Evaluating Performance of National Hockey League Players After a Concussion Versus Lower Body Injury

Abstract

Context Concussions elicit changes in brain function that may extend well beyond clinical symptom recovery. Whether these changes produce meaningful deficits outside the laboratory environment is unclear. The results of player performance postconcussion within professional sports have been mixed. Objective To determine whether National Hockey League (NHL) players with concussions performed worse after returning to sport than players with lower body injuries or uninjured players. Design Cohort study. Setting Publicly available Web sites that compiled injury and player statistics of NHL players. Patients or Other Participants Male NHL players who missed games due to a concussion (n = 22), lower body injury (n = 21), or noninjury (ie, personal reason or season break; n = 13) during the 2013–2014 and 2014–2015 regular seasons. Data on concussed athletes were used to identify similar players with lower body injury and noninjury based on (1) position, (2) time loss, (3) time on the ice, and (4) team. Main Outcome Measure(s) The primary performance metric was a modified plus-minus statistic calculated by weighting the players' plus-minus metric by their team's simple rating system to account for varying team performances. Linear mixed models assessed the relationship between injury type (concussion, lower body, or noninjury) and performance (plus-minus score). Results We observed a quadratic effect for a time2 × group interaction (\upchi _2^2 = 8.85, P = .01). This interaction revealed that the concussion and lower body injury groups had similar patterns of an initial decrease (ie, 2 weeks after return to play), followed by an increase in performance compared with the uninjured group in weeks 5 and 6. Meanwhile, the uninjured group had an initial increase in performance. We observed no group × linear time interaction (P = .47) or overall group effect (P = .57). Conclusions The NHL players in the concussion and lower body injury groups displayed similar performance impairments. Both injured cohorts experienced an initial decrease in performance at weeks 1 to 2 after return to play, followed by improved performance at weeks 5 to 6 after return to play, suggesting that the performance implications of concussion may be short lived.

Return‐to‐performance in elite soccer players after Achilles tendon ruptures: a study using a weighted plus/minus metric and matched‐control analysis

“…Players suffering from ATRs exhibited a return to similar performance levels as measured by a weighted PM metric. Although PM metrics have been mainly used in sports analytics, e.g., in basketball and ice hockey [ 15 ], their use in assessing return-to-performance following injury has also been reported [ 1 , 32 ]. Nevertheless, PM metrics have been criticized for being too simplistic, and, thus, “adjusted” versions of these metrics have also been proposed, e.g., to account for the strengths of teammates or whether the player is in the home or away team.…”

Performance After Concussion in National Hockey League Players

“…It is important to note that over an 82-game season, a 2.5-point difference likely has minimal significance. Van Pelt et al 12 compared player performance data from the 2013 through 2015 seasons in players who experienced SRCs versus those with lower body orthopaedic injuries. They found similar decreases in performance for those with SRCs and lower body injuries in the first 1 to 2 weeks after return to play that improved to baseline by 5 to 6 weeks.…”

Game Spacing and Density in Relation to the Risk of Injuries in the National Hockey League

“… 5 This is problematic, as injuries can have major consequences, particularly at the professional level. In the NHL, varying injuries have been shown to have both short- 21 and long-term 3 , 12 , 18 impairments on player performance after return to play. For individual players, injuries can result in a reduction in games played and decreased financial compensation.…”