1
|
Gellner RA, Begonia MT, Wood M, Rockwell L, Geiman T, Jung C, Rowson S. Instrumented Mouthguard Decoupling Affects Measured Head Kinematic Accuracy. Ann Biomed Eng 2024:10.1007/s10439-024-03550-9. [PMID: 38955890 DOI: 10.1007/s10439-024-03550-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/20/2024] [Indexed: 07/04/2024]
Abstract
Many recent studies have used boil-and-bite style instrumented mouthguards to measure head kinematics during impact in sports. Instrumented mouthguards promise greater accuracy than their predecessors because of their superior ability to couple directly to the skull. These mouthguards have been validated in the lab and on the field, but little is known about the effects of decoupling during impact. Decoupling can occur for various reasons, such as poor initial fit, wear-and-tear, or excessive impact forces. To understand how decoupling influences measured kinematic error, we fit a boil-and-bite instrumented mouthguard to a 3D-printed dentition mounted to a National Operating Committee on Standards for Athletic Equipment (NOCSAE) headform. We also instrumented the headform with linear accelerometers and angular rate sensors at its center of gravity (CG). We performed a series of pendulum impact tests, varying impactor face and impact direction. We measured linear acceleration and angular velocity, and we calculated angular acceleration from the mouthguard and the headform CG. We created decoupling conditions by varying the gap between the lower jaw and the bottom face of the mouthguard. We tested three gap conditions: 0 mm (control), 1.6 mm, and 4.8 mm. Mouthguard measurements were transformed to the CG and compared to the reference measurements. We found that gap condition, impact duration, and impact direction significantly influenced mouthguard measurement error. Error was higher for larger gaps and in frontal (front and front boss) conditions. Higher errors were also found in padded conditions, but the mouthguards did not collect all rigid impacts due to inherent limitations. We present characteristic decoupling time history curves for each kinematic measurement. Exemplary frequency spectra indicating characteristic decoupling frequencies are also described. Researchers using boil-and-bite instrumented mouthguards should be aware of their limitations when interpreting results and should seek to address decoupling through advanced post-processing techniques when possible.
Collapse
Affiliation(s)
- Ryan A Gellner
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA.
| | - Mark T Begonia
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Matthew Wood
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Lewis Rockwell
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Taylor Geiman
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Caitlyn Jung
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Steve Rowson
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| |
Collapse
|
2
|
Gellner R, Begonia M, Rowson S. Choosing Optimal Cutoff Frequencies for Filtering Linear Acceleration and Angular Velocity Signals Associated with Head Impacts Measured by Instrumented Mouthguards. Ann Biomed Eng 2024; 52:1415-1424. [PMID: 38403749 PMCID: PMC10995032 DOI: 10.1007/s10439-024-03466-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/31/2024] [Indexed: 02/27/2024]
Abstract
Head impact sensors worn in the mouth are popular because they couple directly to the teeth and provide six-degree-of-freedom head measurements. Mouthpiece signal filters have conventionally used cutoff frequencies lower than recommended practices (Society of Automotive Engineers, SAE J211-1) to eliminate extraneous noise when measuring with live subjects. However, there is little information about the effects of filter choice on the accuracy of signals measured by instrumented mouthpieces. Lack of standardization in head impact measurement device post-processing techniques can result in data that are not comparable across studies or device brands. This study sought optimal filter cutoff frequencies for six-degree-of-freedom measurements made at the teeth using instrumented mouthguards. We collected linear acceleration and angular velocity signals at the head center of gravity (CG) using laboratory-grade instrumentation. We also collected and filtered similar six-degree-of-freedom measurements from an instrumented mouthguard using 24 cutoff frequencies, from 25 to 600 Hz. We transformed the measurements to linear acceleration at the center of gravity of the head (CG) using all kinematic variables at the teeth, optimizing linear and angular mouthguard cutoff frequencies with one equation. We calculated the percent error in transformed peak resultant linear acceleration and minimized the mean and standard deviation in error. The optimal cutoff frequencies were 175 Hz for linear acceleration and 250 Hz for angular velocity. Rigid impacts (3-5 ms duration) had higher optimal cutoff frequencies (175 Hz linear acceleration, 275 Hz angular velocity) than padded impacts (10-12 ms duration; 100 Hz linear acceleration, 175 Hz angular velocity), and all impacts together (3-12 ms duration; 175 Hz linear acceleration, 250 Hz angular velocity). Instrumented mouthpiece manufacturers and researchers using these devices should consider these optimal filter cutoff frequencies to minimize measurement error. Sport-specific filter criteria for teeth-based sensors may be warranted to account for the difference in optimal cutoff frequency combination by impact duration.
Collapse
Affiliation(s)
- Ryan Gellner
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA.
| | - Mark Begonia
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Steve Rowson
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| |
Collapse
|
3
|
Huber CM, Patton DA, Rownd KR, Patterson Gentile C, Master CL, Arbogast KB. Neurophysiological Effects of Repeated Soccer Heading in Youth. J Biomech Eng 2023; 145:091005. [PMID: 37216312 PMCID: PMC10259471 DOI: 10.1115/1.4062423] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 04/12/2023] [Indexed: 05/24/2023]
Abstract
Repeated head loading in sports is associated with negative long-term brain health, and there is growing evidence of short-term neurophysiological changes after repeated soccer heading. The objective of this study was to quantify the head kinematics and effects of repetitive soccer headers in adolescents using an instrumented mouthguard. Adolescent soccer players aged 13-18 years were randomly assigned to a kicking control, frontal heading, or oblique heading group. Participants completed neurophysiological assessments at three-time points: immediately prior to, immediately after, and approximately 24 h after completing 10 headers or kicks. The suite of assessments included the Post-Concussion Symptom Inventory, visio-vestibular exam, King-Devick test, modified Clinical Test of Sensory Interaction and Balance with force plate sway measurement, pupillary light reflex, and visual evoked potential. Data were collected for 19 participants (17 male). Frontal headers resulted in significantly higher peak resultant linear acceleration (17.4 ± 0.5 g) compared to oblique headers (12.1 ± 0.4 g, p < 0.001), and oblique headers resulted in significantly higher peak resultant angular acceleration (frontal: 1147 ± 45 rad/s2, oblique: 1410 ± 65 rad/s2, p < 0.001). There were no neurophysiological deficits for either heading group or significant differences from controls at either post-heading timepoint, and therefore, a bout of repeated headers did not result in changes in the neurophysiological measures evaluated in this study. The current study provided data regarding the direction of headers with the goal to reduce the risk of repetitive head loading for adolescent athletes.
Collapse
Affiliation(s)
- Colin M. Huber
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104; Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA 19146
| | - Declan A. Patton
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA 19146
| | - Kathryn R. Rownd
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA 19146
| | - Carlyn Patterson Gentile
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA 19146; Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Christina L. Master
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA 19146; Sports Medicine and Performance Center, The Children's Hospital of Philadelphia, Philadelphia, PA 19104; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Kristy B. Arbogast
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA 19146; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| |
Collapse
|
4
|
Jones CM, Austin K, Augustus SN, Nicholas KJ, Yu X, Baker C, Chan EYK, Loosemore M, Ghajari M. An Instrumented Mouthguard for Real-Time Measurement of Head Kinematics under a Large Range of Sport Specific Accelerations. SENSORS (BASEL, SWITZERLAND) 2023; 23:7068. [PMID: 37631606 PMCID: PMC10457941 DOI: 10.3390/s23167068] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Head impacts in sports can produce brain injuries. The accurate quantification of head kinematics through instrumented mouthguards (iMG) can help identify underlying brain motion during injurious impacts. The aim of the current study is to assess the validity of an iMG across a large range of linear and rotational accelerations to allow for on-field head impact monitoring. METHODS Drop tests of an instrumented helmeted anthropometric testing device (ATD) were performed across a range of impact magnitudes and locations, with iMG measures collected concurrently. ATD and iMG kinematics were also fed forward to high-fidelity brain models to predict maximal principal strain. RESULTS The impacts produced a wide range of head kinematics (16-171 g, 1330-10,164 rad/s2 and 11.3-41.5 rad/s) and durations (6-18 ms), representing impacts in rugby and boxing. Comparison of the peak values across ATD and iMG indicated high levels of agreement, with a total concordance correlation coefficient of 0.97 for peak impact kinematics and 0.97 for predicted brain strain. We also found good agreement between iMG and ATD measured time-series kinematic data, with the highest normalized root mean squared error for rotational velocity (5.47 ± 2.61%) and the lowest for rotational acceleration (1.24 ± 0.86%). Our results confirm that the iMG can reliably measure laboratory-based head kinematics under a large range of accelerations and is suitable for future on-field validity assessments.
Collapse
Affiliation(s)
- Chris M. Jones
- Sports and Wellbeing Analytics, Swansea SA7 0AJ, UK; (K.A.)
- Institute of Sport and Exercise Health (ISEH), Division Surgery Interventional Science, University College London, London W1T 7HA, UK
| | - Kieran Austin
- Sports and Wellbeing Analytics, Swansea SA7 0AJ, UK; (K.A.)
