations where an athlete may have experienced head trauma and removing that athlete from practice or play to be further assessed by qualified medical professionals.
  • Multifaceted Assessment – While there are many common symptoms of concussion, a multifaceted approach to assessment should be taken to evaluate the athlete’s condition. The updated Sport Concussion Assessment Tool – 5th Edition (SCAT5) is most effectively used by medical professionals immediately after injury to differentiate between concussed and non-concussed athletes. For children 12 years of age and younger the Child SCAT5 should be used. The CSIG also has provided a general tool, the Concussion Recognition Tool 5, that will help all those involved in sport identify concussion in children, adolescents and adults. Note that it is not intended as a diagnostic tool, but solely to identify suspected concussions.
  • 24-48 Hours of Rest – The CSIG indicates that there is no evidence that complete rest until symptoms resolve is required. Rather rest (physical and cognitive) during the acute stage (24-48 hours) is necessary with gradual and progressive activity encouraged as long activity doesn’t bring on or worsen symptoms.
  • Recovery – While individual circumstances and physiology result in diverse experiences of concussion, most adults generally recover in 10-14 days and most children in 4 weeks. The timeline for recovery for those who experience persistent symptoms is very difficult to predict. “The strongest and most consistent predictor of slower recovery from SRC is the severity of a person’s initial symptoms in the first day, or initial few days, after injury”. Those that have a pre-injury history or who are susceptible to migraines are at greater risk for a longer recovery time.
  • Gradual Return to Learn/Work and Return to Sport Strategy – Return to school/work should precede return to sport. However, early research suggests that both protocols can be run concurrently as long as it is a gradual and progressive reintroduction of either cognitive or physical activity and as long as symptoms do not recur and/or worsen. Schools are encouraged to have concussion policies in place for teachers, staff, students and parents so that proper academic accommodations and support are available.
  • Rehabilitation – Treatment and rehabilitation should address all facets of concussion recovery and may include physical therapy, cognitive therapy and/or behavioural therapy. Currently there is limited evidence to support the use of pharmacotherapy.
  • Widespread, routine use of baseline testing is not supported – While baseline testing may have a role as one of many tools in evaluating concussions, research is still being conducted to validate its use.
  • Long term consequences of concussion – Researchers admit that there is still much to be learned in terms of the long term problems such as cognitive impairment, depression, behavioural inconsistencies, etc. for athletes suffering both singular or repetitive brain traumas. Occurrence of chronic traumatic encephalopathy (CTE) is a real consideration for athletes, however, the cause-and-effect relationship has not been clearly established and more research is required.
  • Concussion prevention strategies can reduce the number and severity of concussions in many sports – Evidence that helmets can reduce the risk of concussion is limited in many sports because of the differing regulations however, the reduction of overall head injuries in sports such as skiing and snowboarding is supported through evidence. Evidence of mouthguard use in preventing SRC is mixed, but there is a non-significant trend of a protective effect in collision sports. There is strong and consistent evidence that removal of body checking in youth ice hockey reduces the risk of concussion. Early evidence shows that there might be promise in the use of vision training to help reduce frequency of head contact. In general there needs to be more research done to examine the effectiveness of other concussion-reducing initiatives in sport (eg. Tackle training without helmets or shoulder pads, tackle training in rugby, red card rules for elbowing in soccer, fair play rules in hockey, etc.).

The body of evidence and evaluation around sport related concussions has increased over the last few decades and has distinguished itself from other sources of brain injury and concussion mostly since it provides a unique opportunity to study the phenomena. However, the study of all traumatic brain injuries advances the management of the field in general. Being educated and aware of sport related concussion is still the best way to help athletes continue to engage in safe sport.

In December of 2011, 10 medical organizations led by the Canadian Academy of Sport and Exercise Medicine (CASEM) and the Canadian Medical Association (CMA) along with the Canadian Centre for Ethics in Sport (CCES) and the then Think First (now Parachute Canada) came together with a primary overall mandate to address growing needs of medical practitioners and their patients in Canada on the area of concussion.  The objective was to provide and develop resources to educate the physician on the recognition, treatment and management of concussion and optimize the care of patients with concussion – out of that meeting, the Canadian Concussion Collaborative (CCC) was born.

