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Peek K, Ross A, Andersen TE, Meyer T, Dahlen S, Georgieva J, Williamson PR, Clarke M, Serner A. Heading in football: a systematic review of descriptors, definitions, and reporting methods used in heading incidence studies. SCI MED FOOTBALL 2024:1-18. [PMID: 38855969 DOI: 10.1080/24733938.2024.2362191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/27/2024] [Indexed: 06/11/2024]
Abstract
The primary objective of this systematic review was to describe the number and type of heading descriptors used in all published studies which report on heading incidence in football. The secondary objective was to detail the data collection and reporting methods used in the included studies to present heading incidence data. Eligible studies were identified through searches of five electronic databases: Ovid MEDLINE, CINAHL, EMBASE, SPORTDiscus, and Web of Science, using a combination of free-text keywords (inception to 12th September 2023). Manual searching of reference lists and retrieved systematic reviews was also performed. A descriptive overview and synthesis of the results is presented. From 1620 potentially eligible studies, 71 studies were included, with the following key findings: 1) only 61% of studies defined a header with even fewer (23%) providing an operational definition of a header within the methods; 2) important study and player demographic data including year and country were often not reported; 3) reported heading descriptors and their coding options varied greatly; 4) visual identification of headers was essential when inertial measurement units were used to collect heading incidence data; and 5) there was a lack of standardisation in the reporting methods used in heading incidence studies making comparison between studies challenging. To address these findings, the development of a standardised, internationally supported, operational definition of a header and related heading descriptors should be prioritised. Further recommendations include the development of minimum reporting criteria for heading incidence research.
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Affiliation(s)
- Kerry Peek
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Andrew Ross
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Physiotherapy Department, College of Sport, Health and Engineering, Victoria University, Melbourne, Australia
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, The Norwegian School of Sport Sciences, Oslo, Norway
- The Norwegian Football Association's Sports Medical Centre, Oslo, Norway
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
| | - Sara Dahlen
- Oslo Sports Trauma Research Center, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Julia Georgieva
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Paula R Williamson
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Mike Clarke
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Andreas Serner
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
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Seeburrun T, Bustamante MC, Hartlen DC, Azar A, Ouellet S, Cronin DS. Assessment of brain response in operators subject to recoil force from firing long-range rifles. Front Bioeng Biotechnol 2024; 12:1352387. [PMID: 38419729 PMCID: PMC10899685 DOI: 10.3389/fbioe.2024.1352387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Mild traumatic brain injury (mTBI) may be caused by occupational hazards military personnel encounter, such as falls, shocks, exposure to blast overpressure events, and recoil from weapon firing. While it is important to protect against injurious head impacts, the repeated exposure of Canadian Armed Forces (CAF) service members to sub-concussive events during the course of their service may lead to a significant reduction in quality of life. Symptoms may include headaches, difficulty concentrating, and noise sensitivity, impacting how personnel complete their duties and causing chronic health issues. This study investigates how the exposure to the recoil force of long-range rifles results in head motion and brain deformation. Direct measurements of head kinematics of a controlled population of military personnel during firing events were obtained using instrumented mouthguards. The experimentally measured head kinematics were then used as inputs to a finite element (FE) head model to quantify the brain strains observed during each firing event. The efficacy of a concept recoil mitigation system (RMS), designed to mitigate loads applied to the operators was quantified, and the RMS resulted in lower loading to the operators. The outcomes of this study provide valuable insights into the magnitudes of head kinematics observed when firing long-range rifles, and a methodology to quantify effects, which in turn will help craft exposure guidelines, guide training to mitigate the risk of injury, and improve the quality of lives of current and future CAF service members and veterans.