- Institute of Sport, Nursing and Allied Health, University of Chichester, Chichester PO19 6PE, UK
| | - Simon N. Augustus
- Department of Applied and Human Sciences, Kingston University London, London KT1 2EE, UK
| | | | - Xiancheng Yu
- HEAD Lab, Dyson School of Design Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; (X.Y.)
| | - Claire Baker
- HEAD Lab, Dyson School of Design Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; (X.Y.)
| | - Emily Yik Kwan Chan
- HEAD Lab, Dyson School of Design Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; (X.Y.)
| | - Mike Loosemore
- Institute of Sport and Exercise Health (ISEH), Division Surgery Interventional Science, University College London, London W1T 7HA, UK
- English Institute of Sport, Manchester M11 3BS, UK
| | - Mazdak Ghajari
- HEAD Lab, Dyson School of Design Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; (X.Y.)
| |
Collapse
|
5
|
Patton DA, Huber CM, Fedonni D, Margulies SS, Master CL, Arbogast KB. Quantifying head impact exposure, mechanisms and kinematics using instrumented mouthguards in female high school lacrosse. Res Sports Med 2023; 31:772-786. [PMID: 35195503 PMCID: PMC9921769 DOI: 10.1080/15438627.2022.2042294] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 02/08/2022] [Indexed: 10/19/2022]
Abstract
Current debate exists regarding the need for protective headwear in female lacrosse. To inform this issue, the current study quantified head impact exposure, mechanisms and kinematics in female lacrosse using instrumented mouthguards. A female high school varsity lacrosse team of 17 players wore the Stanford Instrumented Mouthguard (MiG) during 14 competitive games. Video footage was reviewed to remove false-positive recordings and verify head impacts, which resulted in a rate of 0.32 head impacts per athlete-exposure. Of the 31 video-confirmed head impacts, 54.8% were identified as stick contacts, 38.7% were player contacts and 6.5% were falls. Stick contacts had the greatest peak head kinematics. The most common impact site was the side of the head (35.5%), followed by the face/jaw (25.8%), forehead (6.5%), and crown (6.5%). Impacts to the face/jaw region of the head had significantly (p < 0.05) greater peak kinematics compared to other regions of the head, which may have resulted from the interaction of the impacting surface, or the lower jaw, and the sensor. The current study provides initial data regarding the frequency, magnitude and site of impacts sustained in female high school lacrosse. A larger sample size of high quality head impact data in female lacrosse is required to confirm these findings.
Collapse
Affiliation(s)
- Declan A Patton
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Colin M Huber
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Daniele Fedonni
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Susan S Margulies
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Christina L Master
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Sports Medicine and Performance Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kristy B Arbogast
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
6
|
Arbogast KB, Funk JR, Solomon G, Crandall J. Measuring Head Acceleration Like a CHAMP. J Athl Train 2023; 58:283-284. [PMID: 36521167 PMCID: PMC11215641 DOI: 10.4085/1062-6050-0516.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Affiliation(s)
- Kristy B. Arbogast
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, and Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | | | - Gary Solomon
- Player Health and Safety Department, National Football League, New York, NY
| | | |
Collapse
|
7
|
Schmidt JD, Johnson RS, Lempke LB, Anderson M, Le RK, Lynall RC. Youth Tackle Football Head-Impact Estimation by Players and Parents: Is the Perception the Reality? J Athl Train 2023; 58:285-292. [PMID: 35475900 PMCID: PMC11215644 DOI: 10.4085/1062-6050-0560.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT With growing concerns surrounding exposure to head impacts in youth tackle football, players and parents must understand the exposure level when assenting and consenting to participate. OBJECTIVE To determine whether youth football players and parents could estimate on-field head-impact frequency, severity, and location. DESIGN Prospective cohort study. SETTING Football field. PATIENTS OR OTHER PARTICIPANTS We administered a 10-question head-impact estimation tool to parents (n = 23; mean age = 36.5 years [95% CI = 31.7, 37.3 years]) and players (n = 16 boys; mean age = 11.1 years [95% CI = 10.3, 11.8 years]). MAIN OUTCOME MEASURE(S) Player on-field head-impact exposure was captured using the Triax SIM-G system. We determined the accuracy between player and parent estimates relative to on-field head-impact exposures using κ and weighted κ values. RESULTS Youth tackle football players and parents did not accurately estimate on-field head-impact frequency (κ range = -0.09 to 0.40), severity (κ range = -0.05 to 0.34), or location (κ range = -0.30 to 0.13). Players and parents overestimated head-impact frequency in practices but underestimated the frequency in games. Both groups overestimated head-impact severity, particularly in games. Most players and parents underestimated the number of head impacts to the top of the head, particularly during practices. CONCLUSIONS Underestimations of head-impact frequency in games and to the top of the head suggest that informed consent processes aimed at educating players and parents should be improved. Overestimations of head-impact frequency in practices and severity may explain declining rates of youth tackle football participation.
Collapse
Affiliation(s)
- Julianne D. Schmidt
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens
| | - Rachel S. Johnson
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens
| | - Landon B. Lempke
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens
| | - Melissa Anderson
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens
| | - Rachel Khinh Le
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens
| | - Robert C. Lynall
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens
| |
Collapse
|
8
|
Rowson B, Duma SM. A Review of Head Injury Metrics Used in Automotive Safety and Sports Protective Equipment. J Biomech Eng 2022; 144:1140295. [PMID: 35445266 DOI: 10.1115/1.4054379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Indexed: 11/08/2022]
Abstract
Despite advances in the understanding of human tolerances to brain injury, injury metrics used in automotive safety and protective equipment standards have changed little since they were first implemented nearly a half-century ago. Although numerous metrics have been proposed as improvements over the ones currently used, evaluating the predictive capability of these metrics is challenging. The purpose of this review is to summarize existing head injury metrics that have been proposed for both severe head injuries, such as skull fractures and traumatic brain injuries (TBI), and mild traumatic brain injuries (mTBI) including concussions. Metrics have been developed based on head kinematics or intracranial parameters such as brain tissue stress and strain. Kinematic metrics are either based on translational motion, rotational motion, or a combination of the two. Tissue-based metrics are based on finite element model simulations or in vitro experiments. This review concludes with a discussion of the limitations of current metrics and how improvements can be made in the future.
Collapse
Affiliation(s)
- Bethany Rowson
- Institute for Critical Technology and Applied Science (ICTAS), Virginia Tech, 437 Kelly Hall, 325 Stanger Street, Blacksburg, VA 24061
| | - Stefan M Duma
- Institute for Critical Technology and Applied Science (ICTAS), Virginia Tech, 410H Kelly Hall, 325 Stanger Street, Blacksburg, VA 24061
| |
Collapse
|
9
|
Consensus Head Acceleration Measurement Practices (CHAMP): Study Design and Statistical Analysis. Ann Biomed Eng 2022; 50:1346-1355. [PMID: 36253602 PMCID: PMC9652215 DOI: 10.1007/s10439-022-03101-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/06/2022] [Indexed: 11/28/2022]
Abstract
Head impact measurement devices enable opportunities to collect impact data directly from humans to study topics like concussion biomechanics, head impact exposure and its effects, and concussion risk reduction techniques in sports when paired with other relevant data. With recent advances in head impact measurement devices and cost-effective price points, more and more investigators are using them to study brain health questions. However, as the field's literature grows, the variance in study quality is apparent. This brief paper aims to provide a high-level set of key considerations for the design and analysis of head impact measurement studies that can help avoid flaws introduced by sampling biases, false data, missing data, and confounding factors. We discuss key points through four overarching themes: study design, operational management, data quality, and data analysis.
Collapse
|
10
|
Consensus Head Acceleration Measurement Practices (CHAMP): Laboratory Validation of Wearable Head Kinematic Devices. Ann Biomed Eng 2022; 50:1356-1371. [PMID: 36104642 PMCID: PMC9652295 DOI: 10.1007/s10439-022-03066-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/25/2022] [Indexed: 12/15/2022]
Abstract
Wearable devices are increasingly used to measure real-world head impacts and study brain injury mechanisms. These devices must undergo validation testing to ensure they provide reliable and accurate information for head impact sensing, and controlled laboratory testing should be the first step of validation. Past validation studies have applied varying methodologies, and some devices have been deployed for on-field use without validation. This paper presents best practices recommendations for validating wearable head kinematic devices in the laboratory, with the goal of standardizing validation test methods and data reporting. Key considerations, recommended approaches, and specific considerations were developed for four main aspects of laboratory validation, including surrogate selection, test conditions, data collection, and data analysis. Recommendations were generated by a group with expertise in head kinematic sensing and laboratory validation methods and reviewed by a larger group to achieve consensus on best practices. We recommend that these best practices are followed by manufacturers, users, and reviewers to conduct and/or review laboratory validation of wearable devices, which is a minimum initial step prior to on-field validation and deployment. We anticipate that the best practices recommendations will lead to more rigorous validation of wearable head kinematic devices and higher accuracy in head impact data, which can subsequently advance brain injury research and management.
Collapse
|
11
|
Blythman R, Saxena M, Tierney GJ, Richter C, Smolic A, Simms C. Assessment of deep learning pose estimates for sports collision tracking. J Sports Sci 2022; 40:1885-1900. [DOI: 10.1080/02640414.2022.2117474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Richard Blythman
- V-SENSE, School of Computer Science and Statistics(SCSS), Trinity College Dublin, Dublin, Ireland
| | - Manan Saxena
- School of Engineering, Trinity College Dublin, Dublin, Ireland
| | | | | | - Aljosa Smolic
- V-SENSE, School of Computer Science and Statistics(SCSS), Trinity College Dublin, Dublin, Ireland
| | - Ciaran Simms
- School of Engineering, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
12
|
Jones B, Tooby J, Weaving D, Till K, Owen C, Begonia M, Stokes KA, Rowson S, Phillips G, Hendricks S, Falvey ÉC, Al-Dawoud M, Tierney G. Ready for impact? A validity and feasibility study of instrumented mouthguards (iMGs). Br J Sports Med 2022; 56:bjsports-2022-105523. [PMID: 35879022 DOI: 10.1136/bjsports-2022-105523] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Assess the validity and feasibility of current instrumented mouthguards (iMGs) and associated systems. METHODS Phase I; four iMG systems (Biocore-Football Research Inc (FRI), HitIQ, ORB, Prevent) were compared against dummy headform laboratory criterion standards (25, 50, 75, 100 g). Phase II; four iMG systems were evaluated for on-field validity of iMG-triggered events against video-verification to determine true-positives, false-positives and false-negatives (20±9 player matches per iMG). Phase III; four iMG systems were evaluated by 18 rugby players, for perceptions of fit, comfort and function. Phase IV; three iMG systems (Biocore-FRI, HitIQ, Prevent) were evaluated for practical feasibility (System Usability Scale (SUS)) by four practitioners. RESULTS Phase I; total concordance correlation coefficients were 0.986, 0.965, 0.525 and 0.984 for Biocore-FRI, HitIQ, ORB and Prevent. Phase II; different on-field kinematics were observed between iMGs. Positive predictive values were 0.98, 0.90, 0.53 and 0.94 for Biocore-FRI, HitIQ, ORB and Prevent. Sensitivity values were 0.51, 0.40, 0.71 and 0.75 for Biocore-FRI, HitIQ, ORB and Prevent. Phase III; player perceptions of fit, comfort and function were 77%, 6/10, 55% for Biocore-FRI, 88%, 8/10, 61% for HitIQ, 65%, 5/10, 43% for ORB and 85%, 8/10, 67% for Prevent. Phase IV; SUS (preparation-management) was 51.3-50.6/100, 71.3-78.8/100 and 83.8-80.0/100 for Biocore-FRI, HitIQ and Prevent. CONCLUSION This study shows differences between current iMG systems exist. Sporting organisations can use these findings when evaluating which iMG system is most appropriate to monitor head acceleration events in athletes, supporting player welfare initiatives related to concussion and head acceleration exposure.
