scholarly journals Head injury mechanisms in FIS World Cup alpine and freestyle skiers and snowboarders

2017 ◽  
Vol 52 (1) ◽  
pp. 61-69 ◽  
Author(s):  
Sophie Elspeth Steenstrup ◽  
Arnhild Bakken ◽  
Tone Bere ◽  
Declan Alexander Patton ◽  
Roald Bahr
Keyword(s):  
Brain Injuries ◽  
Head Injuries ◽  
World Cup ◽  
Injury Surveillance System ◽  
Head Impacts ◽  
Injury Mechanisms ◽  
Skiing Injuries ◽  
Reduce Risk ◽  
Alpine Skiers ◽  
Impact Injury

IntroductionHead injuries represent a concern in skiing and snowboarding, with traumatic brain injuries being the most common cause of death.AimTo describe the mechanisms of head and face injuries among World Cup alpine and freestyle skiers and snowboarders.MethodsWe performed a qualitative analysis of videos obtained of head and face injuries reported through the International Ski Federation Injury Surveillance System during 10 World Cup seasons (2006–2016). We analysed 57 head impact injury videos (alpine n=29, snowboard n=13, freestyle n=15), first independently and subsequently in a consensus meeting.ResultsDuring the crash sequence, most athletes (84%) impacted the snow with the skis or board first, followed by the upper or lower extremities, buttocks/pelvis, back and, finally, the head. Alpine skiers had sideways (45%) and backwards pitching falls (35%), with impacts to the rear (38%) and side (35%) of the helmet. Freestyle skiers and snowboarders had backwards pitching falls (snowboard 77%, freestyle 53%), mainly with impacts to the rear of the helmet (snowboard 69%, freestyle 40%). There were three helmet ejections among alpine skiers (10% of cases), and 41% of alpine skiing injuries occurred due to inappropriate gate contact prior to falling. Athletes had one (47%) or two (28%) head impacts, and the first impact was the most severe (71%). Head impacts were mainly on snow (83%) on a downward slope (63%).ConclusionThis study has identified several characteristics of the mechanisms of head injuries, which may be addressed to reduce risk.

scholarly journals Head Injuries in Urban Environment Skiing and Snowboarding: A Retrospective Study on Injury Severity and Injury Mechanisms

2017 ◽  
Vol 107 (2) ◽  
pp. 166-171 ◽  
Author(s):  
A. Stenroos ◽  
L. Handolin
Keyword(s):  
Urban Environment ◽  
Brain Injuries ◽  
Injury Severity ◽  
Head Injuries ◽  
Urban Environments ◽  
University Hospital ◽  
Ski Resort ◽  
Injury Mechanisms ◽  
Icd 10 ◽  
Skiing Injuries

Background and Aim: During the last decade urban skiing and snowboarding has gained a lot of popularity. In urban skiing/snowboarding riders try to balance on handrails and jump off buildings. Previous studies in skiing and snowboarding accidents have mostly been conducted at hospitals located close to alpine terrain with big ski resort areas. The aim of this study is to evaluate the types and severity of traumatic brain injuries occurring in small, suburban hills and in urban environment, and to characterize injury patterns to find out the specific mechanisms of injuries behind. Materials and Methods: This study included all patients admitted to the Helsinki University Hospital Trauma Unit from 2006 to 2015 with a head injury (ICD 10 S06-S07) from skiing or snowboarding accidents in Helsinki capital area. Head injuries that did not require a CT-scan, and injuries older than 24 hours were excluded from this study. Results: There were a total of 72 patients that met the inclusion criteria Mean length of stay in hospital was 2.95 days. According to the AIS classification, 30% had moderate, 14% had severe, and 10% had critical head injuries. Patients who got injured in terrain parks or on streets where more likely to be admitted to ICU than those injured on slopes. Based on GOS score at discharge, 78% were classified as having a good recovery from the injury, 13% had a moderate disability, 5% had a severe disability and 3% of the injuries were fatal. There were no statistically significant differences in decreased GOS between the accident sites. Conclusion: Head injuries occurring in small suburban hills and in urban environments can be serious and potentially fatal. The profile and severity of skiing injuries in urban environments and small, suburban hills is comparable to those on alpine terrain.