 In December of 2014, the member organizations agreed by consensus that membership of the CCC would be widened to include regulated and national health and healthcare organizations with a significant role in the prevention, treatment and management of concussion and its mandate was also widened to ensure the CCC became a resource for not only physicians but for all Canadians.

The mission of the Canadian Concussion Collaborative (CCC) is to create synergy between health organisations concerned with concussions to improve education about concussions, and the implementation of best practices for the prevention and management of concussions. The CCC is composed of members from the following organizations: Canadian Association of Emergency Physicians (CAEP) Canadian Association of Occupational Therapists (CAOT) Canadian Athletic Therapists Association (CATA) Canadian Center for Ethics in Sports (CCES) Canadian Chiropractic Association (CCA) Canadian Medical Association (CMA) Canadian Neurosurgical Society (CNSS) Canadian Paediatric Society (CPS) Canadian Physiotherapy Association (CPA) Canadian Psychological Association (CPA) College of Family Physicians of Canada (CFPC) National Emergency Nurses Association (NENA) Ontario Medical Association Sport Medicine Section (OMA) Parachute (includes the former Think First) Royal College of Chiropractic Sports Sciences (Canada) (RCCSS(C)) and is chaired by the Canadian Academy of Sport and Exercise Medicine (CASEM).

Key documents out of the 5th international conference on concussion in sport:

Key Resources from the CCC on Concussions in Sport

These key messages were developed by the Canadian Concussion Collaborative (June 2017).

This document is intended for any group or organisation aiming to adapt and implement a concussion management policy or protocol in a specific sport or context (school-based and non school-based).

These resources include articles, educational videos, posters, position statements and website resources from CCC member organizations on concussion in sport.

These resources include toolkits, articles, guidelines, online learning modules, and resources created by Canadian organizations for the Canadian public to learn more about concussions.

For all the resources including the Ministry of Education of Ontario and the Government of Ontario’s policies and legislation about concussion in Canada check out the Canadian Concussion Collaborative website. Concussion research and consensus is constantly in flux, as such the CCC continues to monitor and update their resources as new information comes forward.

The growth in knowledge of the potential impact of concussion in recent years has prompted a demand for sports organizations across Canada to work with experts in health and health care to enhance the safety of athletes. One example of this is the collaboration between the Greater Toronto Hockey League (GTHL), the largest hockey league in the world, and Toronto’s Holland Bloorview Kids Rehabilitation Hospital’s concussion centre.  Together they have teamed up for five years to create a first-of-its-kind, integrated concussion strategy to enhance minor hockey player safety. In just one year of the collaboration, the GTHL is already seeing significant changes in concussion awareness and reporting culture among its athletes, and there is more to come.

LEAGUE-WIDE CHANGES

Since 2013, Holland Bloorview’s concussion centre has been conducting innovative research in the field of pediatric concussion and providing evidence-based services for concussion management. At the same time, the demand to translate this knowledge to the sport community soared, especially in the GTHL. The organization was using a return-to-play policy that needed to be updated and supported by the appropriate training and education of volunteers. The need to implement a comprehensive concussion policy in Canada became evident and the GTHL was one of the first to take the lead in this regard.

With expertise from Holland Bloorview, the GTHL was able to launch their new concussion policy prior to the start of the 2016-2017 hockey season. The new policy and protocol made it mandatory for all GTHL players with a suspected concussion to be seen by a physician for diagnosis and medical clearance before getting back in the game. This ensured players were receiving proper diagnosis and followed a gradual return in a hockey-specific environment. Players were also able to see their progress through clear guidelines in the return-to play-protocol, which broke down the recovery process into a series of steps. The idea was to add safe and manageable activity levels; seeing how a player responds, and if all went well, progressively adding more.

The innovative policy involved the collaborative work of medical professionals, coaches, trainers, and families to make sure players were supported in every step of recovery so they could return to their favourite game happy, healthy, and ready to play. One of the critical pieces of the implementation was the fact that all 1,200 coaches and trainers involved with the GTHL’s competitive teams received mandatory training from Holland Bloorview; including education on how to prevent, identify, and manage concussions, as well as their specific role within the new concussion policy. 

 “When it comes to concussion, players, parents, coaches and trainers are looking for direction and support. Thoughtful collaborations between youth sport organizations, health care providers, and researchers can be a real-game changer in making sure that the policies created are relevant and meaningful to everyone,” says Dr. Nick Reed, clinician scientist and co-director of Holland Bloorview’s concussion centre.