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Affiliation(s)
- Tanvi Seeburrun
- Department of Mechanical Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Michael C Bustamante
- Department of Mechanical Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Devon C Hartlen
- Department of Mechanical Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Austin Azar
- Valcartier Research Centre, Defence Research and Development Canada, Quebec, QC, Canada
| | - Simon Ouellet
- Valcartier Research Centre, Defence Research and Development Canada, Quebec, QC, Canada
| | - Duane S Cronin
- Department of Mechanical Engineering, University of Waterloo, Waterloo, ON, Canada
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Basinas I, McElvenny DM, Brooker F, Robertson S, van Hoecke Y, Kemp S, Pearce N, Gallo V, Cherrie JW. Exposure assessment for repeated sub-concussive head impacts in soccer: The HEalth and Ageing Data IN the Game of football (HEADING) study. Int J Hyg Environ Health 2023; 253:114235. [PMID: 37552911 DOI: 10.1016/j.ijheh.2023.114235] [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: 04/29/2023] [Revised: 07/18/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023]
Abstract
The purpose of this paper was to develop exposure estimates for repetitive sub-concussive head impacts (RSHI) for use in epidemiological analyses. We used a questionnaire to collect lifetime history of heading and other head contacts associated with training and playing football from 159 former footballers all members of the English professional football association. We used linear mixed effect regression with player as the random effect, to model the number of headers, blows to the head and head-to-head impacts as a function of potential exposure affecting factors, which were treated as the fixed effects. Exposure affecting factors included playing position, league, context of play (game vs training) and decade of play. Age at time of response to the questionnaire was also included in the models. In model results, playing position was important, with RSHIs being highest among defenders and lowest among goalkeepers. Players headed the ball more during games than in training, and when playing in amateur or youth leagues compared with semi-professional or professional leagues. The average number of reported head impacts declined linearly throughout the observation period (1949-2015). The derived final model for headers explained 43%, 9% and 36% of the between player, within player and total variance in exposure, respectively with good precision and predictive performance. These findings are generally in agreement with previously published results pointing towards the models forming a valid method for estimating exposure to RSHI among former footballers although some further external validation is still warranted.
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Affiliation(s)
- Ioannis Basinas
- Center for Occupational and Environmental Health, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK; Research Group, Institute of Occupational Medicine, Edinburgh, UK.
| | - Damien M McElvenny
- Center for Occupational and Environmental Health, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK; Research Group, Institute of Occupational Medicine, Edinburgh, UK
| | - Finley Brooker
- Research Group, Institute of Occupational Medicine, Edinburgh, UK
| | - Steven Robertson
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Yvonne van Hoecke
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Simon Kemp
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK; Rugby Football Union, London, UK
| | - Neil Pearce
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Valentina Gallo
- Department of Sustainable Health, Campus Fryslan, University of Groningen, Leeuwarden, the Netherlands
| | - John W Cherrie
- Research Group, Institute of Occupational Medicine, Edinburgh, UK; School of Engineering and Physical Sciences, Heriot Watt University, Edinburgh, UK
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Sundaram V, Sundar V, Pearce AJ. Biomechanical characteristics of concussive and sub-concussive impacts in youth sports athletes: A systematic review and meta-analysis. J Sports Sci 2023:1-15. [PMID: 37393593 DOI: 10.1080/02640414.2023.2231317] [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: 02/02/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023]
Abstract
This study aimed to quantitatively investigate and report the biomechanical characteristics of concussive and sub-concussive impacts in youth sports. A systematic search was conducted in September 2022 to identify biomechanical impact studies in athletes ≤18 years of age. Twenty-six studies met the inclusion criteria for quantitative synthesis and analysis. DerSimonian Laird random effects model was used to pool data across the included studies. The pooled estimate of mean peak linear and rotational acceleration of concussive impacts in male youth athletes was 85.56 g (95% CI 69.34-101.79) and 4505.58 rad/s2 (95% CI 2870.28-6140.98), respectively. The pooled estimate of mean peak linear and rotational acceleration of sub-concussive impacts in youth athletes was 22.89 g (95% CI 20.69-25.08) and 1290.13 rad/s2 (95% CI 1050.71-1529.55), respectively. A male vs female analysis in sub-concussive impacts revealed higher linear and rotational acceleration in males and females, respectively. This is the first study to report on impact data in both sexes of youth athletes. Disparity in kinematic impact values suggests future research should aim for standardised measures to reduce heterogeneity in data. Despite this, the data reveals notable impact data that youth athletes are exposed to, suggesting modifications may be required to reduce long-term neurological risks.