Collapse
Affiliation(s)
- Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Leeds Rhinos, Leeds, UK
- Human Biology, University of Cape Town, Division of Exercise and Sports Medicine, Cape Town, South Africa
- School of Science and Technology, University of New England, Armidale, New South Wales, Australia
| | - James Tooby
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
| | - Dan Weaving
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
| | - Kevin Till
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
- Leeds Rhinos, Leeds, UK
| | - Cameron Owen
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
| | - Mark Begonia
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
| | - Keith A Stokes
- Department for Health, University of Bath, Bath, UK
- Rugby Football Union, Twickenham, UK
| | - Steven Rowson
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
| | - Gemma Phillips
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Hull Kingston Rovers, Hull, UK
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
- Human Biology, University of Cape Town, Division of Exercise and Sports Medicine, Cape Town, South Africa
| | - Éanna Cian Falvey
- World Rugby, World Rugby, Dublin, Ireland
- Department of Medicine, University College Cork, Cork, Ireland
| | - Marwan Al-Dawoud
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University, Leeds, UK
| | | |
Collapse
|
13
|
Bertocci G, Smalley C, Brown N, Dsouza R, Hilt B, Thompson A, Bertocci K, McKinsey K, Cory D, Pierce MC. Head biomechanics of video recorded falls involving children in a childcare setting. Sci Rep 2022; 12:8617. [PMID: 35597795 PMCID: PMC9124183 DOI: 10.1038/s41598-022-12489-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/11/2022] [Indexed: 12/04/2022] Open
Abstract
The objective of this study was to characterize head biomechanics of video-recorded falls involving young children in a licensed childcare setting. Children 12 to < 36 months of age were observed using video monitoring during daily activities in a childcare setting (in classrooms and outdoor playground) to capture fall events. Sensors (SIM G) incorporated into headbands worn by the children were used to obtain head accelerations and velocities during falls. The SIM G device was activated when linear acceleration was ≥ 12 g. 174 video-recorded falls activated the SIM G device; these falls involved 31 children (mean age = 21.6 months ± 5.6 SD). Fall heights ranged from 0.1 to 1.2 m. Across falls, max linear head acceleration was 50.2 g, max rotational head acceleration was 5388 rad/s2, max linear head velocity was 3.8 m/s and max rotational head velocity was 21.6 rad/s. Falls with head impact had significantly higher biomechanical measures. There was no correlation between head acceleration and fall height. No serious injuries resulted from falls—only 1 child had a minor injury. In conclusion, wearable sensors enabled characterization of head biomechanics during video-recorded falls involving young children in a childcare setting. Falls in this setting did not result in serious injury.
Collapse
Affiliation(s)
- Gina Bertocci
- Department of Bioengineering, University of Louisville, Louisville, KY, USA.
| | - Craig Smalley
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Nathan Brown
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Raymond Dsouza
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Bret Hilt
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Angela Thompson
- Engineering Fundamentals Department, University of Louisville, Louisville, KY, USA
| | - Karen Bertocci
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Keyonna McKinsey
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Danielle Cory
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Mary Clyde Pierce
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
| |
Collapse
|
14
|
Daly E, Esser P, Griffin A, Costello D, Servis J, Gallagher D, Ryan L. Development of a Novel Coaching Platform to Improve Tackle Technique in Youth Rugby Players: A Proof of Concept. SENSORS (BASEL, SWITZERLAND) 2022; 22:3315. [PMID: 35591003 PMCID: PMC9105744 DOI: 10.3390/s22093315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/20/2022] [Accepted: 04/22/2022] [Indexed: 01/25/2023]
Abstract
Rugby union is a field sport that is played at amateur and professional levels by male and female players globally. One of the most prevalent injury risks associated with the sport involves tackle collisions with opposition players. This suggests that a targeted injury reduction strategy could focus on the tackle area in the game. In amateur rugby union, injuries to the head, face and shoulder are the most common injury sites in youth rugby playing populations. A suboptimal tackle technique may contribute to an increased injury risk in these populations. One proposed mitigation strategy to reduce tackle-related injuries in youth populations may be to increase tackle proficiency by coaching an effective tackle technique. The present study aimed to demonstrate a proof of concept for a tackle technique coaching platform using inertial measurement units (IMUs) and a bespoke mobile application developed for a mobile device (i.e., a mobile phone). The test battery provided a proof of concept for the primary objective of modelling the motion of a player in a tackle event. The prototype (bespoke mobile application) modelled the IMU in a 3D space and demonstrated the orientation during a tackle event. The participants simulated ten tackle events that were ten degrees above and ten degrees below the zero degree of approach, and these (unsafe tackles) were indicated by a red light on the mobile display unit. The parameters of ten degrees above and below the zero angle of approach were measured using an inclinometer mobile application. These tackle event simulations provided a real-time stream of data that displayed the angle of tackles on a mobile device. The novel coaching platform could therefore constitute part of an injury reduction strategy for amateur or novice coaches to instruct safer tackle practice in youth rugby playing populations.
Collapse
Affiliation(s)
- Ed Daly
- Department of Sport, Exercise & Nutrition, Atlantic Technological University (ATU), H91 T8NW Galway, Ireland; (E.D.); (A.G.); (D.C.); (J.S.); (D.G.)
| | - Patrick Esser
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 0BP, UK;
| | - Alan Griffin
- Department of Sport, Exercise & Nutrition, Atlantic Technological University (ATU), H91 T8NW Galway, Ireland; (E.D.); (A.G.); (D.C.); (J.S.); (D.G.)
| | - Damien Costello
- Department of Sport, Exercise & Nutrition, Atlantic Technological University (ATU), H91 T8NW Galway, Ireland; (E.D.); (A.G.); (D.C.); (J.S.); (D.G.)
| | - Justin Servis
- Department of Sport, Exercise & Nutrition, Atlantic Technological University (ATU), H91 T8NW Galway, Ireland; (E.D.); (A.G.); (D.C.); (J.S.); (D.G.)
| | - David Gallagher
- Department of Sport, Exercise & Nutrition, Atlantic Technological University (ATU), H91 T8NW Galway, Ireland; (E.D.); (A.G.); (D.C.); (J.S.); (D.G.)
| | - Lisa Ryan
- Department of Sport, Exercise & Nutrition, Atlantic Technological University (ATU), H91 T8NW Galway, Ireland; (E.D.); (A.G.); (D.C.); (J.S.); (D.G.)
| |
Collapse
|
15
|
Austin K, Lee BJ, Flood TR, Toombs J, Borisova M, Lauder M, Heslegrave A, Zetterberg H, Smith NA. Serum neurofilament light concentration does not increase following exposure to low velocity football heading. SCI MED FOOTBALL 2022; 5:188-194. [PMID: 35077291 DOI: 10.1080/24733938.2020.1853210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objectives: To investigate if heading frequency and impact biomechanics in a single session influence the concentration of serum neurofilament light (NF-L), a sensitive biomarker for axonal damage, up to 7 days after heading incident at ball velocities reflecting basic training drills.Methods: Forty-four males were randomized into either control (n = 8), 10 header (n = 12), 20 header (n = 12) or 40 header (n = 12) groups. Linear and angular head accelerations were quantified during heading. Venous blood samples were taken at baseline, 6 h, 24 h and 7 days after heading. Serum NF-L was quantified using Quanterix NF-L assay kit on the Simoa HD-1 Platform.Results: Serum NF-L did not alter over time (p = 0.44) and was not influenced by number of headers [p = 0.47; mean (95% CI) concentrations at baseline 6.00 pg · ml-1 (5.00-7.00 pg · ml-1); 6 h post 6.50 pg · ml-1 (5.70-7.29 pg · ml-1); 24 h post 6.07 pg · ml-1 (5.14-7.01 pg · ml-1); and 7 days post 6.46 pg · ml-1 (5.45-7.46 pg · ml-1)]. There was no relationship between percentage change in NF-L and summed session linear and angular head accelerations.Conclusion: In adult men, heading frequency or impact biomechanics did not affect NF-L response during a single session of headers at ball velocities reflective of basic training tasks.
