Head impact exposure and time to recovery in youth american football players diagnosed with a concussion

2017 ◽  
Vol 51 (11) ◽  
pp. A16.2-A16
Author(s):  
Verle D Valentine ◽  
Jason C Dorman ◽  
Thayne A Munce
Keyword(s):  
Head Impact ◽  
American Football ◽  
Football Players

Association Between Antemortem FLAIR White Matter Hyperintensities and Neuropathology in Brain Donors Exposed to Repetitive Head Impacts

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013012
Author(s):  
Madeline Uretsky ◽  
Sylvain Bouix ◽  
Ronald J. Killiany ◽  
Yorghos Tripodis ◽  
Brett Martin ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Microvascular Disease ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
Head Impacts ◽  
Repetitive Head Impacts ◽  
Pathological Correlation ◽  
Daily Function

Background and Objectives:Late neuropathologies of repetitive head impacts from contact sports can include chronic traumatic encephalopathy (CTE) and white matter degeneration. White matter hyperintensities (WMH) on fluid attenuated inversion recovery (FLAIR) MRI scans are often viewed as microvascular disease from vascular risk, but might have unique underlying pathologies and risk factors in the setting of repetitive head impacts. We investigated the neuropathological correlates of antemortem WMH in brain donors exposed to repetitive head impacts. The association between WMH, and repetitive head impact exposure and informant-reported cognitive and daily function were tested.Methods:This imaging-pathological correlation study included symptomatic deceased men exposed to repetitive head impacts. Donors had antemortem FLAIR scans from medical records and were without evidence of CNS neoplasm, large vessel infarcts, hemorrhage, and/or encephalomalacia. WMH were quantified using log-transformed values for total lesion volume (TLV), calculated using the lesion prediction algorithm from the Lesion Segmentation Toolbox. Neuropathological assessments included semi-quantitative ratings of white matter rarefaction, cerebrovascular disease, p-tau severity (CTE stage, dorsolateral frontal cortex), and Aβ. Among football players, years of play was a proxy for repetitive head impact exposure. Retrospective informant-reported cognitive and daily function were assessed using the Cognitive Difficulties Scale (CDS) and Functional Activities Questionnaire (FAQ). Regression models controlled for demographics, diabetes, hypertension, and MRI resolution. Statistical significance was defined as p<0.05.Results:The sample included 75 donors: 67 football players and 8 non-football contact sport athletes and/or military veterans. Dementia was the most common MRI indication (64%). Fifty-three (70.7%) had CTE at autopsy. Log-TLV was associated with white matter rarefaction (OR=2.32, 95% CI=1.03,5.24, p=0.04), arteriolosclerosis (OR=2.38, 95% CI=1.02,5.52, p=0.04), CTE stage (OR=2.58, 95% CI=1.17,5.71, p=0.02), and dorsolateral frontal p-tau severity (OR=3.03, 95% CI=1.32,6.97, p=0.01). There was no association with Aβ. More years of football play was associated with log-TLV (b=0.04, 95% CI=0.01,0.06, p=0.01). Greater log-TLV correlated with higher FAQ (unstandardized beta=4.94, 95% CI=0.42,8.57, p=0.03) and CDS scores (unstandardized beta=15.35, 95% CI=-0.27,30.97, p=0.05).Discussion:WMH might capture long-term white matter pathologies from repetitive head impacts, including those from white matter rarefaction and p-tau, in addition to microvascular disease. Prospective imaging-pathological correlation studies are needed.Classification of Evidence:This study provides Class IV evidence of associations between FLAIR white matter hyperintensities, and neuropathological changes (white matter rarefaction, arteriolosclerosis, p-tau accumulation), years of American football play, and reported cognitive symptoms in symptomatic brain donors exposed to repetitive head impacts.