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Affiliation(s)
- Vasanth Sundaram
- Department of Sports Biomechanics and Kinesiology, Tamil Nadu Physical Education and Sports University, Chennai, India
| | - Viswanath Sundar
- Physical Education and Sports Science, Visva-Bharati University, West Bengal, India
| | - Alan J Pearce
- College of Science, Health, and Engineering, La Trobe University, Bundoora, Melbourne, Australia
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Choi JY, Jeon S, Kim H, Ha J, Jeon GS, Lee J, Cho SI. Health-Related Indicators Measured Using Earable Devices: Systematic Review. JMIR Mhealth Uhealth 2022; 10:e36696. [PMID: 36239201 PMCID: PMC9709679 DOI: 10.2196/36696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 09/23/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Earable devices are novel, wearable Internet of Things devices that are user-friendly and have potential applications in mobile health care. The position of the ear is advantageous for assessing vital status and detecting diseases through reliable and comfortable sensing devices. OBJECTIVE Our study aimed to review the utility of health-related indicators derived from earable devices and propose an improved definition of disease prevention. We also proposed future directions for research on the health care applications of earable devices. METHODS A systematic review was conducted of the PubMed, Embase, and Web of Science databases. Keywords were used to identify studies on earable devices published between 2015 and 2020. The earable devices were described in terms of target health outcomes, biomarkers, sensor types and positions, and their utility for disease prevention. RESULTS A total of 51 articles met the inclusion criteria and were reviewed, and the frequency of 5 health-related characteristics of earable devices was described. The most frequent target health outcomes were diet-related outcomes (9/51, 18%), brain status (7/51, 14%), and cardiovascular disease (CVD) and central nervous system disease (5/51, 10% each). The most frequent biomarkers were electroencephalography (11/51, 22%), body movements (6/51, 12%), and body temperature (5/51, 10%). As for sensor types and sensor positions, electrical sensors (19/51, 37%) and the ear canal (26/51, 51%) were the most common, respectively. Moreover, the most frequent prevention stages were secondary prevention (35/51, 69%), primary prevention (12/51, 24%), and tertiary prevention (4/51, 8%). Combinations of ≥2 target health outcomes were the most frequent in secondary prevention (8/35, 23%) followed by brain status and CVD (5/35, 14% each) and by central nervous system disease and head injury (4/35, 11% each). CONCLUSIONS Earable devices can provide biomarkers for various health outcomes. Brain status, healthy diet status, and CVDs were the most frequently targeted outcomes among the studies. Earable devices were mostly used for secondary prevention via monitoring of health or disease status. The potential utility of earable devices for primary and tertiary prevention needs to be investigated further. Earable devices connected to smartphones or tablets through cloud servers will guarantee user access to personal health information and facilitate comfortable wearing.
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Affiliation(s)
- Jin-Young Choi
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Seonghee Jeon
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hana Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jaeyoung Ha
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Gyeong-Suk Jeon
- Department of Nursing, College of Natural Science, Mokpo National University, Mokpo, Republic of Korea
| | - Jeong Lee
- Department of Nursing, College of Health and Medical Science, Chodang University, Muan, Republic of Korea
| | - Sung-Il Cho
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
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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.
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Basinas I, McElvenny DM, Pearce N, Gallo V, Cherrie JW. A Systematic Review of Head Impacts and Acceleration Associated with Soccer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095488. [PMID: 35564889 PMCID: PMC9100160 DOI: 10.3390/ijerph19095488] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/06/2022] [Accepted: 04/26/2022] [Indexed: 02/04/2023]
Abstract
Epidemiological studies of the neurological health of former professional soccer players are being undertaken to identify whether heading the ball is a risk factor for disease or premature death. A quantitative estimate of exposure to repeated sub-concussive head impacts would provide an opportunity to investigate possible exposure-response relationships. However, it is unclear how to formulate an appropriate exposure metric within the context of epidemiological studies. We have carried out a systematic review of the scientific literature to identify the factors that determine the magnitude of head impact acceleration during experiments and from observations during playing or training for soccer, up to the end of November 2021. Data were extracted from 33 experimental and 27 observational studies from male and female amateur players including both adults and children. There was a high correlation between peak linear and angular accelerations in the observational studies (p < 0.001) although the correlation was lower for the experimental data. We chose to rely on an analysis of maximum or peak linear acceleration for this review. Differences in measurement methodology were identified as important determinants of measured acceleration, and we concluded that only data from accelerometers fixed to the head provided reliable information about the magnitude of head acceleration from soccer-related impacts. Exposures differed between men and women and between children and adults, with women on average experiencing higher acceleration but less frequent impacts. Playing position appears to have some influence on the number of heading impacts but less so on the magnitude of the head acceleration. Head-to-head collisions result in high levels of exposure and thus probably risk causing a concussion. We concluded, in the absence of evidence to the contrary, that estimates of the cumulative number of heading impacts over a playing career should be used as the main exposure metric in epidemiological studies of professional players.