Collapse
Affiliation(s)
- Kieran Austin
- Institute of Sport, University of Chichester, Chichester, UK
| | - Ben J Lee
- Institute of Sport, University of Chichester, Chichester, UK
| | - Tessa R Flood
- Institute of Sport, University of Chichester, Chichester, UK
| | - Jamie Toombs
- Centre for Discovery Brain Sciences, UK Dementia Research Institute, The University of Edinburgh, UK
| | - Mina Borisova
- Department of Neurodegenerative Diseases, University College London, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Mike Lauder
- Institute of Sport, University of Chichester, Chichester, UK
| | - Amanda Heslegrave
- Department of Neurodegenerative Diseases, University College London, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Henrik Zetterberg
- Department of Neurodegenerative Diseases, University College London, London, UK.,UK Dementia Research Institute at UCL, London, UK.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Neal A Smith
- Institute of Sport, University of Chichester, Chichester, UK
| |
Collapse
|
16
|
Career Head Impact Exposure Profile of Canadian University Football Players. J Appl Biomech 2022; 38:47-57. [PMID: 35045388 DOI: 10.1123/jab.2020-0228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/03/2021] [Accepted: 12/08/2021] [Indexed: 11/18/2022]
Abstract
This study quantified head impact exposures for Canadian university football players over their varsity career. Participants included 63 players from one team that participated in a minimum of 3 seasons between 2013 and 2018. A total of 127,192 head impacts were recorded from 258 practices and 65 games. The mean (SD) number of career impacts across all positions was 2023.1 (1296.4), with an average of 37.1 (20.3) impacts per game and 7.4 (4.4) impacts per practice. The number of head impacts that players experienced during their careers increased proportionally to the number of athletic exposures (P < .001, r = .57). Linebackers and defensive and offensive linemen experienced significantly more head impacts than defensive backs, quarterbacks, and wide receivers (P ≤ .014). Seniority did not significantly affect the number of head impacts a player experienced. Mean linear acceleration increased with years of seniority within defensive backs and offensive linemen (P ≤ .01). Rotational velocity increased with years of seniority within defensive backs, defensive and offensive linemen, running backs, and wide receivers (P < .05). These data characterize career metrics of head impact exposure for Canadian university football players and provide insights to reduce head impacts through rule modifications and contact regulations.
Collapse
|
17
|
Head Impact Exposure and Biomechanics in University Varsity Women's Soccer. Ann Biomed Eng 2022; 50:1461-1472. [PMID: 35041117 PMCID: PMC8765100 DOI: 10.1007/s10439-022-02914-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/01/2022] [Indexed: 11/17/2022]
Abstract
Soccer is a unique sport where players purposefully and voluntarily use their unprotected heads to manipulate the direction of the ball. There are limited soccer head impact exposure data to further study brain injury risks. The objective of the current study was to combine validated mouthpiece sensors with comprehensive video analysis methods to characterize head impact exposure and biomechanics in university varsity women’s soccer. Thirteen female soccer athletes were instrumented with mouthpiece sensors to record on-field head impacts during practices, scrimmages, and games. Multi-angle video was obtained and reviewed for all on-field activity to verify mouthpiece impacts and identify contact scenarios. We recorded 1307 video-identified intentional heading impacts and 1011 video-verified sensor impacts. On average, athletes experienced 1.83 impacts per athlete-exposure, with higher exposure in practices than games/scrimmages. Median and 95th percentile peak linear and peak angular accelerations were 10.0, 22.2 g, and 765, 2296 rad/s2, respectively. Long kicks, top of the head impacts and jumping headers resulted in the highest impact kinematics. Our results demonstrate the importance of investigating and monitoring head impact exposure during soccer practices, as well as the opportunity to limit high-kinematics impact exposure through heading technique training and reducing certain contact scenarios.
Collapse
|
18
|
Comparison of Video-Identified Head Contacts and Sensor-Recorded Events in High School Soccer. J Appl Biomech 2021; 37:573-577. [PMID: 34784581 DOI: 10.1123/jab.2021-0191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/08/2021] [Accepted: 09/16/2021] [Indexed: 11/18/2022]
Abstract
Field studies have evaluated the accuracy of sensors to measure head impact exposure using video analysis, but few have studied false negatives. Therefore, the aim of the current study was to investigate the proportion of potential false negatives in high school soccer head impact data. High school athletes (23 females and 31 males) wore headband-mounted Smart Impact Monitor-G impact sensors during competitive soccer games. Video footage from 41 varsity games was analyzed by 2 independent reviewers to identify head contact events, which were defined as visually observed contact to the head. Of the 1991 video-identified head contact events for which sensors were functioning and worn by the players, 1094 (55%) were recorded by the sensors. For female players, 45% of video-identified head contact events were recorded by the sensor compared with 59% for male players. For both females and males, sensitivity varied by impact mechanism. By quantifying the proportion of potential false negatives, the sensitivity of a sensor can be characterized, which can inform the interpretation of previous studies and the design of future studies using head impact sensors. Owing to the difficulty in obtaining ground truth labels of head impacts, video review should be considered a complementary tool to head impact sensors.
Collapse
|
19
|
Head Impact Research Using Inertial Sensors in Sport: A Systematic Review of Methods, Demographics, and Factors Contributing to Exposure. Sports Med 2021; 52:481-504. [PMID: 34677820 DOI: 10.1007/s40279-021-01574-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The number and magnitude of head impacts have been assessed in-vivo using inertial sensors to characterise the exposure in various sports and to help understand their potential relationship to concussion. OBJECTIVES We aimed to provide a comprehensive review of the field of in-vivo sensor acceleration event research in sports via the summary of data collection and processing methods, population demographics and factors contributing to an athlete's exposure to sensor acceleration events. METHODS The systematic search resulted in 185 cohort or cross-sectional studies that recorded sensor acceleration events in-vivo during sport participation. RESULTS Approximately 5800 participants were studied in 20 sports using 18 devices that included instrumented helmets, headbands, skin patches, mouthguards and earplugs. Female and youth participants were under-represented and ambiguous results were reported for these populations. The number and magnitude of sensor acceleration events were affected by a variety of contributing factors, suggesting sport-specific analyses are needed. For collision sports, being male, being older, and playing in a game (as opposed to a practice), all contributed to being exposed to more sensor acceleration events. DISCUSSION Several issues were identified across the various sensor technologies, and efforts should focus on harmonising research methods and improving the accuracy of kinematic measurements and impact classification. While the research is more mature for high-school and collegiate male American football players, it is still in its early stages in many other sports and for female and youth populations. The information reported in the summarised work has improved our understanding of the exposure to sport-related head impacts and has enabled the development of prevention strategies, such as rule changes. CONCLUSIONS Head impact research can help improve our understanding of the acute and chronic effects of head impacts on neurological impairments and brain injury. The field is still growing in many sports, but technological improvements and standardisation of processes are needed.
Collapse
|
20
|
Gabler LF, Dau NZ, Park G, Miles A, Arbogast KB, Crandall JR. Development of a Low-Power Instrumented Mouthpiece for Directly Measuring Head Acceleration in American Football. Ann Biomed Eng 2021; 49:2760-2776. [PMID: 34263384 DOI: 10.1007/s10439-021-02826-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/28/2021] [Indexed: 01/04/2023]
Abstract
Instrumented mouthpieces (IM) offer a means of measuring head impacts that occur in sport. Direct measurement of angular head kinematics is preferential for accuracy; however, existing IMs measure angular velocity and differentiate the measurement to calculate angular acceleration, which can limit bandwidth and consume more power. This study presents the development and validation of an IM that uses new, low-power accelerometers for direct measurement of linear and angular acceleration over a broad range of head impact conditions in American football. IM sensor accuracy for measuring six-degree-of-freedom head kinematics was assessed using two helmeted headforms instrumented with a custom-fit IM and reference sensor instrumentation. Head impacts were performed at 10 locations and 6 speeds representative of the on-field conditions associated with injurious and non-injurious impacts in American football. Sensor measurements from the IM were highly correlated with those from the reference instrumentation located at the maxilla and skull center of gravity. Based on pooled data across headform and impact location, R2 ≥ 0.94, mean absolute error (AE) ≤ 7%, and mean relative impact angle ≤ 11° for peak linear and angular acceleration and angular velocity while R2 ≥ 0.90 and mean AE ≤ 7% for kinematic-based injury metrics used in helmet tests.
Collapse
Affiliation(s)
- Lee F Gabler
- Biomechanics Consulting and Research, LLC, 1627 Quail Run Drive, Charlottesville, VA, 22911, USA.
| | - Nathan Z Dau
- Biomechanics Consulting and Research, LLC, 1627 Quail Run Drive, Charlottesville, VA, 22911, USA
| | - Gwansik Park
- Biomechanics Consulting and Research, LLC, 1627 Quail Run Drive, Charlottesville, VA, 22911, USA
| | - Alex Miles
- Biomechanics Consulting and Research, LLC, 1627 Quail Run Drive, Charlottesville, VA, 22911, USA
| | - Kristy B Arbogast
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, 19146, USA
| | - Jeff R Crandall
- Biomechanics Consulting and Research, LLC, 1627 Quail Run Drive, Charlottesville, VA, 22911, USA
| |
Collapse
|
21
|
Stitt D, Draper N, Alexander K, Kabaliuk N. Laboratory Validation of Instrumented Mouthguard for Use in Sport. SENSORS 2021; 21:s21186028. [PMID: 34577235 PMCID: PMC8472105 DOI: 10.3390/s21186028] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022]
Abstract
Concussion is an inherent risk of participating in contact, combat, or collision sports, within which head impacts are numerous. Kinematic parameters such as peak linear and rotational acceleration represent primary measures of concussive head impacts. The ability to accurately measure and categorise such impact parameters in real time is important in health and sports performance contexts. The purpose of this study was to assess the accuracy of the latest HitIQ Nexus A9 instrumented mouthguard (HitIQ Pty. Ltd. Melbourne Australia) against reference sensors in an aluminium headform. The headform underwent drop testing at various impact intensities across the NOCSAE-defined impact locations, comparing the peak linear and rotational acceleration (PLA and PRA) as well as the shapes of the acceleration time-series traces for each impact. Mouthguard PLA and PRA measurements strongly correlated with (R2 = 0.996 and 0.994 respectively), and strongly agreed with (LCCC = 0.997) the reference sensors. The root mean square error between the measurement devices was 1 ± 0.6g for linear acceleration and 47.4 ± 35 rad/s2 for rotational acceleration. A Bland-Altman analysis found a systematic bias of 1% for PRA, with no significant bias for PLA. The instrumented mouthguard displayed high accuracy when measuring head impact kinematics in a laboratory setting.
