Subcommittee on Sports-Related Concussions in Canada committee  There is some literature to suggest that full face protection could potentially reduce the severity of injury, but that literature is limited, so we definitely need more in that area. Also, we don't know what that threshold might actually look like—how many Gs of force we need to actually have a concussion happen and whether that changes per person.

Subcommittee on Sports-Related Concussions in Canada committee  This could also mean doing coordinated activities around educating Canadians about concussions. There are already a lot of organizations that do some of this type of work. We're involved in a lot of this type of work ourselves as well. Making sure there's a coordinated effort at this particular time will actually get the attention of Canadians so that we have people focusing on it.

Subcommittee on Sports-Related Concussions in Canada committee  In terms of trying to facilitate making things mandatory, tying an organization's funding to having met certain requirements is one way to do that. These things are not necessarily going to take up too much of the organization's time and effort, but they are going to have a big payoff in the end for the athletes, as well as the coaches, the team, the staff, and everyone involved in this.

Subcommittee on Sports-Related Concussions in Canada committee  You mentioned a preventative measure, but my first comment is going to be about management and some of the research I'm doing right now. I mentioned that we're doing some exercises to help people get back to their normal functioning, and one of the areas we focus on is the strengthening of the neck and neck exercises, because even if it's not part of the concussion injury itself, you often see that co-occurring with the injury of concussion, where somebody has issues around their neck, the neck muscles and something going on there.

Subcommittee on Sports-Related Concussions in Canada committee  Of course, at the same time, certain individuals, certain women and girls may not have.... One woman could have better neck musculature than a male, so it's important to look at gender and sex and all those factors as well.

Subcommittee on Sports-Related Concussions in Canada committee  At this point, in terms of management, I don't know that we have enough information to say that this is the way we're going to manage for females versus males, but there are particular considerations that can be applied to everybody and that might be particularly useful for one or the other.

Subcommittee on Sports-Related Concussions in Canada committee  Also, in terms of looking at prevention but at the same time at management, we purposefully made our suggestions comprehensive and across the board, because it's important to do things like tracking, looking at prevention and doing all those things. People are still going to get concussions, and we obviously have people who have concussions already.

Subcommittee on Sports-Related Concussions in Canada committee  Yes, it's a challenge across a lot of health research fields not to have representation of females in the research. Females may respond differently to the injury or may have different pre-existing factors. We need to know whether there is a difference and, if so, what we need to do about that.

Subcommittee on Sports-Related Concussions in Canada committee  At this time, for example, we know that some of the research is suggesting that maybe females do have a different experience in terms of symptoms and so on. There is research to say that we should be looking at this further, for sure. There is some research to say that females might experience more symptoms and so on, but there are other considerations that we need to take.

Subcommittee on Sports-Related Concussions in Canada committee  Thank you.

Subcommittee on Sports-Related Concussions in Canada committee  The first of these is a national concussion awareness week. This would help us improve education and awareness in the general population across the country.

Subcommittee on Sports-Related Concussions in Canada committee  The final one is a governmental concussion board. This would be useful for evaluation and accountability, but also for continuity. Canada has a unique position where we actually have this amazing opportunity to become leaders in the concussion policy landscape, but also to be proactive in terms of reducing the risk of concussions through prevention and promoting the well-being of our citizens, and we call upon our government to do so.

Subcommittee on Sports-Related Concussions in Canada committee  Thank you for the question. I'll respond in English. We agree that a culture change is needed across the board. There are many ways and many areas in which to do that. For example, at the level of professional sports, we need to see a change in culture of the way sport is played, the way we look at what “sports” means, from athletes' perspectives, coaches' perspectives and the teams' perspectives, but also the perspectives of fans and how we consume sports, as well as the media.

Subcommittee on Sports-Related Concussions in Canada committee  If you look at evidence-based change as well, there are theories in the literature in terms of how we can actually make this change. If we're thinking about intention or behaviour change, what are the other factors around that in terms of what we need to do? What are the norms and attitudes and all these types of factors that we need to look at before we expect change to actually happen?

Subcommittee on Sports-Related Concussions in Canada committee  Next, we're recommending that the government encourage sport organizations to mandate that all athletes, as well as coaches, referees and other team staff, complete concussion management education. We also believe that it's imperative to have support for concussion management research, as knowledge in this area can help us better understand how to improve outcomes and how to reduce the recovery times, as well as improve the injury experience itself.