Brain tissue analysis of impacts to American football helmets

Physiological and Biomechanical Monitoring in American Football Players: A Scoping Review

American football is the sport with the highest rates of concussion injuries. Biomedical engineering applications may support athletes in monitoring their injuries, evaluating the effectiveness of their equipment, and leading industrial research in this sport. This literature review aims to report on the applications of biomedical engineering research in American football, highlighting the main trends and gaps. The review followed the PRISMA guidelines and gathered a total of 1629 records from PubMed (n = 368), Web of Science (n = 665), and Scopus (n = 596). The records were analyzed, tabulated, and clustered in topics. In total, 112 studies were selected and divided by topic in the biomechanics of concussion (n = 55), biomechanics of footwear (n = 6), biomechanics of sport-related movements (n = 6), the aerodynamics of football and catch (n = 3), injury prediction (n = 8), heat monitoring of physiological parameters (n = 8), and monitoring of the training load (n = 25). The safety of players has fueled most of the research that has led to innovations in helmet and footwear design, as well as improvements in the understanding and prevention of injuries and heat monitoring. The other important motivator for research is the improvement of performance, which has led to the monitoring of training loads and catches, and studies on the aerodynamics of football. The main gaps found in the literature were regarding the monitoring of internal loads and the innovation of shoulder pads.

Analysis of HIC and Hydrostatic Pressure in the Human Head during NOCSAE Tests of American Football Helmets

Brain damage is a serious economic and social burden. Contact sports such as American football, are one of the most common sources of concussions. The biomechanical response of the head-helmet system caused by dynamic loading plays a major role. The literature has focused on measuring the resultant kinematics that act on the head and helmet during tackles. However, few studies have focused on helmet validation tests, supported by recent findings and emerging numerical approaches. The future of helmet standards could benefit from insights at the level of injury mechanisms, using numerical tools to assess the helmets. Therefore, in this work, a numerical approach is employed to investigate the influence of intracranial pressure (ICP) on brain pathophysiology during and after helmeted impacts, which are common in American football. The helmeted impacts were performed at several impact locations according to the NOCSAE standard (configurations A, AP, B, C, D, F, R, UT). In order to evaluate the ICP levels, the αHEAD finite element head and brain model was combined with a Hybrid III-neck structure and then coupled with an American football helmet to simulate the NOCSAE impacts. In addition, the ICP level was analyzed together with the resulting HIC value, since the latter is commonly used, in this application and others, as the injury criterion. The obtained results indicate that ICP values exceed the common threshold of head injury criteria and do not correlate with HIC values. Thus, this work raises concern about applying the HIC to predict brain injury in American football direct head impacts, since it does not correlate with ICP predicted with the FE head model.

In vivo estimates of axonal stretch and 3D brain deformation during mild head impact

The rapid deformation of brain tissue in response to head impact can lead to traumatic brain injury. In vivo measurements of brain deformation during non-injurious head impacts are necessary to understand the underlying mechanisms of traumatic brain injury and compare to computational models of brain biomechanics. Using tagged magnetic resonance imaging (MRI), we obtained measurements of three-dimensional strain tensors that resulted from a mild head impact after neck rotation or neck extension. Measurements of maximum principal strain (MPS) peaked shortly after impact, with maximal values of 0.019-0.053 that correlated strongly with peak angular velocity. Subject-specific patterns of MPS were spatially heterogeneous and consistent across subjects for the same motion, though regions of high deformation differed between motions. The largest MPS values were seen in the cortical gray matter and cerebral white matter for neck rotation and the brainstem and cerebellum for neck extension. Axonal fiber strain (Ef) was estimated by combining the strain tensor with diffusion tensor imaging data. As with MPS, patterns of Ef varied spatially within subjects, were similar across subjects within each motion, and showed group differences between motions. Values were highest and most strongly correlated with peak angular velocity in the corpus callosum for neck rotation and in the brainstem for neck extension. The different patterns of brain deformation between head motions highlight potential areas of greater risk of injury between motions at higher loading conditions. Additionally, these experimental measurements can be directly compared to predictions of generic or subject-specific computational models of traumatic brain injury.

Describing headform pose and impact location for blunt impact testing

Reproduction of anthropomorphic test device (ATD) head impact test methods is a critical element needed to develop guidance and technologies that reduce the risk for brain injury in sport. However, there does not appear to be a consensus for reporting ATD pose and impact location for industry and researchers to follow. Thus, the purpose of this article is to explore the various methods used to report impact location and ATD head pose for sport-related head impact testing and provide recommendations for standardizing these descriptions. A database search and exclusion process identified 137 articles that met the review criteria. Only 4 of the 137 articles provided a description similar to the method we propose to describe ATD pose and impact location. We thus propose a method to unambiguously convey the impact location and pose of the ATD based on the sequence, quantifiable design, and articulation of ATD mount joints. This reporting method has been used to a limited extent in the literature, but we assert that adoption of this method will help to standardize the reporting of ATD headform pose and impact location as well as aid in the replication of impact test protocols across laboratories.

Vulnerable locations on the head to brain injury and implications for helmet design

In studying traumatic brain injury (TBI), it has been long hypothesized that the head is more vulnerable to injury from impacts in certain directions or locations, as the relationship between impact force and the resulting neurological outcome is complex and can vary significantly between individual cases. Many studies have identified head angular acceleration to be the putative cause of brain trauma, but it is not well understood how impact location can affect the resulting head kinematics and tissue strain. Here, we identify the susceptibility of the head to accelerations and brain strain from normal forces at contact points across the surface of the skull and jaw using a 3-dimensional, 20 degree-of-freedom rigid-body head and cervical spine model. We find that head angular acceleration and brain tissue strain resulting from an input force can vary by orders of magnitude based on impact location on the skull, with the mandible as the most vulnerable region. Conversely, head linear acceleration is not sensitive to contact location. Using these analyses, we present an optimization scheme to distribute helmet padding thickness to minimize angular acceleration, resulting in a reduction of angular acceleration by an estimated 25% at the most vulnerable contact point compared to uniform thickness padding. This work gives intuition behind the relationship between input force and resulting brain injury risk, and presents a framework for developing and evaluating novel head protection gear.