THE RELATIONSHIP BETWEEN REPETITIVE HEAD IMPACT EXPOSURE AND CHRONIC TRAUMATIC ENCEPHALOPATHY IN AMERICAN FOOTBALL PLAYERS

2017 ◽  
Vol 13 (7) ◽  
pp. P1469-P1470
Author(s):  
Jesse Mez ◽  
Daniel H. Daneshvar ◽  
Bobak Abdolmohammadi ◽  
Patrick T. Kiernan ◽  
Michael L. Alosco ◽  
...  
Keyword(s):  
Chronic Traumatic Encephalopathy ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
The Relationship

scholarly journals Similar head impact acceleration measured using instrumented ear patches in a junior rugby union team during matches in comparison with other sports

2016 ◽  
Vol 18 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Doug A. King ◽  
Patria A. Hume ◽  
Conor Gissane ◽  
Trevor N. Clark
Keyword(s):  
Injury Risk ◽  
Linear Acceleration ◽  
Rugby Union ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
Head Impacts ◽  
Impact Acceleration ◽  
The Impact ◽  
Rugby Players

OBJECTIVE Direct impact with the head and the inertial loading of the head have been postulated as major mechanisms of head-related injuries, such as concussion. METHODS This descriptive observational study was conducted to quantify the head impact acceleration characteristics in under-9-year-old junior rugby union players in New Zealand. The impact magnitude, frequency, and location were collected with a wireless head impact sensor that was worn by 14 junior rugby players who participated in 4 matches. RESULTS A total of 721 impacts > 10g were recorded. The median (interquartile range [IQR]) number of impacts per player was 46 (IQR 37–58), resulting in 10 (IQR 4–18) impacts to the head per player per match. The median impact magnitudes recorded were 15g (IQR 12g–21g) for linear acceleration and 2296 rad/sec2 (IQR 1352–4152 rad/sec2) for rotational acceleration. CONCLUSIONS There were 121 impacts (16.8%) above the rotational injury risk limit and 1 (0.1%) impact above the linear injury risk limit. The acceleration magnitude and number of head impacts in junior rugby union players were higher than those previously reported in similar age-group sports participants. The median linear acceleration for the under-9-year-old rugby players were similar to 7- to 8-year-old American football players, but lower than 9- to 12-year-old youth American football players. The median rotational accelerations measured were higher than the median and 95th percentiles in youth, high school, and collegiate American football players.

Behavioral Tackling Interventions Decrease Head Impact Frequency in American Football Players: A Critically Appraised Topic

2020 ◽  
pp. 1-7
Author(s):  
Ashley E. Evans ◽  
Madeline Curtis ◽  
Marguerite (Meg) Montjoy ◽  
Erica Beidler
Keyword(s):  
High School ◽  
Injury Prevention ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
Clinical Question ◽  
Impact Frequency ◽  
Bottom Line ◽  
Head Impacts ◽  
Different Types

Context: The rate of sport-related concussion diagnosis has significantly increased in recent years, which has created a need for injury prevention initiatives. There have been efforts put forth by researchers and American football organizations to teach athletes how to tackle properly in order to decrease the number of subconcussive head impacts and concussions. Clinical Question: Does the implementation of a behavioral tackling intervention decrease the head impact frequency in American football players? Clinical Bottom Line: There is moderate SORT Level B evidence to support the use of behavioral tackling interventions as a means for reducing head impact frequency in football athletes. All four included studies found a significant reduction in head impacts following a behavioral tackling intervention with study findings ranging from a 26–33% reduction in impact frequency. These findings were consistent in youth, high school, and college football players and for different types of behavioral tackling interventions. Therefore, these results indicate that behavioral tackling interventions have the potential to reduce the number of head impacts sustained by American football players, which may ultimately lead to a reduction in concussion occurrence as well.

Comparing In Vivo Head Impact Kinematics From American Football With Laboratory Drop and Linear Impactors

2013 ◽  
Author(s):  
Fidel Hernandez ◽  
Pete B. Shull ◽  
Bruce Cam ◽  
Lyndia Wu ◽  
Rebecca Shultz ◽  
...  
Keyword(s):  
High School ◽  
Brain Function ◽  
Laboratory Testing ◽  
Laboratory Tests ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
Test Apparatus ◽  
Kinematic Measures

