Re-establishing and refining baseline neuropsychological test data among professional hockey players: part 2 regression-based adjustment of neuropsychological norms in professional hockey

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OBJECTIVE: To determine whether a regression-based approach provides a more appropriate normative framework for professional hockey players after accounting for estimated overall cognitive ability, language proficiency or acculturation, and baseline performance on other cognitive measures. METHODS: Players were randomly selected from club rosters to complete the National Hockey League/National Hockey League Players' Association (NHL/NHLPA) paper and pencil (PnP) concussion battery and English Proficiency Questionnaire (EPQ) during 2022-2023 and 2023-2024 pre-season camps (oversampling Primary Non-English Language Speakers; PNELS). The final sample consisted of 305 players: 114 Primary English Language Speakers (PELS) and 191 PNELS. Age, estimates of premorbid function, baseline Immediate Post-concussion Assessment and Cognitive Testing (ImPACT), Sport Concussion Assessment Tool® (SCAT), and EPQ data were included as predictors of PnP performance in regression models. RESULTS: Regression-based models accounted for 15%-34% of the variance in PnP test performance among PELS and between 13%-39% of variance in PnP performance among PNELS. CONCLUSION: Regression modeling allows for a more precise calculation of normative data in professional hockey. This approach may be more sensitive to subtle changes in cognitive functioning by accounting for baseline cognition, estimated premorbid abilities, and English language proficiency/acculturation.

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