Re-establishing and refining baseline neuropsychological test data among professional hockey players: part 1 -...

To create contemporary, culturally responsive paper-and-pencil (PnP) baseline reference values for evaluating concussed National Hockey League (NHL) players.

Players were stratified by language groups then randomly selected from club rosters to complete the NHL/NHL Players' Association (NHLPA) PnP test battery during 2022-2023 and 2023-2024 pre-season training camps (oversampling Primary Non-English Language Speakers; PNELS). The final sample consisted of 305 players: 114 Primary English Language Speakers (PELS) and 191 PNELS. Using these samples, language specific normative data were created.

Overall significant test score differences were observed between language groups on: Hopkins Verbal Learning Test-Revised (HVLT-R; HVLT-R Total, HVLT-R Delay), Symbol Digit Modality Test (SDMT)-Total Correct, Verbal Fluency, Trails B, Digit Span Forward/Backward. In contrast, Brief Visual Motor Test-Revised (BVMT-R) scores were generally consistent across language groups. Most pairwise differences were observed between PELS and PNELS players. Differences with small to medium effects were also observed between NHL 2024 Renorming data and NHL-Specific Legacy normative data collected between 1997-2000. Differences with medium to large effects were seen between PNELS reference values and published English language general population normative data.

Results underscore the importance of considering primary language fluency/preference when interpreting performance on commonly used PnP tests. Comparisons of renormed scores to legacy data suggest periodic renorming may be beneficial. Additionally, medium to large differences between PNELS and population-based English-language normative values suggest that it may not always be appropriate to use English-language normative data with individuals for whom English is not their primary/preferred language.