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Affiliation(s)
- Ioannis Basinas
- Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK; (I.B.); (D.M.M.)
- Division of Population Health, Health Services Research & Primary Care, Centre for Occupational and Environmental Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Damien M. McElvenny
- Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK; (I.B.); (D.M.M.)
- Division of Population Health, Health Services Research & Primary Care, Centre for Occupational and Environmental Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Neil Pearce
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Valentina Gallo
- Campus Fryslân, University of Groningen, 8911 CE Leeuwarden, The Netherlands;
| | - John W. Cherrie
- Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK; (I.B.); (D.M.M.)
- Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Edinburgh EH14 4AS, UK
- Correspondence:
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Porfido T, Caccese J, Gutt J, Wentworth C, Peek K, Bretzin AC, Esopenko C. A standardized method for quantifying and characterizing repetitive head impacts in soccer matches using video footage. SCI MED FOOTBALL 2022; 6:331-339. [DOI: 10.1080/24733938.2022.2056233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Tara Porfido
- School of Graduate Studies, Rutgers Biomedical and Health Sciences, Newark, NJ, 07107 USA
| | - Jaclyn Caccese
- School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH, 43210 USA
| | - Jessica Gutt
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, 07107 USA
| | - Conor Wentworth
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, 07107 USA
| | - Kerry Peek
- Discipline of Physiotherapy, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW 2006 Australia
| | - Abigail C Bretzin
- Penn Injury Science Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, 19104 USA
| | - Carrie Esopenko
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, 07107 USA
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Doan BK, Heaton KJ, Self BP, Butler Samuels MA, Adam GE. Quantifying head impacts and neurocognitive performance in collegiate boxers. J Sports Sci 2021; 40:509-517. [PMID: 34930100 DOI: 10.1080/02640414.2021.2001175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Head impacts and neurocognition were quantified in 27 intercollegiate male boxers engaged in two, two-minute sparring rounds. Head impacts were measured using Instrumented Boxing Headgear (IBH). Pre and post-sparring neurocognitive performance was compared using two computerized neuropsychological test batteries (CNTs): Immediate Post-concussion Assessment and Cognitive Testing (ImPACT™) and Automated Neuropsychological Assessment Metrics - Military Battery (ANAM4® MIL). An average of 27.63 ± 17.87 impacts above the 9.6 g IBH threshold were recorded per boxer, with average peak linear acceleration of 23.48 ± 15.20 g and average peak rotational acceleration of 1761.40 ± 1064.34 rad/s2. Small, but measurable declines in delayed memory and improvement in response time from pre- to post-bout were noted. Number of impacts and concussion history predicted degraded memory performance. This is a runique quantificationof head impacts in collegiate boxing, which were similar in frequency and location, but lower in magnitude as compared to amateur boxing. Improved understanding of impact kinematics may enhance safety in boxing and other contact sports. Subtle post-bout decrements in delayed memory performance and mild improvement in response time reinforce prior research and provide evidence of congruence in our two CNT assessments, which may facilitate comparisons of outcomes across settings utilizing these tests.
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Affiliation(s)
- Brandon K Doan
- Associate Professor of Exercise Science, Georgia Gwinnett College, School of Science & Technology, Lawrenceville, GA, USA
| | - Kristin J Heaton
- Research Psychologist, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Brian P Self
- Professor, Mechanical Engineering, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Michelle A Butler Samuels
- Associate Professor, Department of Behavioral Sciences and Leadership, United States Air Force Academy, Usaf Academy, CO, USA
| | - Gina E Adam
- Commander, US Army Medical Materiel Development Activity (USAMMDA), MD, USA
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Characterization of Head Impact Exposure in Women's Collegiate Soccer. J Appl Biomech 2021; 38:2-11. [PMID: 34911036 DOI: 10.1123/jab.2020-0304] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 08/25/2021] [Accepted: 09/29/2021] [Indexed: 11/18/2022]
Abstract
Soccer players are regularly exposed to head impacts by intentionally heading the ball. Evidence suggests repetitive subconcussive head impacts may affect the brain, and females may be more vulnerable to brain injury than males. This study aimed to characterize head impact exposure among National Collegiate Athletic Association women's soccer players using a previously validated mouthpiece-based sensor. Sixteen players were instrumented during 72 practices and 24 games. Head impact rate and rate of risk-weighted cumulative exposure were compared across session type and player position. Head kinematics were compared across session type, impact type, player position, impact location, and ball delivery method. Players experienced a mean (95% confidence interval) head impact rate of 0.468 (0.289 to 0.647) head impacts per hour, and exposure rates varied by session type and player position. Headers accounted for 89% of head impacts and were associated with higher linear accelerations and rotational accelerations than nonheader impacts. Headers in which the ball was delivered by a long kick had greater peak kinematics (all P < .001) than headers in which the ball was delivered by any other method. Results provide increased understanding of head impact frequency and magnitude in women's collegiate soccer and may help inform efforts to prevent brain injury.
