Selective head-neck cooling after concussion shortens return-to-play in ice hockey players

Anna Gard, Yelverton Tegner, Mohammad Fazel Bakhsheshi, Niklas Marklund, Anna Gard, Yelverton Tegner, Mohammad Fazel Bakhsheshi, Niklas Marklund

Abstract

We aimed to investigate whether selective head-neck cooling could shorten recovery after sports-related concussions (SRCs). In a nonrandomized study of 15 Swedish professional ice hockey teams, 29 concussed players received immediate head and neck cooling for ≥30 min (initiated at 12.3 ± 9.2 min post-SRC by a portable cooling system), and 52 SRC controls received standard management. Players receiving head-neck cooling had shorter time to return-to-play than controls (7 vs 12.5 days, p < 0.0001), and 7% in the intervention group versus 25% in the control group were out of play for ≥3 weeks (p = 0.07). Immediate selective head-neck cooling is a promising option in the acute management of SRC that should be addressed in larger cohorts.

Keywords: brain temperature; concussion; hypothermia; ice hockey; return to play; selective head–neck cooling; sports-related concussion; traumatic brain injury.

Conflict of interest statement

Financial & competing interests disclosure Centrum för idrottsforskning, 2020-0116. Regional funds from the Skåne University Hospital, 2018-Projekt0081. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

© 2021 Niklas Marklund and co authors.

Figures

Figure 1.. Consort flow diagram.
Figure 1.. Consort flow diagram.
Figure 2.. Selective head-neck cooling system.
Figure 2.. Selective head-neck cooling system.
(A) The PolarCap® System is a high-powered portable cooling system. (B) The PolarCap® Coolant flows through a silicone-based head cap. (C) An insulating neoprene cover is put on top of the cap to isolate the cold.
Figure 3.. Concussions per team.
Figure 3.. Concussions per team.
Figure 4.. Previous concussions.
Figure 4.. Previous concussions.
Number of previous concussion (number/player) in the control and intervention (head–neck cooling) groups. Mean value is indicated by a larger gray dot. There were no differences between the groups.
Figure 5.. Return to play.
Figure 5.. Return to play.
Figure 6.. Core and subdermal forehead temperatures.
Figure 6.. Core and subdermal forehead temperatures.

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