Collapse
Affiliation(s)
- Danyon Stitt
- Department of Mechanical Engineering, University of Canterbury, Christchurch 8041, New Zealand; (D.S.); (K.A.); (N.K.)
| | - Nick Draper
- School of Health Sciences, University of Canterbury Christchurch, Christchurch 8041, New Zealand
- Correspondence: ; Tel.: +64-3-369-3878
| | - Keith Alexander
- Department of Mechanical Engineering, University of Canterbury, Christchurch 8041, New Zealand; (D.S.); (K.A.); (N.K.)
| | - Natalia Kabaliuk
- Department of Mechanical Engineering, University of Canterbury, Christchurch 8041, New Zealand; (D.S.); (K.A.); (N.K.)
| |
Collapse
|
22
|
Le RK, Anderson MN, Johnson RS, Lempke LB, Schmidt JD, Lynall RC. On-field Characteristics and Head Impact Magnitude in Youth Tackle Football. Pediatr Neurol 2021; 121:33-39. [PMID: 34146964 DOI: 10.1016/j.pediatrneurol.2021.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study determined the effect of video-verified collision characteristics on head impact magnitudes in male youth tackle football. METHODS Participants (n = 23, age = 10.9 ± 0.3 years, height = 150.0 ± 8.3 cm, mass = 41.6 ± 8.4 kg) wore Triax Sim-G sensors throughout the fall 2019 season. Ten filmed games were used to identify nine different collision characteristics: mechanism, preparedness, head direction, struck versus striking activity, stance, play type, closing distance, penalty, and quarter. Random-effects general linear models and Cohen d effect sizes were used to examine differences in log-transformed peak linear (PLA; g) and rotational (PRA; rad/s2) accelerations across characteristics. The 10 games produced 533 total video-verified impacts and 23.2 ± 7.2 impacts per athlete. RESULTS PLA (P range: 0.107 to 0.923) and PRA (P range: 0.057 to 0.768) did not differ across characteristics. Struck players (3370 rads/s2, 95% confidence interval [CI] = 2986 to 3808) had a small effect for higher PRA compared with striking players (3037 rads/s2, 95% CI = 2713 to 3404, d = 0.251), but negligible effect for simultaneous struck-striking players (3340 rad/s2, 95% CI = 2945 to 3792, d = 0.018). Fourth quarter impacts (3490 rads/s2, 95% CI = 3083 to 3951) had a small effect for higher PRA compared with first (2945 rads/s2, 95% CI = 2596 to 3337, d = 0.404), second (3196 rads/s2, 95% CI = 2832 to 3604, d = 0.219), and third quarters (3241 rads/s2, 95% CI = 2841 to 3699, d = 0.144). CONCLUSION Youth tackle football characteristics did not significantly affect head impact magnitudes during games. More research is needed to explore additional factors that could be modified for sport safety rather than mitigating impact mechanism.
Collapse
Affiliation(s)
- Rachel K Le
- UGA Concussion Research Laboratory, Department of Kinesiology, The University of Georgia, Athens, Georgia.
| | - Melissa N Anderson
- UGA Concussion Research Laboratory, Department of Kinesiology, The University of Georgia, Athens, Georgia
| | - Rachel S Johnson
- UGA Concussion Research Laboratory, Department of Kinesiology, The University of Georgia, Athens, Georgia
| | - Landon B Lempke
- UGA Concussion Research Laboratory, Department of Kinesiology, The University of Georgia, Athens, Georgia
| | - Julianne D Schmidt
- UGA Concussion Research Laboratory, Department of Kinesiology, The University of Georgia, Athens, Georgia
| | - Robert C Lynall
- UGA Concussion Research Laboratory, Department of Kinesiology, The University of Georgia, Athens, Georgia
| |
Collapse
|
23
|
Lempke LB, Johnson RS, Le RK, Anderson MN, Schmidt JD, Lynall RC. Head Impact Biomechanics in Youth Flag Football: A Prospective Cohort Study. Am J Sports Med 2021; 49:2817-2826. [PMID: 34264780 DOI: 10.1177/03635465211026643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Youth flag football participation has rapidly grown and is a potentially safer alternative to tackle football. However, limited research has quantitatively assessed youth flag football head impact biomechanics. PURPOSE To describe head impact biomechanics outcomes in youth flag football and explore factors associated with head impact magnitudes. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS We monitored 52 player-seasons among 48 male flag football players (mean ± SD; age, 9.4 ± 1.1 years; height, 138.6 ± 9.5 cm; mass, 34.7 ± 9.2 kg) across 3 seasons using head impact sensors during practices and games. Sensors recorded head impact frequencies, peak linear (g) and rotational (rad/s2) acceleration, and estimated impact location. Impact rates (IRs) were calculated as 1 impact per 10 player-exposures; IR ratios (IRRs) were used to compare season, event type, and age group IRs; and 95% CIs were calculated for IRs and IRRs. Weekly and seasonal cumulative head impact frequencies and magnitudes were calculated. Mixed-model regression models examined the association between player characteristics, event type, and seasons and peak linear and rotational accelerations. RESULTS A total of 429 head impacts from 604 exposures occurred across the study period (IR, 7.10; 95% CI, 4.81-10.50). Weekly and seasonal cumulative median head impact frequencies were 1.00 (range, 0-2.63) and 7.50 (range, 0-21.00), respectively. The most frequent estimated head impact locations were the skull base (n = 96; 22.4%), top of the head (n = 74; 17.2%), and back of the head (n = 66; 15.4%). The combined event type IRs differed among the 3 seasons (IRR range, 1.45-2.68). Games produced greater IRs (IRR, 1.24; 95% CI, 1.01-1.53) and peak linear acceleration (mean difference, 5.69g; P = .008) than did practices. Older players demonstrated greater combined event-type IRs (IRR, 1.46; 95% CI, 1.12-1.90) and increased head impact magnitudes than did younger players, with every 1-year age increase associated with a 3.78g and 602.81-rad/s2 increase in peak linear and rotational acceleration magnitude, respectively (P≤ .005). CONCLUSION Head IRs and magnitudes varied across seasons, thus highlighting multiple season and cohort data are valuable when providing estimates. Head IRs were relatively low across seasons, while linear and rotational acceleration magnitudes were relatively high.
Collapse
Affiliation(s)
- Landon B Lempke
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia, USA.,The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Rachel S Johnson
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| | - Rachel K Le
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| | - Melissa N Anderson
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| | - Julianne D Schmidt
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| | - Robert C Lynall
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| |
Collapse
|
24
|
Liu J, Wang L, Zhou H. The Application of Human-Computer Interaction Technology Fused With Artificial Intelligence in Sports Moving Target Detection Education for College Athlete. Front Psychol 2021; 12:677590. [PMID: 34366996 PMCID: PMC8339562 DOI: 10.3389/fpsyg.2021.677590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/18/2021] [Indexed: 12/29/2022] Open
Abstract
The purposes are to digitalize and intellectualize current professional sports training and enrich the application scenarios of motion capture technology of moving targets based on artificial intelligence (AI) and human–computer interaction (HCI) in sports training. From an educational psychology perspective, sport techniques are a cognitive ability of sports, and a tacit knowledge. However, sports technology, language, image, and other methods play an auxiliary role in sports training. Here, a General Framework of Knowledge-Based Coaching System (KBCS) is proposed using the HCI technology and sports knowledge to accomplish autonomous and intelligent sports training. Then, the KBCS is applied to table tennis training. The athletic performance is evaluated quantitatively through the calculation of the sports features, motion recognition, and the hitting stage division in table tennis. Results demonstrate that the speed calculated by the position after mosaicking has better continuity after the initial frame of the unmarked segment is compared with the end frame of the market segment. The typical serve and return trajectories in three serving modes of slight-spin, top-spin, and back-spin, as well as the trajectories of common services and return errors, are obtained through the judgment of the serving and receiving of table tennis. Comparison results prove that the serving accuracy of slight-spin and back-spin is better than that of top-spin, and a lower serve speed has higher accuracy. Experimental results show that the level distribution of the three participants calculated by the system is consistent with the actual situation in terms of the quality of the ball returned and the standard of the motion, proving that the proposed KBCS and algorithm are useful in a small sample, thereby further improving the accuracy of pose restoration of athletes in sports training.
Collapse
Affiliation(s)
- Jie Liu
- Sports Training and Health Care, Zhoukou Normal University, Zhoukou, China
| | - Le Wang
- Sports Training, Zhongyuan University of Technology, Zhengzhou, China
| | - Hang Zhou
- Computer Science and Technology, Zhoukou Normal University, Zhoukou, China
| |
Collapse
|
25
|
Huber CM, Patton DA, Jain D, Master CL, Margulies SS, McDonald CC, Arbogast KB. Variations in Head Impact Rates in Male and Female High School Soccer. Med Sci Sports Exerc 2021; 53:1245-1251. [PMID: 33986230 PMCID: PMC8122001 DOI: 10.1249/mss.0000000000002567] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Repetitive head impacts in soccer have been linked to short-term neurophysiological deficits, and female soccer players have higher concussion rates than males. These findings have inspired investigation into gender differences in head impact exposure and how head impact rate contributes to the cumulative effect of head impact exposure on neurological outcomes. Various periods of exposure have been used to calculate head impact rates, including head impacts per season, game, and player-hour. PURPOSE The aim of this study was to apply different methodological approaches to quantify and compare head impact rates by gender for two seasons of high school varsity soccer. METHODS Video review was used to confirm all events recorded by a headband-mounted impact sensor and calculate playing time for all players. Impact rates were calculated per athlete exposure (presence and participation) and per player-hour (scheduled game time, individual play time, and absolute time). RESULTS Impact rates per athlete exposure ranged from 2.5 to 3.2 for males and from 1.4 to 1.6 for females, and impact rates per player-hour ranged from 2.7 to 3.8 for males and from 1.0 to 1.6 for females. The exposure calculation method significantly affected head impact rates; however, regardless of approach, the head impact rate for males was higher, up to threefold, than for females. Individual head impact exposure varied substantially within a team with one in five players experiencing no impacts. CONCLUSIONS Overall, the gender differences found in this study indicate that males experience higher head impact exposure compared with females. Future studies are needed to understand potential clinical implications of variability in head impact exposure and reconcile higher female concussion rates with the reduced head impact rates presented herein.
