Changes in measures of cervical, vestibular, dynamic balance and tasks of divided attention following sport-related concussions in elite youth ice hockey players

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To evaluate acute changes in measures of cervical spine, vestibulo-ocular reflex (VOR) function, dynamic balance and tasks of divided attention in elite youth ice hockey players following a sport-related concussion.

Study Design

Prospective Case series


Sport Medicine Centre, Calgary, Alberta, Canada


Five hundred and fifty-nine (474 males) elite (AA and AAA) Bantam (13-14 years) and Midget (15-17 years) youth ice hockey players.

Outcome measures

Clinical measurements including cervical flexor endurance test (CFE), head perturbation test, head thrust test, dynamic visual acuity (DVA) (clinical and computerised), Functional Gait Assessment (FGA) and Walking While Talking (WWTT) test at baseline and acutely following concussion.

Main results

Sixty-nine of 97 (71%) players completed both baseline and acute post concussion measures for their first concussion and were included in these analyses. Following concussion, neck pain, headache and dizziness increased in 42%, 58% and 40% of participants respectively. After Bonferroni corrections (α=0.00625), using Wilcoxon Signed-Rank Test, cervical spine measures were significantly worse following concussion compared to baseline [cervical flexor endurance test (z=−5.195, p<0.001) and head perturbation test (z=−4.631, p<0.001)]. Time to complete a complex task of divided attention (WWTT) relative to their normal walking speed was longer than baseline (z=−2.762, p=0.0057). There was no change in DVA or FGA following concussion.


Measures of cervical spine function and tasks of divided attention were worse following concussion. However, tests of VOR and dynamic balance were not significantly different than at baseline. Future research to evaluate the mechanism underlying these changes is warranted.

Competing interests


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