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the game changer

Hockey helmets are seen in this file photo.Peter Power/The Globe and Mail

While concussion experts prepare to gather in Switzerland next week to hammer out new international guidelines for identifying and treating the brain injury, Hockey Canada officials say parents and coaches can access the latest data via their smart phones.

The free concussion awareness apps are meant to mitigate confusion for parents and coaches when it comes to equipment, diagnosing the injury, and helping a hurt child return to sport.

"We're hoping that this is seen as a positive step in terms of making the game safer," Hockey Canada president Bob Nicholson said Thursday, when the app was unveiled in Toronto.

As Canada's national winter sport grapples with the issue of head injuries for players of all ages and levels, its governing body has been criticized for being slow to seize control of the issue. Parents fearing for a child's safety, along with the country's changing demographics, has led to stagnating enrolment rates in minor hockey, Nicholson said.

The app – which can be downloaded from the Hockey Canada website, iTunes, BlackBerry's App World or Google Play Store – was created with a federal government grant and in consultation with safety experts.

The free software answers questions such as: Can a helmet prevent a concussion? (no); do mouthguards help? (science is unclear); and what should be done if a player suffers a concussion? (Rest the brain for at least a week, see a trained doctor and make a gradual return according to a six-step protocol.)

But there are many queries the app can't answer as even top scientists are still grappling with them, said Brian Benson, a University of Calgary researcher who has worked as a team doctor for national junior hockey teams.

Benson will be among the presenters at the fourth international consensus conference on concussion in sport, to held at the FIFA headquarters in Zurich on Nov. 1 and 2. He and other researchers will share the latest findings to update the guidelines produced at the third conference, four years ago. An updated consensus statement is expected to be published in June of 2013.

Benson said some of the big issues to be tackled are fundamental ones: What is the best way to diagnose a concussion? How do you know if a player has healed?

Even with newer tools such as baseline testing and return-to-play protocols, effectiveness can vary from player to player.

"We don't have great objective tools to assess concussion and determine when a player is truly recovered from their injury. So there is a dire need in the concussion world to be better at that. And then follow it forward in time: How many concussions are too many? What's going to happen in 10 years? In 20 years? Am I going to get Alzheimer's, Parkinson's or CTE? Still, we don't have the answers for that," Benson said.

And Hockey Canada officials still aren't willing to touch one possible prevention tool: stricter rules on bodychecking.

Despite studies that have shown bodychecking can significantly increase a player's risk of concussion, Nicholson said Thursday it is more important to focus on teaching children how to check properly. Those who don't want to play in elite leagues can always opt for recreational leagues where hits are banned, he said. "I'm afraid if you don't introduce checking until 13 or 14, then the injuries could be much more serious, because they haven't done those other first steps."

Several studies, including one led by U of C researcher Carolyn Emery, showed 11- and 12-year-old athletes in leagues that allow hits are nearly four times more likely to suffer a concussion than players where the such contact is banned.

Asked about the 2010 report, which followed 2,000 pee wee players and was published in the Journal of the American Medical Association, Nicholson said: "That's one of many, many studies that we have on our plate. We haven't had enough studies of seeing what happens."