Project Summary/Abstract: Ice hockey is a collision/contact sport with a high rate of injury. Body checking, where an athlete intentionally collides with an opponent to gain possession of the puck is a critical component of play in boys’ and men’s hockey. Although body checking is not allowed in women’s and girls’ hockey, it is still considered a contact sport; male and female hockey athletes share comparable rates of concussion. Recent evidence suggests that exposure to subconcussive head impacts, even in the absence of clinically-diagnosed concussion is sufficient to cause alterations in brain microstructure and cognitive function. Assessments of postural control have been used to aid diagnosis of concussion, and evidence suggest that such assessments are sensitive enough to detect subclinical injury. To date, no studies have evaluated individual-level performance (athlete skill) as a determinant of head impact exposure. Future interventions could target skill development in an effort to improve sport safety, particularly at the youth level. However, accurate quantification of head impact exposure and the relationship it shares with individual performance metrics and clinical postural control deficits is necessary before interventions can be implemented. The objective of this study is to use a mouthpiece-sensor for measurement of head impact exposure in male and female youth hockey athletes and evaluate the relationships between cumulative exposure, individual performance metrics, and postural control deficits. The study team identified in this proposal has extensive history in quantifying head impact exposure in youth sports and in evaluating clinical outcomes. A well-developed research and mentorship plan has been prepared for the successful completion of the following aims. In Aim 1, 32 boys’ and 32 girls’ youth hockey athletes will complete a pre- and post-season assessment of ice hockey performance. Youth athletes will be instrumented with a custom mouthpiece sensor to wear during the season. All on-ice sessions will be recorded and reviewed to identify characteristics of head impacts. We will quantify impact frequency and magnitude for each impact. In Aim 2, instrumented youth athletes will undergo a pre- and post-season postural control assessment. Changes in postural control measures from pre- to post- season will be evaluated for correlation with on-ice head impact exposure and youth athlete performance metrics. Successful completion of this research will elucidate previously undescribed relationships between head impact exposure, youth athlete performance metrics, and postural control deficits. Future intervention studies can utilize this research to design strategies aimed at improving youth athlete performance to reduce exposure, which in turn may decrease postural control deficits. This research could ultimately serve as an early advancement towards policy change that will improve youth hockey safety and mitigate risk of brain inju...