Roughly 5% of all collegiate and high school American football players suffer a concussion each season [1]. Concussions and repetitive sub-concussive trauma can have measurable effects on brain function and neurophysiological changes [2]. Several studies have suggested that a combination of linear and angular kinematic measures may be predictive of concussion [3, 4]. Presently, laboratory testing and analysis of purely linear kinematics is used to design and assess the safety of protective headgear. However, it is not known how well existing laboratory tests recapitulate angular kinematics. In this study, we analyze combinations of linear and angular head kinematics experienced by players on the field. This study sought to answer the question: how well do the twin-wire drop test apparatus and a spring-driven linear impactor reproduce the combination of linear and angular head impact kinematics experienced in vivo by players of American football?

scholarly journals Magnitude and frequency of head impact among university American football players

2019 ◽  
Vol 8 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Takashi Fukuda ◽  
Sekiya Koike ◽  
Shumpei Miyakawa ◽  
Hiroto Fujiya ◽  
Yuki Yamamoto
Keyword(s):  
Head Impact ◽  
American Football ◽  
Football Players

An Investigation of Factors Associated With Head Impact Exposure in Professional Male and Female Australian Football Players

2020 ◽  
Vol 48 (6) ◽  
pp. 1485-1495
Author(s):  
Jonathan Reyes ◽  
Biswadev Mitra ◽  
Andrew McIntosh ◽  
Patrick Clifton ◽  
Michael Makdissi ◽  
...  
Keyword(s):  
Skill Development ◽  
Head Impact ◽  
Ice Hockey ◽  
American Football ◽  
Football Players ◽  
Impact Rate ◽  
Direct Head ◽  
Australian Football ◽  
Player Experience

Background: Exposure to head acceleration events (HAEs) has been associated with player sex, player position, and player experience in North American football, ice hockey, and lacrosse. Little is known of these factors in professional Australian football. Video analysis allows HAE verification and characterization of important determinants of injury. Purpose: To characterize verified HAEs in the nonhelmeted contact sport of professional Australian football and investigate the association of sex, player position, and player experience with HAE frequency and magnitude. Study Design: Descriptive epidemiology study. Methods: Professional Australian football players wore a nonhelmeted accelerometer for 1 match, with data collected across 14 matches. HAEs with peak linear accelerations (PLAs) ≥30 g were verified with match video. Verified HAEs were summarized by frequency and median PLA and compared between the sexes, player position, and player experience. Characterization of match-related situations of verified HAEs was conducted, and the head impact rate per skill execution was calculated. Results: 92 male and 118 female players were recruited during the 2017 season. Male players sustained more HAEs (median, 1; IQR, 0-2) than female players (median, 0; IQR, 0-1; P = .007) during a match. The maximum PLAs incurred during a match were significantly higher in male players (median, 61.8 g; IQR, 40.5-87.1) compared with female players (median, 44.5 g; IQR, 33.6-74.8; P = .032). Neither player position nor experience was associated with HAE frequency. Of all verified HAEs, 52% (n = 110) occurred when neither team had possession of the football, and 46% (n = 98) were caused by contact from another player attempting to gain possession of the football. A subset of HAEs (n = 12; 5.7%) resulted in players seeking medical aid and/or being removed from the match (median PLA, 58.8 g; IQR, 34.0-89.0), with 2 (male) players diagnosed with concussion after direct head impacts and associated PLAs of 62 g and 75 g, respectively. In the setting of catching (marking) the football, female players exhibited twice the head impact rate (16 per 100 marking contests) than male players (8 per 100 marking contests). Conclusion: Playing situations in which players have limited control of the football are a common cause of impacts. Male players sustained a greater exposure to HAEs compared with female players. Female players, however, sustained higher exposure to HAEs than male players during certain skill executions, possibly reflecting differences in skill development. These findings can therefore inform match and skill development in the emerging professional women’s competition of Australian football.

scholarly journals Comparison of video-based and sensor-based head impact exposure

2017 ◽  
Author(s):  
Calvin Kuo ◽  
Lyndia Wu ◽  
Jesus Loza ◽  
Daniel Senif ◽  
Scott C. Anderson ◽  
...  
Keyword(s):  
Angular Position ◽  
Head Impact ◽  
American Football ◽  
Rear Side ◽  
Football Players ◽  
Head Impacts ◽  
Video Assessment ◽  
Impact Location ◽  
Video Observations ◽  
Time Stamps