LEADING THE WAY

This unique initiative didn’t stop at policy change and education. The two partners also engaged 939 coaches and trainers to participate in concussion research that involved completing a survey prior to and after the training sessions to learn about stakeholders’ baseline concussion knowledge, attitudes and practices in hockey. These surveys will be repeated every few years to provide insight into how a sports partnership with a health care organization can influence change over an established period of time, and help inform future concussion education efforts in sports nationally and internationally.

Today, the GTHL is leading the way in how they are executing on a comprehensive concussion strategy in minor sports. A year into the league changes and training, the GTHL has seen significant improvements in concussion awareness and reporting. During the 2015-2016 season, under the former policy, a total of 105 concussions were reported. This year, 352 suspected concussions were reported throughout the season – an increase of 235 per cent. This indicates that greater education and policy implementation is leading to behaviour change in concussion reporting. More players with a concussion are now following evidence-based protocols through physician diagnosis, gradual return-to-play protocols, and medical clearance from physicians before returning to contact play.

“This collaboration truly delivers an innovative, world-class concussion strategy across the entire GTHL,” says Scott Oakman, executive director and chief operating officer of the GTHL.

LOOKING INTO THE FUTURE

Establishing itself as a leader in the Canadian minor sports scene doesn’t stop there for the GTHL. In partnership with Holland Bloorview, the minor hockey league has started to conduct leading-edge concussion research by measuring the impact of policy change and mandatory education on the league in the 2017-2018 season. Currently, the research is exploring the concussion injuries that have occurred in the GTHL before and after policy implementation to provide guidance for further research and injury-prevention strategies. Additional research will also measure changes in concussion knowledge, attitudes, and practices of coaches and trainers before and after concussion education, as well as changes over the next five years of the partnership. This will help evaluate their effectiveness in improving the identification and management of concussion injury in minor hockey for all future players.

Far too often, kids and those involved at the youth and grassroots sports level are overlooked with respect to concussion support and policy development.  With creative collaborations that are designed to meet the unique concussion-related needs specific to youth athletes and those involved in youth sport, the future is bright.  Together, we can promote safer sport experiences for all youth and keep kids engaged in being active and having fun.

************************************

Greater Toronto Hockey League (GTHL)

Founded in 1911, the Greater Toronto Hockey League (GTHL) is a non-profit organization and the largest minor hockey league in the world. The GTHL registers more than 40,000 annual participants in Mississauga, Toronto, Markham and Vaughan.

Holland Bloorview Kids Rehabilitation Hospital

Holland Bloorview Kids Rehabilitation Hospital is Canada’s largest children’s rehabilitation hospital, fully affiliated with the University of Toronto. We pioneer treatments, technologies, therapies and real-world programs that give children with disabilities the tools to participate fully in life. Holland Bloorview’s concussion centre is one of the first in the world dedicated exclusively to pediatric concussion. The centre includes clinicians specifically trained in pediatric brain injury and researchers who are leading experts in the field of youth concussion care, research, and education. It is focused on getting kids back to doing what they need, want and love to do after sustaining a concussion. For more information, visit hollandbloorview.ca.

Most athletes, competitive through recreational, experience injury in their sport at some time. There are many practitioners out there who can help heal the physical symptoms of the injury from the family doctor to the physical therapist. But dealing with the physical side of injury is only half the battle. What we cannot forget to address is the importance of healing the mind of the injured athlete. So what kinds of things do injured athletes feel and how can we as athletes, teammates, coaches, parents and friends aid the recovery process?

Many things can influence the way a person feels about their injury such as: the severity of the injury, previous injuries, their position on a team, their family and friends, and the type of sport they play. Girls often experience greater injury anxiety than boys. All of these factors combine together to leave the athlete dealing not only with the injury itself but a whole host of fears and insecurities. A player may experience fear about feeling left-out of the team activities with other teammates progressing while they are away. They may feel that they are letting themselves and their teammates down. Some may feel that they will lose their place on the team with prolonged absence. Many may have a fear regarding their ability to return to their pre-injury skill level or re-injuring themselves. Some athletes have trouble with their self-esteem and self-worth, wondering who they are if they cannot be the athlete they are used to being.

