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Am J Sports Med. 2018 Jul;46(9):2253-2262. doi: 10.1177/0363546518777244. Epub 2018 Jun 1.

Comparison of Head Impact Exposure Between Male and Female High School Ice Hockey Athletes.

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Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA.
School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA.
Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, USA.



Concussion incidence rates are higher among female than male athletes in sports played by both sexes. Biomechanical factors may play a role in observed sex-based differences in concussion incidence.


To compare head impact counts and magnitudes during sports participation between male and female high school ice hockey athletes.


Cohort study; Level of evidence, 2.


Over 2 seasons, a total of 21 male and 19 female ice hockey athletes from a single high school were instrumented with impact-sensing adhesive skin patches worn over the mastoid process while participating in games and practices. The impact sensors recorded the number, magnitude (peak linear acceleration [PLA, g] and peak angular acceleration [PAA, rad/s2] of the head; Head Impact Telemetry severity profile [HITsp]), and location of impacts sustained during each instrumented session. Head impact counts, magnitudes, and locations were compared between the sexes.


Males experienced more head impacts than females during games (mean ± SD: 7.7 ± 3.0 vs 5.3 ± 2.0, P < .001) as well as practices (4.3 ± 1.6 vs 3.8 ± 1.1, P = .002). Mean impact magnitudes were greater for females for PLA (18.8 g ± 1.7 g vs 17.1 g ± 1.6 g, P < .001) and HITsp (19.7 ± 1.5 vs 17.7 ± 1.4, P < .001), while mean PAA was greater for males (3057.6 ± 2.0 rad/s2 vs 2778.3 ± 2.7 rad/s2, P < .001). Female athletes experienced higher PLA, PAA, and HITsp magnitudes for the top 10%, 5%, and 1% of impacts (all P < .050). Males experienced more impacts to the front (34.3%) and back (31.7%) of the head, while females experienced more impacts to the side (43.1%) and top (4.1%) (χ2 = 295.70, df = 3, P < .001).


While male high school ice hockey athletes experienced more head impacts than females, impact magnitudes tended to be higher for females.


X-Patch; concussion; female athletes; head impact biomechanics; ice hockey

[Indexed for MEDLINE]

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