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11
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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.
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Koerte IK, Bahr R, Filipcik P, Gooijers J, Leemans A, Lin AP, Tripodis Y, Shenton ME, Sochen N, Swinnen SP, Pasternak O. REPIMPACT - a prospective longitudinal multisite study on the effects of repetitive head impacts in youth soccer. Brain Imaging Behav 2021; 16:492-502. [PMID: 34505977 PMCID: PMC8825640 DOI: 10.1007/s11682-021-00484-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 12/31/2022]
Abstract
Repetitive head impacts (RHI) are common in youth athletes participating in contact sports. RHI differ from concussions; they are considered hits to the head that usually do not result in acute symptoms and are therefore also referred to as “subconcussive” head impacts. RHI occur e.g., when heading the ball or during contact with another player. Evidence suggests that exposure to RHI may have cumulative effects on brain structure and function. However, little is known about brain alterations associated with RHI, or about the risk factors that may lead to clinical or behavioral sequelae. REPIMPACT is a prospective longitudinal study of competitive youth soccer players and non-contact sport controls aged 14 to 16 years. The study aims to characterize consequences of exposure to RHI with regard to behavior (i.e., cognition, and motor function), clinical sequelae (i.e., psychiatric and neurological symptoms), brain structure, function, diffusion and biochemistry, as well as blood- and saliva-derived measures of molecular processes associated with exposure to RHI (e.g., circulating microRNAs, neuroproteins and cytokines). Here we present the structure of the REPIMPACT Consortium which consists of six teams of clinicians and scientists in six countries. We further provide detailed information on the specific aims and the design of the REPIMPACT study. The manuscript also describes the progress made in the study thus far. Finally, we discuss important challenges and approaches taken to overcome these challenges.
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Affiliation(s)
- Inga K Koerte
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany. .,Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Peter Filipcik
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Jolien Gooijers
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, Goup Biomedical Sciences, KU Leuven, Leuven, Belgium.,KU Leuven Brain Institute (LBI), Leuven, Belgium
| | - Alexander Leemans
- PROVIDI Lab, Image Sciences Institute, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Alexander P Lin
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.,Boston University Alzheimer's Disease Center and Boston University CTE Center, Boston University School of Medicine, Boston, MA, USA
| | - Martha E Shenton
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nir Sochen
- Department of Applied Mathematics, School of Mathematical Sciences, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Stephan P Swinnen
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, Goup Biomedical Sciences, KU Leuven, Leuven, Belgium.,KU Leuven Brain Institute (LBI), Leuven, Belgium
| | - Ofer Pasternak
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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13
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Eitzen I, Renberg J, Færevik H. The Use of Wearable Sensor Technology to Detect Shock Impacts in Sports and Occupational Settings: A Scoping Review. SENSORS (BASEL, SWITZERLAND) 2021; 21:4962. [PMID: 34372198 PMCID: PMC8348544 DOI: 10.3390/s21154962] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 12/03/2022]
Abstract
Shock impacts during activity may cause damage to the joints, muscles, bones, or inner organs. To define thresholds for tolerable impacts, there is a need for methods that can accurately monitor shock impacts in real-life settings. Therefore, the main aim of this scoping review was to present an overview of existing methods for assessments of shock impacts using wearable sensor technology within two domains: sports and occupational settings. Online databases were used to identify papers published in 2010-2020, from which we selected 34 papers that used wearable sensor technology to measure shock impacts. No studies were found on occupational settings. For the sports domain, accelerometry was the dominant type of wearable sensor technology utilized, interpreting peak acceleration as a proxy for impact. Of the included studies, 28 assessed foot strike in running, head impacts in invasion and team sports, or different forms of jump landings or plyometric movements. The included studies revealed a lack of consensus regarding sensor placement and interpretation of the results. Furthermore, the identified high proportion of validation studies support previous concerns that wearable sensors at present are inadequate as a stand-alone method for valid and accurate data on shock impacts in the field.