Collapse
Affiliation(s)
- Colin M Huber
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA,Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Declan A. Patton
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Divya Jain
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA,Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Christina L. Master
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA,Sports Medicine and Performance Center, Children’s Hospital of Philadelphia, Philadelphia, PA,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Susan S. Margulies
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA
| | - Catherine C. McDonald
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA,School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Kristy B. Arbogast
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
26
|
Cecchi NJ, Monroe DC, Fote GM, Small SL, Hicks JW. Head impact exposure and concussion in women's collegiate club lacrosse. Res Sports Med 2021; 30:677-682. [PMID: 33998942 DOI: 10.1080/15438627.2021.1929226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study sought to describe head impact exposure in women's collegiate club lacrosse. Eleven women's collegiate club lacrosse players wore head impact sensors during eight intercollegiate competitions. Video recordings of competitions were used to verify impact data. Athletes completed questionnaires detailing their concussion history and perceived head impact exposure. During the monitored games, no diagnosed concussions were sustained. Three athletes reported sustaining head impacts (median = 0; range: 0-3 impacts per game). Six impacts registered by the sensors were verified on video across a total of 81 athlete-game exposures. Verified impacts had a median peak linear acceleration of 21.0 g (range: 18.3 g - 48.3 g) and peak rotational acceleration of 1.1 krad/s2 (range: 0.7 krad/s2 - 5.7 krad/s2). Women competing in collegiate club lacrosse are at a low risk of sustaining head impacts, comparable to previous reports of the high school and collegiate varsity levels of play.
Collapse
Affiliation(s)
- Nicholas J Cecchi
- Department of Ecology and Evolutionary Biology, University of California, Irvine, Irvine, California, USA
| | - Derek C Monroe
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA.,Department of Neurology, University of California, Irvine, Irvine, California, USA
| | - Gianna M Fote
- Department of Biological Chemistry, University of California, Irvine, Irvine, California, USA
| | - Steven L Small
- Department of Neurology, University of California, Irvine, Irvine, California, USA.,School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA
| | - James W Hicks
- Department of Ecology and Evolutionary Biology, University of California, Irvine, Irvine, California, USA
| |
Collapse
|
27
|
Huber CM, Patton DA, McDonald CC, Jain D, Simms K, Lallo VA, Margulies SS, Master CL, Arbogast KB. Sport- and Gender-Based Differences in Head Impact Exposure and Mechanism in High School Sports. Orthop J Sports Med 2021; 9:2325967120984423. [PMID: 33738313 PMCID: PMC7933779 DOI: 10.1177/2325967120984423] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/27/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Repeated head impacts sustained by athletes have been linked to short-term neurophysiologic deficits; thus, there is growing concern about the number of head impacts sustained in sports. Accurate head impact exposure data obtained via head impact sensors may help identify appropriate strategies across sports and between genders to mitigate repetitive head impacts. Purpose: To quantify sport- and gender-based differences in head impact rate and mechanism for adolescents. Study Design: Cohort study; Level of evidence, 2. Methods: High school female and male varsity soccer, basketball, lacrosse, and field hockey (female only) teams were instrumented with headband-mounted impact sensors during games over 2 seasons of soccer and 1 season of basketball, lacrosse, and field hockey. Video review was used to remove false-positive sensor-recorded events, and the head impact rate per athlete-exposure (AE) was calculated. Impact mechanism was categorized as equipment to head, fall, player to head, or head to ball (soccer only). Results: Male players had significantly higher head impact rates as compared with female players in soccer (3.08 vs 1.41 impacts/AE; rate ratio, 2.2 [95% CI, 1.8-2.6]), basketball (0.90 vs 0.25; 3.6 [2.6-4.6]), and lacrosse (0.83 vs 0.06; 12.9 [10.1-15.8]). Impact mechanism distributions were similar within sports between boys and girls. In soccer, head to ball represented 78% of impacts, whereas at least 88% in basketball were player-to-player contact. Conclusion: Across sports for boys and girls, soccer had the highest impact rate. Male high school soccer, basketball, and lacrosse teams had significantly higher head impact rates than did female teams of the same sport. For girls, basketball had a higher head impact rate than did lacrosse and field hockey, and for boys, basketball had a similar impact rate to lacrosse, a collision sport. Sport differences in the distribution of impact mechanisms create sport-specific targets for reducing head impact exposure.
Collapse
Affiliation(s)
- Colin M Huber
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Declan A Patton
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Catherine C McDonald
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Divya Jain
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Katherine Simms
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Valerie A Lallo
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Biomedical Engineering Department, Widener University, Chester, Pennsylvania, USA
| | - Susan S Margulies
- Walter H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
| | - Christina L Master
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kristy B Arbogast
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
28
|
Langevin TL, Antonoff D, Renodin C, Shellene E, Spahr L, Marsh WA, Rosene JM. Head impact exposures in women's collegiate rugby. PHYSICIAN SPORTSMED 2021; 49:68-73. [PMID: 32419585 DOI: 10.1080/00913847.2020.1770568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: To describe the incidence, magnitude, and distribution of head impacts and track concussions sustained in a collegiate level women's rugby season. Methods: Data on head impact incidence and magnitude were collected via Smart Impact Monitors (SIM) (Triax Technologies, Inc., Norwalk, CT) within fitted headbands during practices and games of one competitive season. Magnitude data included peak linear acceleration (PLA) and peak rotational velocity (PRV) measurements and were reported as median [IQR]. Results: Players sustained 120 head impacts ≥15 g (18.1 g - 78.9 g) with 1199 total athlete exposures. In eight games, 67 head impacts were recorded with a mean rate of 0.40 ± 0.22 hits per-player per-match, median PLA of 32.2 g, and PRV of 13.5 rad.sec-1. There were 53 head impacts in 47 practices with a mean rate of 0.05 ± 0.04 hits per-player per-practice, median PLA of 29.8 g and PRV of 15.7 rad.sec-1. Four concussions were reported and monitored. Conclusion: The incidence and magnitude of head impacts in collegiate level women's rugby over one season of practices and games were fewer than those reported in other comparable studies. These findings give insight into the impact burden that female collegiate rugby athletes withstand throughout a competitive season.
Collapse
Affiliation(s)
- Taylor L Langevin
- Medical student, University of New England College of Osteopathic Medicine , Biddeford, ME, USA
| | - Daniel Antonoff
- Medical student, University of New England College of Osteopathic Medicine , Biddeford, ME, USA
| | - Christina Renodin
- Medical student, University of New England College of Osteopathic Medicine , Biddeford, ME, USA
| | - Erin Shellene
- Department of Athletics, University of New England , Biddeford, ME, USA
| | - Lee Spahr
- Department of Exercise and Sport Performance, University of New England , Biddeford, ME, USA
| | - Wallace A Marsh
- Associate Dean, University of New England College of Pharmacy , Portland, ME, USA
| | - John M Rosene
- Department of Exercise and Sport Performance, University of New England , Biddeford, ME, USA
| |
Collapse
|
29
|
Huber CM, Patton DA, Wofford KL, Margulies SS, Cullen DK, Arbogast KB. Laboratory Assessment of a Headband-Mounted Sensor for Measurement of Head Impact Rotational Kinematics. J Biomech Eng 2021; 143:024502. [PMID: 32975553 PMCID: PMC10782863 DOI: 10.1115/1.4048574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 08/31/2020] [Indexed: 11/08/2022]
Abstract
Head impact sensors measure head kinematics in sports, and sensor accuracy is crucial for investigating the potential link between repetitive head loading and clinical outcomes. Many validation studies mount sensors to human head surrogates and compare kinematic measures during loading from a linear impactor. These studies are often unable to distinguish intrinsic instrumentation limitations from variability caused by sensor coupling. The aim of the current study was to evaluate intrinsic sensor error in angular velocity in the absence of coupling error for a common head impact sensor. Two Triax SIM-G sensors were rigidly attached to a preclinical rotational injury device and subjected to rotational events to assess sensor reproducibility and accuracy. Peak angular velocities between the SIM-G sensors paired for each test were correlated (R2 > 0.99, y = 1.00x, p < 0.001). SIM-G peak angular velocity correlated with the reference (R2 = 0.96, y = 0.82x, p < 0.001); however, SIM-G underestimated the magnitude by 15.0% ± 1.7% (p < 0.001). SIM-G angular velocity rise time (5% to 100% of peak) correlated with the reference (R2 = 0.97, y = 1.06x, p < 0.001) but exhibited a slower fall time (100% to 5% of peak) by 9.0 ± 3.7 ms (p < 0.001). Assessing sensor performance when rigidly coupled is a crucial first step to interpret on-field SIM-G rotational kinematic data. Further testing in increasing biofidelic conditions is needed to fully characterize error from other sources, such as coupling.
