An analysis of falls experienced by a stratified population sample of 553 subjects, 65 years and over, was performed. It is estimated that one third of people 65 years and over experience one or more falls in a year. To analyse the association of physical and social variables with falls, the falls were divided into pattern falls and occasional falls. Pattern falls were those which, on history and examination, were assessed as arising from only minimal external upset and primarily from a disorder of balance or postural stability in the subject. Occasional falls were those which had arisen under circumstances which would be liable to cause a fit person to fall. Bivariate analysis showed those having pattern falls tended to have more functional disability, to have increased impairment of mobility, to use more aids to mobility, to be more depressed, to have lower mental test scores and to need more professional support. Women experiencing pattern falls also tended to be older and have poorer vision, while men had lower systolic blood pressure. Discriminant analysis showed that the principal effective 'predictors' of pattern falls in women were functional disability, the need for support services and informal help and the use of walking aids. In men they were functional disability and the need for support services and informal help.

PROSPERO 2016:CRD42016039162.

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BackgroundA 2015, Hockey Calgary body checking (BC) policy change disallowed BC from non-elite Bantam (ages 13–14, lower 60% of divisions). This was informed by evidence that disallowing BC in Pee Wee (ages 11–12) reduced the risk of injury, specifically concussion, by >3-fold.ObjectiveTo compare the frequency of type and intensity of player-to-player contacts (PC) and head contact in non-elite Bantam ice hockey games in leagues allowing BC (2014–15) compared with leagues disallowing BC (2015–16).DesignCohort study.SettingIce-hockey arenas in Calgary, Canada.ParticipantsNon-elite Bantam players in 2014–15 (n=348 players) and 2015–16 (n=309 players) seasons.InterventionsIn the 2014–15 season, non-elite Bantam leagues allowed BC. In 2015–2016, BC was disallowed.Main Outcome MeasurementsThirteen games pre-policy change (2014–2015) and 13 post-policy change were video recorded. Analysis using validated methodology was used to compare the frequency, type (i.e., trunk, head and other types of PC with limb/head/stick), and intensity (trunk contacts level 1–5 with increasing intensity) of PCs. Incidence rate ratios (IRR) were estimated using Poisson regression (controlling for cluster by team, offset by player minutes).ResultsThere were a total of 3485 trunk contacts and 1395 other contacts in 26 games. The overall risk of trunk PCs was lower post-policy change (IRR=0.50, 95% CI; 0.45–0.56). Post-policy change, high intensity (body checking - level 4,5) contacts decreased (IRR4=0.19, 95% CI; 0.13–0.26 IRR5=0.11, 95% CI; 0.03–0.51), lower intensity (level 2,3) PCs were less frequent (IRR2=0.45, 95% CI; 0.40–0.50 and IRR3=0.47, 95% CI; 0.35–0.63), and other contacts made with the limb/stick also decreased (IRR=0.60, 95% CI; 0.48–0.73). Head contact decreased (IRR=0.40, 95% CI; 0.25–0.61).ConclusionsPost-policy change disallowing BC in non-elite Bantam, incidence of high intensity (level 4,5) PCs decreased 82%. Head contact decreased 60% and stick/limbs contact decreased 40%. These findings inform the mechanisms of injury explaining concussion risk reduction post-BC policy change.

To compare physical contacts (PCs) and head contacts (HCs) in nonelite U15 (ages 13-14) and U18 (ages 15-17) ice hockey players in body checking (BC) and non-BC leagues. Design: Cohort video analysis study. Setting: Ice hockey arenas in Calgary, Canada. Participants: Players from 13 BC and 13 non-BC games at the nonelite U15 and U18 levels (n 5 52 total games). Assessment of Risk Factors: Games were videotaped and analyzed to compare PC variables between leagues allowing and prohibiting BC. Main Outcome Measures: Validated methodology for PC type (trunk PC and other types of PC with limb/stick/head), intensity (low and high intensity), and HC. Incidence rate ratios (IRRs) were estimated using Poisson regression (controlling for cluster by team game and offset by player minutes) to compare the incidence of PCs in BC and non-BC games. Results: The rate of trunk PCs was lower in the non-BC leagues for both U15 (IRR 5 0.50, 99% confidence interval [CI]: 0.43-0.58) and U18 (IRR 5 0.56, 99%