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Affiliation(s)
- Ingrid Eitzen
- Department of Smart Sensor Systems, SINTEF Digital, 0373 Oslo, Norway
| | - Julie Renberg
- Department of Health Research, SINTEF Digital, 7034 Trondheim, Norway
| | - Hilde Færevik
- Department of Health Research, SINTEF Digital, 7034 Trondheim, Norway
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14
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McCunn R, Beaudouin F, Stewart K, Meyer T, MacLean J. Heading in Football: Incidence, Biomechanical Characteristics and the Association with Acute Cognitive Function-A Three-Part Systematic Review. Sports Med 2021; 51:2147-2163. [PMID: 34129222 DOI: 10.1007/s40279-021-01492-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is growing concern surrounding the role of repetitive sub-concussive head impacts, such as football heading, on brain health. OBJECTIVES Three questions were addressed while only considering studies that observed heading exposure directly: (1) how frequently does heading occur within football training and matches, (2) what are the biomechanical characteristics of heading, and (3) is cognitive function affected by heading? METHODS This review followed the steps described in the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Electronic databases including MEDLINE and SPORTDiscus were searched from the earliest entry to July 2020. Studies that reported independently quantified heading exposure, biomechanical characteristics of heading or the relationship between heading and cognitive function were included. Data were extracted and used to populate summary tables with reference to each research question. RESULTS Heading incidence ranged between one to nine headers per player per match. The number of headers observed in small-sided games during training varied depending on the exact format used but generally speaking ranged between zero to one per player per game. The three most commonly reported biomechanical variables were head acceleration, head rotational velocity and overall movement kinematics during the heading action. Average head acceleration ranged from approximately four to 50 g. Nine out of 12 included studies did not observe a negative impact on cognitive test performance following exposure to heading and while three did, these negative effects were limited to specific outcome measures: reaction time and memory function. CONCLUSION The current weight of evidence summarised herein does not support the notion that heading is deleterious to cognitive performance in the short term; however, this conclusion is tentative due to methodological shortcomings in the existing evidence base.
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Affiliation(s)
- Robert McCunn
- Heart of Midlothian Football Club, Tynecastle Park , Edinburgh, EH11 2NL, UK.
| | - Florian Beaudouin
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Katy Stewart
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Hampden Sports Clinic, Glasgow, UK
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - John MacLean
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Hampden Sports Clinic, Glasgow, UK
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15
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Abstract
Recent public concern over the short- and long-term effects of repetitive head impacts (RHI) associated with purposeful heading in soccer has led researchers to study a multitude of variables related to this important aspect of the game. Of particular interests are the effects of soccer heading in the youth population (≤ 13 years old) whose brains are undergoing rapid development. We conducted a review on youth soccer heading that includes purposeful heading frequency, head impact biomechanics, head injuries, clinical outcomes, and modifying factors. We have concluded that youth soccer players head the ball at a low frequency that typically increases with age and with a finding that boys head the ball more often than girls do. Interestingly, although girls head the ball less frequently than boys do, they tend to sustain higher head impact magnitudes. Head injuries are more likely to occur in girls versus boys and during games because of contact with another player. Clinical outcome measures of concussion are often utilized to study the effects of soccer heading, in both field and laboratory environments. Immediately following soccer heading, youth often report having a headache and demonstrate some deficits in balance measures. Modifying factors that may benefit soccer players participating in purposeful heading activities include stronger neck musculature, wearing headgear, and the use of mouthguards. Research involving youth soccer players needs to be expanded and funded appropriately to better understand the consequences of RHI in both the short and long term.
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16
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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.