Collapse
Affiliation(s)
- Colin M. Huber
- Department of Bioengineering, University of Pennsylvania, 2716 South Street, Philadelphia, PA 19146; Children's Hospital of Philadelphia, Center for Injury Research and Prevention (CIRP), 2716 South Street, Philadelphia, PA 19146
| | - Declan A. Patton
- Children's Hospital of Philadelphia, Center for Injury Research and Prevention (CIRP), 2716 South Street, Philadelphia, PA 19146
| | - Kathryn L. Wofford
- Department of Neurosurgery, University of Pennsylvania, 3320 Smith Walk, 105 Hayden Hall, Philadelphia, PA 19104
| | - Susan S. Margulies
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, U.A. Whitaker Building, 313 Ferst Drive, Suite 2116, Atlanta, GA 30332-0535
| | - D. Kacy Cullen
- Department of Neurosurgery, Center for Brain Injury & Repair, University of Pennsylvania, 3320 Smith Walk, 105E Hayden Hall, Philadelphia, PA 19104; Department of Bioengineering, University of Pennsylvania, 3320 Smith Walk, 105E Hayden Hall, Philadelphia, PA 19104
| | - Kristy B. Arbogast
- Children's Hospital of Philadelphia, Center for Injury Research and Prevention (CIRP), 2716 South Street, Philadelphia, PA 19146; Department of Pediatrics, University of Pennsylvania, 2716 South Street, Philadelphia, PA 19146
| |
Collapse
|
30
|
Sports medicine: bespoke player management. Digit Health 2021. [DOI: 10.1016/b978-0-12-818914-6.00021-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
31
|
Rowson B, Duma SM. A Review of On-Field Investigations into the Biomechanics of Concussion in Football and Translation to Head Injury Mitigation Strategies. Ann Biomed Eng 2020; 48:2734-2750. [PMID: 33200263 DOI: 10.1007/s10439-020-02684-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022]
Abstract
This review paper summarizes the scientific advancements in the field of concussion biomechanics in American football throughout the past five decades. The focus is on-field biomechanical data collection, and the translation of that data to injury metrics and helmet evaluation. On-field data has been collected with video analysis for laboratory reconstructions or wearable head impact sensors. Concussion biomechanics have been studied across all levels of play, from youth to professional, which has allowed for comparison of head impact exposure and injury tolerance between different age groups. In general, head impact exposure and injury tolerance increase with increasing age. Average values for concussive head impact kinematics are lower for youth players in both linear and rotational acceleration. Head impact data from concussive and non-concussive events have been used to develop injury metrics and risk functions for use in protective equipment evaluation. These risk functions have been used to evaluate helmet performance for each level of play, showing substantial differences in the ability of different helmet models to reduce concussion risk. New advances in head impact sensor technology allow for biomechanical measurements in helmeted and non-helmeted sports for a more complete understanding of concussion tolerance in different demographics. These sensors along with advances in finite element modeling will lead to a better understanding of the mechanisms of injury and human tolerance to head impact.
Collapse
Affiliation(s)
- Bethany Rowson
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA.
| | - Stefan M Duma
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA
| |
Collapse
|
32
|
MIHALIK JASONP, AMALFE STEPHANIEA, ROBY PATRICIAR, FORD CASSIEB, LYNALL ROBERTC, RIEGLER KAITLINE, TEEL ELIZABETHF, WASSERMAN ERINB, PUTUKIAN MARGOT. Sex and Sport Differences in College Lacrosse and Soccer Head Impact Biomechanics. Med Sci Sports Exerc 2020; 52:2349-2356. [DOI: 10.1249/mss.0000000000002382] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
33
|
Bartsch AJ, Hedin D, Alberts J, Benzel EC, Cruickshank J, Gray RS, Cameron K, Houston MN, Rooks T, McGinty G, Kozlowski E, Rowson S, Maroon JC, Miele VJ, Ashton JC, Siegmund GP, Shah A, McCrea M, Stemper B. High Energy Side and Rear American Football Head Impacts Cause Obvious Performance Decrement on Video. Ann Biomed Eng 2020; 48:2667-2677. [PMID: 33111969 PMCID: PMC7674260 DOI: 10.1007/s10439-020-02640-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/24/2020] [Indexed: 12/23/2022]
Abstract
The objective of this study was to compare head impact data acquired with an impact monitoring mouthguard (IMM) to the video-observed behavior of athletes' post-collision relative to their pre-collision behaviors. A total of n = 83 college and high school American football players wore the IMM and were video-recorded over 260 athlete-exposures. Ex-athletes and clinicians reviewed the video in a two-step process and categorized abnormal post-collision behaviors according to previously published Obvious Performance Decrement (OPD) definitions. Engineers qualitatively reviewed datasets to check head impact and non-head impact signal frequency and magnitude. The ex-athlete reviewers identified 2305 head impacts and 16 potential OPD impacts, 13 of which were separately categorized as Likely-OPD impacts by the clinical reviewers. All 13 Likely-OPD impacts were in the top 1% of impacts measured by the IMM (ranges 40-100 g, 3.3-7.0 m/s and 35-118 J) and 12 of the 13 impacts (92%) were to the side or rear of the head. These findings require confirmation in a larger data set before proposing any type of OPD impact magnitude or direction threshold exists. However, OPD cases in this study compare favorably with previously published impact monitoring studies in high school and college American football players that looked for OPD signs, impact magnitude and direction. Our OPD findings also compare well with NFL reconstruction studies for ranges of concussion and sub-concussive impact magnitudes in side/rear collisions, as well as prior theory, analytical models and empirical research that suggest a directional sensitivity to brain injury exists for single high-energy impacts.
Collapse
Affiliation(s)
| | - Daniel Hedin
- Advanced Medical Electronics, Maple Grove, MN, USA
| | | | | | | | | | | | | | - Tyler Rooks
- United States Army Aeromedical Research Laboratory, Fort Rucker, AL, USA
| | - Gerald McGinty
- United States Air Force Academy, Air Force Academy, CO, USA
| | | | | | - Joseph C Maroon
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Vincent J Miele
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Gunter P Siegmund
- School of Kinesiology, University of British Columbia, Vancouver, BC, USA
| | - Alok Shah
- Medical College of Wisconsin, Wauwatosa, WI, USA
| | | | | |
Collapse
|
34
|
Rowson S, Campolettano ET, Duma SM, Stemper B, Shah A, Harezlak J, Riggen L, Mihalik JP, Brooks A, Cameron KL, Svoboda SJ, Houston MN, McAllister T, Broglio S, McCrea M. Concussion Risk Between Individual Football Players: Survival Analysis of Recurrent Events and Non-events. Ann Biomed Eng 2020; 48:2626-2638. [PMID: 33113020 DOI: 10.1007/s10439-020-02675-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 10/21/2020] [Indexed: 10/23/2022]
Abstract
Concussion tolerance and head impact exposure are highly variable among football players. Recent findings highlight that head impact data analyses need to be performed at the subject level. In this paper, we describe a method of characterizing concussion risk between individuals using a new survival analysis technique developed with real-world head impact data in mind. Our approach addresses the limitations and challenges seen in previous risk analyses of football head impact data. Specifically, this demonstrative analysis appropriately models risk for a combination of left-censored recurrent events (concussions) and right-censored recurrent non-events (head impacts without concussion). Furthermore, the analysis accounts for uneven impact sampling between players. In brief, we propose using the Consistent Threshold method to develop subject-specific risk curves and then determine average risk point estimates between subjects at injurious magnitude values. We describe an approach for selecting an optimal cumulative distribution function to model risk between subjects by minimizing injury prediction error. We illustrate that small differences in distribution fit can result in large predictive errors. Given the vast amounts of on-field data researchers are collecting across sports, this approach can be applied to develop population-specific risk curves that can ultimately inform interventions that reduce concussion incidence.
Collapse
Affiliation(s)
- Steven Rowson
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA.
| | - Eamon T Campolettano
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA
| | - Stefan M Duma
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA
| | - Brian Stemper
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alok Shah
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jaroslaw Harezlak
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Larry Riggen
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jason P Mihalik
- Department of Exercise and Sport Science, Matthew Gfeller Sport-Related Traumatic Brain Injury Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alison Brooks
- Department of Orthopedics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Kenneth L Cameron
- Department of Orthopaedic Surgery, Keller Army Community Hospital, United States Military Academy, West Point, NY, USA.,Department of Sports Medicine, United States Air Force Academy, Colorado Springs, CO, USA
| | - Steven J Svoboda
- Department of Orthopaedic Surgery, Keller Army Community Hospital, United States Military Academy, West Point, NY, USA
| | - Megan N Houston
- Department of Orthopaedic Surgery, Keller Army Community Hospital, United States Military Academy, West Point, NY, USA
| | - Thomas McAllister
- Department of Psychiatry, Indiana School of Medicine, Indianapolis, IN, USA
| | - Steven Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
| | - Michael McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
35
|
Head Impact Sensor Studies In Sports: A Systematic Review Of Exposure Confirmation Methods. Ann Biomed Eng 2020; 48:2497-2507. [PMID: 33051746 DOI: 10.1007/s10439-020-02642-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/26/2020] [Indexed: 10/23/2022]
Abstract
To further the understanding of long-term sequelae as a result of repetitive head impacts in sports, in vivo head impact exposure data are critical to expand on existing evidence from animal model and laboratory studies. Recent technological advances have enabled the development of head impact sensors to estimate the head impact exposure of human subjects in vivo. Previous research has identified the limitations of filtering algorithms to process sensor data. In addition, observer and/or video confirmation of sensor-recorded events is crucial to remove false positives. The purpose of the current study was to conduct a systematic review to determine the proportion of published head impact sensor data studies that used filtering algorithms, observer confirmation and/or video confirmation of sensor-recorded events to remove false positives. Articles were eligible for inclusion if collection of head impact sensor data during live sport was reported in the methods section. Descriptive data, confirmation methods and algorithm use for included articles were coded. The primary objective of each study was reviewed to identify the primary measure of exposure, primary outcome and any additional covariates. A total of 168 articles met the inclusion criteria, the publication of which has increased in recent years. The majority used filtering algorithms (74%). The majority did not use observer and/or video confirmation for all sensor-recorded events (64%), which suggests estimates of head impact exposure from these studies may be imprecise.
Collapse
|
36
|
Describing headform pose and impact location for blunt impact testing. J Biomech 2020; 109:109923. [PMID: 32807308 DOI: 10.1016/j.jbiomech.2020.109923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 06/26/2020] [Accepted: 06/26/2020] [Indexed: 11/22/2022]
Abstract
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.
