Thanks so much for the invitation to present to the group today on behalf of the integrated concussion research program at the University of Calgary.
Concussion is one of the most common injuries suffered by children, adolescents and young adults, with an estimated 250,000 concussions occurring each year in Canada. While the majority of individuals recover in the days to weeks following concussion, up to 30% suffer symptoms and functional difficulties that last for more than one month.
Concussion can lead to reduced participation in sport and recreational activities, increase the risk of overweight and obesity, and ultimately increase the risk of chronic disease. Alternatively, staying physically active across the lifespan has many known benefits. Ultimately, the collaborative aim of our program is to minimize the public health impact of concussion across the lifespan through scientific discovery and evidence-informed practice and policy regarding concussion.
The ICRP is a university-wide initiative at the University of Calgary that includes experts from kinesiology, arts and the Cumming School of Medicine, with support from the Alberta Children's Hospital Research Institute and the Hotchkiss Brain Institute. Concussion is a heterogeneous injury, and an interdisciplinary approach is imperative. For example, we we have many different researchers and clinicians who work together, each of whom have different areas of expertise as part of our collaborative team. Many of our researchers are also clinicians and collaborate to answer critical questions, thus creating a very unique environment and leading to groundbreaking research and clinical work.
The research success and impact at the University of Calgary is also a testament to our strong and sustained clinical, community, industry, education and sport partnerships; national and international collaboration; and our robust training and education programs for the generation of researchers in concussion. The ICRP addresses concussion across the spectrum of injury and includes critical research questions related to prevention, diagnosis, prognosis, mechanism of injury and rehabilitation. I will share with you a couple of highlights of our research program.
With regard to prevention, ultimately, if we can prevent concussions from happening in the first place, we will decrease the public health burden from concussion. Over a decade of concussion prevention research and sustained partnerships with the hockey community—including Hockey Canada, Hockey Calgary, B.C. Hockey and others—has characterized the work of my colleague Dr. Carolyn Emery, chair of the sport injury prevention research centre at the University of Calgary.
As a result of her work, an evidence-informed bodychecking policy change occurred nationally in 2013. A 70% reduction in the risk of concussion was found following a national bodychecking policy change disallowing bodychecking in the peewee age group, which is 11- and 12-year-olds. This translates to an estimated reduction per year of 580 concussions in Alberta and 4,800 concussions in Canada among 11- and 12-year-olds alone. She was also the lead author on the systematic review evaluating the prevention of concussion that informed the fifth international consensus on concussion in sport.
Another example of policy change that's been informed by our research was also presented at the fifth international consensus conference on concussion in sport in the sport of volleyball. One of my undergraduate students, Derek Meeuwisse, worked with Volleyball Canada on a survey that showed that 15% of concussions were actually happening in the warm-up, when players ran under the net to go and get the ball. Volleyball Alberta made a rule change to no longer allow players to run under the net. That was subsequently instituted by Volleyball Canada at the youth national championships last year and will be done again this year. That's the largest youth sport competition, with over 10,000 volleyball athletes.
Speaking more recently, Dr. Emery is the lead principal investigator on a pan-Canadian research program funded by the NFL scientific advisory board. Collaborating with 17 ICRP researchers at the University of Calgary, 25 researchers from nine other Canadian universities, sport organizations, educators and multidisciplinary clinical teams at each site, we will complete a research program entitled “SHRED concussions”, or surveillance in high school to reduce concussions and their consequences. The pan-Canadian research program will enrol 6,000 students participating in high-risk concussion sports in 60 high schools from five provinces across Canada, and will follow them for three years. The research will target the prevention, detection, diagnosis, prognosis and management of sport concussion in youth.
On diagnosis, researchers at the University of Calgary are evaluating new tools to diagnose concussion, including novel neuroimaging, robotics and fluid biomarkers.
On prognosis, a multidisciplinary research team is working to identify factors that will predict prolonged recovery following concussion in children to inform targeted treatment strategies that will reduce the consequences of concussion. Dr. Yeates leads that program, an A-CAP study.
On mechanism, there are many innovations across animal and human models that will inform mechanisms of concussion and recovery.
On rehabilitation, our group works collaboratively to identify and optimize the management of concussion. Some of the research I have led has shown that youth and young adults who are treated with a combination of treating the neck and the balance systems were 10 times more likely to get medically cleared to return to sport within an eight-week time period compared with the people who weren't treated.
Other examples include evaluation of physical activity and sleep therapies to assist with recovery from concussion. We have a number of different studies looking at combinations of treatment as well.
I led the research for the systematic review on the effects of rest and treatment that informed the 5th consensus on concussion in sport.
We're also working with Alberta Health Services' strategic clinical networks, with funding through Alberta Health Services and Brain Canada, and with Dr. Keith Yeates, who leads our integrated concussion research program and is testing the effectiveness of a clinical pathway for pediatric concussion in the emergency department. The pathway includes a novel web portal that families can use to obtain evidence-based information about concussion and to track recovery.
Other highlights include leading the development of a massive, open online course in concussion. I checked on my way here today. We have over 4,200 people registered so far. We also have a number of our program group who were involved in the 5th international consensus on concussion in sport. I was part of the scientific committee, and we'll be doing so again for the 6th consensus. Dr. Emery and I led two of the systematic reviews and we've been involved in tools that were outputs from the meeting, such as the concussion recognition tool and the SCAT5.