BackgroundHockey Canada’s evidence-based body checking (BC) policy change (2013) was informed by evidence that policy allowing BC in Pee Wee (11–12 year old) ice hockey players resulted in a >3-fold increased risk of injury and concussion compared with leagues where BC was not allowed.ObjectiveTo compare the frequency of type and intensity of physical contacts (PC) and head contact in elite (upper 30%) Pee Wee ice hockey games in leagues not allowing BC (2013–2014) compared with leagues allowing BC (2007–2008) using video analysis.MethodsTen elite games pre-policy change (2007–2008) and 11 elite games post-policy change (2013–2014) were video recorded and analysed using a validated methodology to compare the frequency of type (trunk and other types of PC with limb/head/stick) and intensity (trunk contacts – level 1–5 intensity) of PC and head contact. Incidence rate ratios (IRR) were estimated using Poisson regression controlling for clustering by game) to compare PC before and after the BC policy change.ResultsA total of 4409 trunk PCs and 2623 other PCs were observed. The total number of trunk PCs (IRR = 0.97, 95% CI: 0.83–1.14) and other contacts (IRR = 0.87, 95% CI: 0.59–1.29) did not change post-policy change. High intensity contacts (levels 4 and 5) were less frequent post-policy change (IRR4 = 0.13, 95% CI: 0.09–0.19 and IRR5 = 0.13, 95% CI: 0.07–0.26) and low intensity contacts (level 2) increased (IRR2 = 1.47, 95% CI: 1.21–1.79). Limb PCs decreased in 2013–14 (IRR = 0.48, 95% CI; 0.33–0.71) and there was no difference for head contacts (IRR = 0.81, 95% CI; 0.51–1.30).ConclusionsThere were no significant differences in total number of PC by study year. However, the incidence of high intensity (level 4–5) PCs decreased post -policy change. There was no significant difference in direct head contact or total number of other contacts. This will inform the development and evaluation of injury prevention and skill training strategies in youth ice hockey.

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BackgroundHockey Canada’s 2013 body checking (BC) policy change was informed by evidence that BC leads to a >3-fold increased risk of injury compared with non-BC leagues. Video analyses found a reduction in high intensity physical contacts (PC) following this policy change. The association between BC experience and incidence of PCs has not been examined. As such, the incidence of intensity and types of PC were examined following the policy change in Pee Wee (PW) leagues (ages 11–12) with (Calgary) and without (Québec) BC experience.MethodsPW games were videotaped in Calgary (N = 21, with BC experience) and Québec City (N = 20, without BC experience), both non-BC leagues. Games were analysed using Dartfish with a validated observation system to quantify incidence of PC. Five levels of intensity (trunk contacts coded Level 1–5 intensity) and other types of PC (limb/head/stick). PC incidence rates per team-game and incidence rate ratios (IRR) (95% CI) were estimated to compare games between two cohorts.ResultsIn total 4433 trunk contacts in Calgary and 2667 in Québec were recorded. Of the trunk contacts, 97.5% (Calgary) and 95.7% (Québec) were classified as low level PC. The incidence of total trunk contacts (number of contacts per team-game) was higher in Calgary than Québec (IRR = 1.58, 95% CI: 1.40–1.79). There was no difference in high intensity contacts (Level 4 [IRR = 0.72 95% CI: 0.48–1.07], Level 5 [IRR = 1.21, 95% CI: 0.57–2.56]). The incidence of other PCs was lower in Calgary than Québec (IRR = 0.71, 95% CI: 0.53–0.96).ConclusionFollowing a policy change disallowing BC, PW players with experience BC had a greater incidence of total trunk contacts but not greater high intensity contacts than players without BC experience. Players with no experience had a higher incidence of other PCs. These results inform a greater understanding of mechanisms of contact in youth ice hockey that will in turn inform injury prevention and player development.