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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
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17
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Sandmo SB, Gooijers J, Seer C, Kaufmann D, Bahr R, Pasternak O, Lipton ML, Tripodis Y, Koerte IK. Evaluating the validity of self-report as a method for quantifying heading exposure in male youth soccer. Res Sports Med 2020; 29:427-439. [PMID: 33283535 DOI: 10.1080/15438627.2020.1853541] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Assessing heading exposure in football is important when exploring the association between heading and brain alterations. To this end, questionnaires have been developed for use in adult populations. However, the validity of self-report in adolescents remains to be elucidated. Male youth soccer players (n = 34) completed a questionnaire on heading exposure after a two-week period, which included matches and training sessions. Self-reported numbers were compared to observation (considered reference). In total, we observed 157 training sessions and 64 matches. Self-reported heading exposure correlated with observed heading exposure (Spearman's rho 0.68; p < 0.001). Players systematically overestimated their heading exposure by a factor of 3 with the random error of 46%. Area under the curve was 0.87 (95% CI 0.67-1) utilizing self-report for identifying players from high- and low-exposure groups. Thus, in this study, self-reported data could be used to group youth players into high and low heading exposure groups, but not to quantify individual heading exposure.
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Affiliation(s)
- Stian B 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.,Department of Neurology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Jolien Gooijers
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, Biomedical Sciences, KU Leuven, Leuven, Belgium.,LBI - KU Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Caroline Seer
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, Biomedical Sciences, KU Leuven, Leuven, Belgium.,LBI - KU Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - David Kaufmann
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Department of Radiology, Charité Universitätsmedizin, Berlin, Germany
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Ofer Pasternak
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael L Lipton
- Departments of Radiology, Psychiatry and Behavioral Sciences and the Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Inga K Koerte
- cBRAIN, 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, MA, USA
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18
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Cassoudesalle H, Bildet M, Petit H, Dehail P. Head impacts in semiprofessional male Soccer players: a prospective video analysis over one season of competitive games. Brain Inj 2020; 34:1685-1690. [PMID: 33070665 DOI: 10.1080/02699052.2020.1831067] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Soccer exposes players to head injuries and involves repeated intentional head impacts through heading the ball. Our objective was to investigate the rate of both intentional headers and involuntary head impacts in semiprofessional male soccer players during one season. In this prospective cohort study, we followed 54 men (16-35 years) playing in two soccer clubs participating in the same regional French championship throughout the 2017-2018 season. All head impacts that occurred in competitive games were analyzed using video recordings. Player position, game exposure, referee's decision were also reported. Head impact incidence rate (IR) per 1000 player-hours, with the 95% confidence intervals (CIs) were calculated. Results: Headers IR was 3584.7 per 1000 player-hours (95% CI = 3431.9, 3737.5). Forwards and center-backs performed a higher number of headers. Involuntary head impacts IR was 44.1/1000 player-hours (95% CI = 27.1, 60.9). Just under half led the referee to stop playing time for a caregiver examination. Three concussions with a loss of consciousness after a head-to-head impact in a heading duel were recorded. Conclusions: Intentional headers were relatively common, contrary to involuntary head impacts that were however mainly due to heading duels. Head-to-head impact should lead to a systematic exit from the game for suspicion of concussion.
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Affiliation(s)
- Hélène Cassoudesalle
- Physical and Rehabilitation Medicine Unit, University Hospital of Bordeaux , Bordeaux, France.,Bordeaux Public Health Research Center- U1219, Handicap Activity Cognition & Health Team, University of Bordeaux, INSERM, F-33000 , Bordeaux, France
| | - Maxime Bildet
- Physical and Rehabilitation Medicine Unit, University Hospital of Bordeaux , Bordeaux, France
| | - Hervé Petit
- Physical and Rehabilitation Medicine Center, Korian Medical Clinic « Les Grands Chênes » , Bordeaux, France
| | - Patrick Dehail
- Physical and Rehabilitation Medicine Unit, University Hospital of Bordeaux , Bordeaux, France.,Bordeaux Public Health Research Center- U1219, Handicap Activity Cognition & Health Team, University of Bordeaux, INSERM, F-33000 , Bordeaux, France
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19
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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.