Common psychological factors that contribute to an athlete’s concerns about returning to sport:

So what can we do to help an injured athlete through their recovery? As coaches, parents, teammates, and friends we can support an injured athlete in many ways. First of all, it is important that we understand what they are feeling by having them talk about their fears. It is also important to find out how much support and what kind of support the athlete wants. We can involve the athlete and provide them with feelings of control by helping them imagine and plan a healthy and successful recovery and return to participation. We can help them maintain their confidence by continuing to train those parts of their body that they still can. We can provide them with tangible and progressive physical challenges to meet along their road to recovery. We can also provide them with meaningful opportunities to interact with their teammates.

Tips to help athletes cope with injuries:

After injury and the following recovery, the goal for most athletes is to get back on the field as soon as possible; however returning to sport after an injury is not always a clear cut process and many factors need to be considered before the choice is made. The combination of both physical rehabilitation and psychological interventions working together helps to reduce recovery time, improve coping skills, and prevents re-injury anxiety. With this multifaceted approach there is a greater likelihood that an athlete will make a smoother and quicker transition from injury, recovery, and back to training and competition. If you are a coach or athletic trainer and feel you are not equipped to deal with the psychological aspects of recovery, it’s a good idea to refer your athlete to a professional that can help them get back on track. By addressing the mental aspects of injury and recovery, an athlete is much more likely to have healthy and productive return to the sport they enjoy so much. And after all, that is what success is all about!

Knowing what to eat and when to eat for sports can seem like a science. Don’t let all the information out there leave you frazzled and hungry. For the everyday athlete a little preparation can make it very simple!

The phrase “you are what you eat” is true. Nutrition can play a key role in the final minutes of a game or race. Over time the body becomes fatigued during exercise. In order for muscles to contract properly water, carbohydrates and sodium are needed. Maintaining a healthy diet, eating high-carbohydrate meals leading up to competition, maintaining proper fuel throughout performance and planning for recovery nourishment is essential.

What does this all mean? Studies recommend that a light, high-carbohydrate meal be consumed 3-hours before the event. This can include cereal with fruit, pasta, sandwiches or fruit salad with yogurt. One hour before the event consume a high-carbohydrate snack like fruit, yogurt, cereal bars or a sports drink. During the event keep hydrated and consume carbohydrates such as water combined with energy gels, a sports drink depending on the intensity and duration of your exertion. If you are concerned with stomach cramps or gastrointestinal upset (like diarrhea) go for a liquid meal like a fruit smoothie or orange juice.

Finally, don’t forget recovery. It is at this time the body needs fuel to restore what it has lost in order to repair muscles and prevent injury and muscle soreness. Studies show that food consumed within 30 minutes of exercising will have a significant effect on glycogen stores and muscle recovery. A snack that contains carbohydrates (restores muscle glycogen) and protein (repairs damaged muscle fibres) is suggested. This could be as easy as a peanut-butter/jam sandwich or 500ml of chocolate milk. Check out the table below for some easy suggestions to include in your nutritional planning.

Quick Guide
3 Hours Before 1 Hour Before During Recovery
Cereal with fruit Yogurt Water Peanut Butter/Jam Sandwich
Waffles with fruit and syrup Banana Sports Drink Chocolate Milk
Pasta with tomato sauce Oatmeal Energy Gels Orange Juice
Fruit salad with yogurt Cereal Bar Cut Up Energy Bar Cereal with Milk
Fruit Smoothie Sports Drink Energy Bar

The type and amount of food and liquid consumed depends on the activity the athlete has just completed, and when the next training session will be. If you have just finished an endurance event, then try to drink a smoothie, sport drink, chocolate milk, or water. Each of these drinks provides protein and/or liquid to the body which helps prevent muscle damage.

Again remember to stay hydrated! Water is an excellent choice to replace fluids especially in low intensity and short duration sports. With prolonged bouts of exercise, sports drinks can be used to replace electrolytes such as sodium or potassium.

When plotting your nutritional plan, it’s important to recognize that there is no one-size-fits-all solution. Every athlete and sport is going to require individual tweaks to find a nutrition plan that works best for them. If you want to ensure that you get the most of your recovery nutrition, first try consulting a registered dietitian or sport trainer.