AbstractPrevious research has sought to quantify head impact exposure using wearable kinematic sensors. However, many sensors suffer from poor accuracy in estimating impact kinematics and count, motivating the need for additional independent impact exposure quantification for comparison. Here, we equipped seven collegiate American football players with instrumented mouthguards, and video recorded practices and games to compare video-based and sensor-based exposure rates and impact location distributions. Over 50 player-hours, we identified 271 helmet contact periods in video, while the instrumented mouthguard sensor recorded 2,032 discrete head impacts. Matching video and mouthguard real-time stamps yielded 193 video-identified helmet contact periods and 217 sensor-recorded impacts. To compare impact locations, we binned matched impacts into frontal, rear, side, oblique, and top locations based on video observations and sensor kinematics. While both video-based and sensor-based methods found similar location distributions, our best method utilizing integrated linear and angular position only correctly predicted 81 of 217 impacts. Finally, based on the activity timeline from video assessment, we also developed a new exposure metric unique to American football quantifying number of cross-verified sensor impacts per player-play. We found significantly higher exposure during games (0.35, 95% CI: 0.29-0.42) than practices (0.20, 95% CI: 0.17-0.23) (p<0.05). In the traditional impacts per player-hour metric, we observed higher exposure during practices (4.7) than games (3.7) due to increased player activity in practices. Thus, our exposure metric accounts for variability in on-field participation. While both video-based and sensor-based exposure datasets have limitations, they can complement one another to provide more confidence in exposure statistics.

scholarly journals Disparate Associations of Years of Football Participation and a Metric of Head Impact Exposure with Neurobehavioral Outcomes in Former Collegiate Football Players

2021 ◽  
pp. 1-13
Author(s):  
Benjamin L. Brett ◽  
Amy M. Nader ◽  
Zachary Y. Kerr ◽  
Avinash Chandran ◽  
Samuel R. Walton ◽  
...  
Keyword(s):  
Sport Participation ◽  
Verbal Learning ◽  
Brief Symptom Inventory ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
Structured Interviews ◽  
Head Impacts ◽  
Exposure Estimate ◽  
Neurobehavioral Outcomes

Abstract Objectives: Years of sport participation (YoP) is conventionally used to estimate cumulative repetitive head impacts (RHI) experienced by contact sport athletes. The relationship of this measure to other estimates of head impact exposure and the potential associations of these measures with neurobehavioral functioning are unknown. We investigated the association between YoP and the Head Impact Exposure Estimate (HIEE), and whether associations between the two estimates of exposure and neurobehavioral functioning varied. Methods: Former American football players (N = 58; age = 37.9 ± 1.5 years) completed in-person evaluations approximately 15 years following sport discontinuation. Assessments consisted of neuropsychological assessment and structured interviews of head impact history (i.e., HIEE). General linear models were fit to test the association between YoP and the HIEE, and their associations with neurobehavioral outcomes. Results: YoP was weakly correlated with the HIEE, p = .005, R 2 = .13. Higher YoP was associated with worse performance on the Symbol Digit Modalities Test, p = .004, R 2 = .14, and Trail Making Test-B, p = .001, R 2 = .18. The HIEE was associated with worse performance on the Delayed Recall trial of the Hopkins Verbal Learning Test-Revised, p = .020, R 2 = .09, self-reported cognitive difficulties (Neuro-QoL Cognitive Function), p = .011, R 2 = .10, psychological distress (Brief Symptom Inventory-18), p = .018, R 2 = .10, and behavioral regulation (Behavior Rating Inventory of Executive Function for Adults), p = .017, R 2 = .10. Conclusions: YoP was marginally associated with the HIEE, a comprehensive estimate of head impacts sustained over a career. Associations between each exposure estimate and neurobehavioral functioning outcomes differed. Findings have meaningful implications for efforts to accurately quantify the risk of adverse long-term neurobehavioral outcomes potentially associated with RHI.

Racial and Athletic Identity of African American Football Players

2009 ◽  
Author(s):  
Jesse A. Steinfeldt ◽  
Courtney Reed ◽  
Clint M. Steinfeldt
Keyword(s):  
African American ◽  
Athletic Identity ◽  
American Football ◽  
Football Players
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