Collapse
|
37
|
Development, Validation and Pilot Field Deployment of a Custom Mouthpiece for Head Impact Measurement. Ann Biomed Eng 2019; 47:2109-2121. [PMID: 31297724 DOI: 10.1007/s10439-019-02313-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 06/22/2019] [Indexed: 10/26/2022]
Abstract
The objective of this study was to develop a mouthpiece sensor with improved head kinematic measurement for use in non-helmeted and helmeted sports through laboratory validation and pilot field deployment in female youth soccer. For laboratory validation, data from the mouthpiece sensor was compared to standard sensors mounted in a headform at the center of gravity as the headform was struck with a swinging pendulum. Linear regression between peak kinematics measured from the mouthpiece and headform showed strong correlation, with r2 values of 0.95 (slope = 1.02) for linear acceleration, 1.00 (slope = 1.00) for angular velocity, and 0.97 (slope = 0.96) for angular acceleration. In field deployment, mouthpiece data were collected from four female youth soccer players and time-synchronized with film. Film-verified events (n = 915) were observed over 9 practices and 5 games, and 632 were matched to a corresponding mouthpiece event. This resulted in an overall sensitivity of 69.2% and a positive predictive value of 80.3%. This validation and pilot field deployment data demonstrates that the mouthpiece provides highly accurate measurement of on-field head impact data that can be used to further study the effects of impact exposure in both helmeted and non-helmeted sports.
Collapse
|
38
|
Swartz EE, Myers JL, Cook SB, Guskiewicz KM, Ferrara MS, Cantu RC, Chang H, Broglio SP. A helmetless-tackling intervention in American football for decreasing head impact exposure: A randomized controlled trial. J Sci Med Sport 2019; 22:1102-1107. [PMID: 31204104 DOI: 10.1016/j.jsams.2019.05.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 04/01/2019] [Accepted: 05/30/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate a behavioral intervention to reduce head impact exposure in youth playing American football. DESIGN Nested randomized controlled trial. METHODS Participants, ages 14-17 years, wore head impact sensors (SIM-G™) during two seasons of play. Those randomized to the intervention group underwent weekly tackling/blocking drills performed without helmets (WoH) and shoulder pads while the control group trained as normal, matching frequency and duration. Research personnel provided daily oversight to maintain fidelity. Head impact frequency (≥10g) per athlete exposure (ImpAE) was analyzed over time (two 11-week seasons) using mixed effect models or ANCOVA. Secondary outcomes included exposure-type (training, game) and participation level (entry-level versus upper-level secondary education). RESULTS One-hundred fifteen participants (59 WoH, 56 control) met compliance criteria, contributing 47,382 head impacts and 10,751 athlete exposures for analysis. WoH had fewer ImpAE during games compared to control participants at weeks 4 (p=0.0001 season 1, p=0.0005 season 2) and 7 (p=0.0001 both seasons). Upper-level WoH participants had less ImpAE during games than their matched controls at weeks 4 (p=0.017 and p=0.026) and 7 (p=0.037 and p=0.014) in both seasons, respectively. Upper-level WoH also had fewer ImpAE during training at week 7 (p=0.015) in season one. CONCLUSIONS Tackling and blocking drills performed without a helmet during training reduced the frequency of head impacts during play, especially during games. However, these differences disappeared by the end of the season. Future research should explore the frequency of behavioral intervention and a dose-response relationship considering years of player experience. TRIAL REGISTRATION ClinicalTrials.gov # NCT02519478.
Collapse
Affiliation(s)
- Erik E Swartz
- University of Massachusetts - Lowell, Department of Physical Therapy and Kinesiology, United States; University of New Hampshire, Department of Kinesiology, United States.
| | - Jay L Myers
- University of Massachusetts - Lowell, Department of Physical Therapy and Kinesiology, United States; University of New Hampshire, Department of Kinesiology, United States
| | - Summer B Cook
- University of New Hampshire, Department of Kinesiology, United States
| | | | - Michael S Ferrara
- University of New Hampshire, Department of Kinesiology, United States
| | - Robert C Cantu
- Emerson Hospital, Department of Neurosurgery, United States
| | - Hong Chang
- Clinical and Translational Sciences Institute, Tufts University, United States
| | | |
Collapse
|
39
|
Lynall RC, Lempke LB, Johnson RS, Anderson MN, Schmidt JD. A Comparison of Youth Flag and Tackle Football Head Impact Biomechanics. J Neurotrauma 2019; 36:1752-1757. [DOI: 10.1089/neu.2018.6236] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Robert C. Lynall
- Department of Kinesiology, UGA Concussion Research Laboratory, University of Georgia, Athens, Georgia
| | - Landon B. Lempke
- Department of Kinesiology, UGA Concussion Research Laboratory, University of Georgia, Athens, Georgia
| | - Rachel S. Johnson
- Department of Kinesiology, UGA Concussion Research Laboratory, University of Georgia, Athens, Georgia
| | - Melissa N. Anderson
- Department of Kinesiology, UGA Concussion Research Laboratory, University of Georgia, Athens, Georgia
| | - Julianne D. Schmidt
- Department of Kinesiology, UGA Concussion Research Laboratory, University of Georgia, Athens, Georgia
| |
Collapse
|
40
|
Sayre HD, Bradney DA, Breedlove KM, Bowman TG. Concussive Head Impact Biomechanics in Women's Lacrosse and Soccer Athletes: A Case Series. ACTA ACUST UNITED AC 2019. [DOI: 10.3928/19425864-20190228-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
41
|
Sandmo SB, McIntosh AS, Andersen TE, Koerte IK, Bahr R. Evaluation of an In-Ear Sensor for Quantifying Head Impacts in Youth Soccer. Am J Sports Med 2019; 47:974-981. [PMID: 30802147 DOI: 10.1177/0363546519826953] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Wearable sensor systems have the potential to quantify head kinematic responses of head impacts in soccer. However, on-field use of sensors (eg, accelerometers) remains challenging, owing to poor coupling to the head and difficulties discriminating low-severity direct head impacts from inertial loading of the head from human movements, such as jumping and landing. PURPOSE To test the validity of an in-ear sensor for quantifying head impacts in youth soccer. STUDY DESIGN Descriptive laboratory study. METHODS First, the sensor was mounted to a Hybrid III headform and impacted with a linear impactor or a soccer ball. Peak linear acceleration (PLA), peak rotational acceleration (PRA), and peak rotational velocity (PRV) were obtained from both systems; random and systematic errors were calculated with Hybrid III as reference. Then, 6 youth soccer players wore sensors and performed a structured training protocol, including heading and nonheading exercises; they also completed 2 regular soccer sessions. For each accelerative event recorded, PLA, PRA, and PRV outputs were compared with video recordings. Receiver operating characteristic curves were used to determine the sensor's discriminatory capacity in both on-field settings, establishing cutoff values for predicting outcomes. RESULTS For the laboratory tests, the random error was 11% for PLA, 20% for PRA, and 5% for PRV; the systematic error was 11%, 19%, and 5%, respectively. For the structured training protocol, heading events resulted in higher absolute values (PLA = 15.6 g± 11.8 g) than nonheading events (PLA = 4.6 g± 1.2 g); the area under the curve was 0.98 for PLA. In regular training sessions, the area under the curve was >0.99 for PLA. A 9 g cutoff value yielded a positive predictive value of 100% in the structured training protocol versus 65% in the regular soccer sessions. CONCLUSION The in-ear sensor displayed considerable random error and substantially overestimated head impact exposure. Despite the sensor's excellent on-field accuracy for discriminating headings from other accelerative events in youth soccer, absolute values must be interpreted with caution, and there is a need for secondary means of verification (eg, video analysis) in real-life settings. CLINICAL RELEVANCE Wearable sensor systems can potentially provide valuable insights into head impact exposures in contact sports, but their limitations require careful consideration.
Collapse
Affiliation(s)
- Stian Bahr Sandmo
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Andrew S McIntosh
- School of Engineering and ACRISP, Edith Cowan University, Joondalup, Australia.,Monash University Accident Research Centre, Monash University, Melbourne, Australia.,McIntosh Consultancy and Research, Sydney, Australia
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Inga Katharina Koerte
- Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| |
Collapse
|
42
|
McIntosh AS, Willmott C, Patton DA, Mitra B, Brennan JH, Dimech-Betancourt B, Howard TS, Rosenfeld JV. An assessment of the utility and functionality of wearable head impact sensors in Australian Football. J Sci Med Sport 2019; 22:784-789. [PMID: 31000457 DOI: 10.1016/j.jsams.2019.02.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/05/2019] [Accepted: 02/21/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To assess the utility and functionality of the X-Patch® as a measurement tool to study head impact exposure in Australian Football. Accuracy, precision, reliability and validity were examined. DESIGNS Laboratory tests and prospective observational study. METHODS Laboratory tests on X-Patch® were undertaken using an instrumented Hybrid III head and neck and linear impactor. Differences between X-Patch® and reference data were analysed. Australian Football players wore the X-Patch® devices and games were video-recorded. Video recordings were analysed qualitatively for head impact events and these were correlated with X-Patch® head acceleration events. Wearability of the X-Patch® was assessed using the Comfort Rating Scale for Wearable Computers. RESULTS Laboratory head impacts, performed at multiple impact sites and velocities, identified significant correlations between headform-measured and device-measured kinematic parameters (p<0.05 for all). On average, the X-Patch®-recorded peak linear acceleration (PLA) was 17% greater than the reference PLA, 28% less for peak rotational acceleration (PRA) and 101% greater for the Head Injury Criterion (HIC). For video analysis, 118 head acceleration events (HAE) were included with PLA ≥30g across 53 players. Video recordings of X-Patch®-measured HAEs (PLA ≥30g) determined that 31.4% were direct head impacts, 9.3% were indirect impacts, 44.1% were unknown or unclear and 15.3% were neither direct nor indirect head impacts. The X-Patch® system was deemed wearable by 95-100% of respondents. CONCLUSIONS This study reinforces evidence that use of the current X-Patch® devices should be limited to research only and in conjunction with video analysis.
Collapse
Affiliation(s)
- Andrew S McIntosh
- MUARC, Monash University, Melbourne, Australia; Federation University Australia, Ballarat, Australia.
| | - Catherine Willmott
- Monash Institute of Cognitive & Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia
| | | | - Biswadev Mitra
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia; Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
| | - James H Brennan
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia
| | - Bleydy Dimech-Betancourt
- Monash Institute of Cognitive & Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia
| | - Teresa S Howard
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia
| | - Jeffrey V Rosenfeld
- Department of Neurosurgery, The Alfred Hospital, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia
| |
Collapse
|