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20
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Beaudouin F, Gioftsidou A, Larsen MN, Lemmink K, Drust B, Modena R, Espinola JR, Meiu M, Vouillamoz M, Meyer T. The UEFA Heading Study: Heading incidence in children's and youth' football (soccer) in eight European countries. Scand J Med Sci Sports 2020; 30:1506-1517. [PMID: 32335945 DOI: 10.1111/sms.13694] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 04/15/2020] [Accepted: 04/20/2020] [Indexed: 12/28/2022]
Abstract
To assess the real-life magnitude of the heading incidence in children's and youth' football in eight European countries with different "football cultures," a cross-sectional observational design, in which one match per team in 480 different teams from eight European countries (2017/18-2018/19), was recorded by video. One training session was recorded in 312 teams. Clubs with Under-10, Under-12 (female/male/mixed), and Under-16 female and male teams were eligible to participate. Heading frequencies and types were analyzed. Results are presented as headers per match/training and per team. Incidence rates (IR) per 1000 match/training hours were calculated. Under-10 teams carried out the lowest average number of headers per match (8.8), followed by Under-16 female (17.7), Under-12 (18.4), and Under-16 male (35.5). Total number of headers per match and team varied between countries. 80% of the total number of headers were single intentional headers, 12% heading duels, 3% unintentional headers by getting hit, and 5% others (trends apparent in all age groups). Three head injuries occurred during match play corresponding to an IR of 0.70 (95% CI, 0.23-2.16). The lowest number of headers per training and team was found in Under-10 (21.3), followed by Under-16 females (34.1), Under-12 (35.8), and Under-16 males (45.0). In conclusion, this large-scale study presents novel data about the number and type of headers in youth' football throughout Europe. A more precise understanding of the heading incidence, specifically in young players, is mandatory for the debate of restrictions on heading in youth football.
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Affiliation(s)
- Florian Beaudouin
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Asimenia Gioftsidou
- Department of Physical Education and Sport Sciences, Democritus University of Thrace, Komotini, Greece
| | - Malte Nejst Larsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Koen Lemmink
- Center of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Barry Drust
- Sport and Exercise Sciences, John Moores University, Liverpool, UK
| | - Roberto Modena
- CeRiSM Research Center Sport Mountain and Health, University of Verona, Verona, Italy
| | | | - Mihai Meiu
- Romanian Football Federation, Bucharest, Romania
| | - Marc Vouillamoz
- Union des Associations Européennes de Football (UEFA), Nyon, Switzerland
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
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21
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Sandmo SB, Filipcik P, Cente M, Hanes J, Andersen TE, Straume-Naesheim TM, Bahr R. Neurofilament light and tau in serum after head-impact exposure in soccer. Brain Inj 2020; 34:602-609. [DOI: 10.1080/02699052.2020.1725129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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
| | - Peter Filipcik
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Martin Cente
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Jozef Hanes
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Truls Martin Straume-Naesheim
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Orthopedic Surgery, Akershus University Hospital, Lørenskog, Norway
- Department of Orthopedic Surgery, Haugesund Rheumatism Hospital, Haugesund, Norway
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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22
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Sandmo SB, Andersen TE, Koerte IK, Bahr R. Head impact exposure in youth football-Are current interventions hitting the target? Scand J Med Sci Sports 2019; 30:193-198. [PMID: 31584703 PMCID: PMC6916205 DOI: 10.1111/sms.13562] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/27/2019] [Accepted: 10/01/2019] [Indexed: 12/20/2022]
Abstract
Restrictions on heading in youth football have been implemented in some countries to limit head impact exposure. However, current interventions remain poorly guided by evidence. Our objective was to quantify heading exposure in youth football, assessing the effects of sex and age. Football matches played during an international youth football tournament with no heading restrictions were directly observed, including players from both sexes (11-19 years). The elite senior level was included for comparison, using video analysis. All heading events were registered, classified, and assigned to individual players. Heading rates were calculated for each sex and age group. We observed a total of 267 matches, corresponding to 4011 player hours (1927 player hours for females, 2083 player hours for males). Males headed more frequently than females (2.7 vs 1.8 headers/player hour; P < .001). Heading rates increased with age (ANOVA, P < .001), approaching the elite senior level for players 16 years and older. There was substantial variation within teams for all age and sex groups, with the widest range (1-18 headers) observed for girls aged 19. Girls younger than 12 years had the lowest exposure, with an average of <2 players per team heading the ball, each with 1-2 headers. In conclusion, age and sex influence head impact exposure in youth football, and warrants careful consideration when introducing injury prevention measures. Males are more frequently exposed than females, heading rates increase with age, and there is substantial variation between players. Heading is a rare event in the youngest age groups, especially among females.
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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
| | - 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, MA, USA
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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