Combat Helmet Design Incorporating Multiple Ballistic Threats, Brain Functional Areas and Injury Considerations

2016 ◽  
Author(s):  
Peter Matic ◽  
Alex E. Moser ◽  
Robert N. Saunders
Keyword(s):  
Head Injury ◽  
Diagnostic Criteria ◽  
Computer Aided Design ◽  
Brain Injuries ◽  
Head Injuries ◽  
Design Parameters ◽  
Head Impacts ◽  
Direct Head ◽  
Back Face ◽  
Helmet Design

Combat helmet protection zone parametric design is presented for small arms and explosive device ballistic threat notional spatial distributions. The analysis is conducted using a computer aided design software application developed to evaluate ballistic threats, helmet design parameters, and a standard set of common brain injuries associated with head impacts. The analysis helps to define the helmet trade space, facilitates prototyping, and supports helmet design optimization. Direct head impacts and helmet impacts, with and without helmet back face contact to the head, are tabulated. Head strikes are assumed to produce critical or fatal penetrating injuries. Helmet back face deflections and impact generated projectile-helmet-head motions are determined. Helmet impact obliquity is accounted for by attenuating back face deflection. Head injury estimates for ten common focal and diffuse head injuries are determined from the back face deflections and the head injury criteria. These, in turn, are related to the abbreviated injury score and associated radiographic dimensional diagnostic criteria and loss of consciousness diagnostic criteria from the trauma literature.

Experimental Determination of Pressure Wave Transmission to the Brain During Head-Neck Blast Tests

2013 ◽  
Author(s):  
Kyle Ott ◽  
Liming Voo ◽  
Andrew Merkle ◽  
Alexander Iwaskiw ◽  
Alexis Wickwire ◽  
...  
Keyword(s):  
Brain Injury ◽  
Brain Injuries ◽  
Head Injuries ◽  
Strong Association ◽  
Skull Fracture ◽  
Linear Acceleration ◽  
Military Operations ◽  
Blunt Impact ◽  
Injury Mechanisms ◽  
Inertial Loading

Traumatic Brain Injury (TBI) has been the termed the “signature injury” in wounded soldiers in recent military operations [1]. Evidence has shown a strong association between TBI and blast loading to the head due to exposure to explosive events [2, 3]. Head injury mechanisms in a primary blast environment remain elusive and are the subject of much speculation and hypotheses. However, brain injury mechanisms have traditionally been attributed to either a direct impact or a rapid head acceleration or deceleration. Extensive research has been performed regarding the effects of blunt trauma and inertial loading on head injuries [4, 5]. Direct impacts to the head can largely be described based on linear acceleration measurements that correlate to skull fracture and focal brain injuries [6]. Computational head modeling of blunt impact events has shown that the linear acceleration response correlates well with increases in brain pressure [7]. Intracranial pressure, therefore, has been one of the major quantities investigated for correlation to blast induced TBI injury mechanisms [8–14].

scholarly journals Reconstruction of head impacts in FIS World Cup alpine skiing

2017 ◽  
Vol 52 (11) ◽  
pp. 709-715 ◽  
Author(s):  
Sophie Elspeth Steenstrup ◽  
Kam-Ming Mok ◽  
Andrew S McIntosh ◽  
Roald Bahr ◽  
Tron Krosshaug
Keyword(s):  
Head Injury ◽  
Sagittal Plane ◽  
Two Dimensions ◽  
Head Impact ◽  
World Cup ◽  
Injury Surveillance System ◽  
Velocity Change ◽  
Head Impacts ◽  
Impact Biomechanics ◽  
Testing Speed

IntroductionPrior to the 2013/2014 season, the International Ski Federation (FIS) increased the helmet testing speed from 5.4 to 6.8 m/s for alpine downhill, super-G and giant slalom. Whether this increased testing speed reflects head impact velocities in real head injury situations on snow is unclear. We therefore investigated the injury mechanisms and gross head impact biomechanics in seven real head injury situations among World Cup (WC) alpine skiers.MethodsWe analysed nine head impacts from seven head injury videos from the FIS Injury Surveillance System, throughout nine WC seasons (2006–2015) in detail. We used commercial video-based motion analysis software to estimate head impact kinematics in two dimensions, including directly preimpact and postimpact, from broadcast video. The sagittal plane angular movement of the head was also measured using angle measurement software.ResultsIn seven of nine head impacts, the estimated normal to slope preimpact velocity was higher than the current FIS helmet rule of 6.8 m/s (mean 8.1 (±SD 0.6) m/s, range 1.9±0.8 to 12.1±0.4 m/s). The nine head impacts had a mean normal to slope velocity change of 9.3±1.0 m/s, range 5.2±1.1 to 13.5±1.3 m/s. There was a large change in sagittal plane angular velocity (mean 43.3±2.9 rad/s (range 21.2±1.5 to 64.2±3.0 rad/s)) during impact.ConclusionThe estimated normal to slope preimpact velocity was higher than the current FIS helmet rule of 6.8 m/s in seven of nine head impacts.

scholarly journals Concussion in Rugby Union and the Role of Biomechanics

Res Medica ◽  
2017 ◽  
Vol 24 (1) ◽  
pp. 87-95
Author(s):  
Gregory J Tierney ◽  
Ciaran K Simms
Keyword(s):  
Medical Staff ◽  
Brain Injuries ◽  
Sports Injuries ◽  
Head Injuries ◽  
Rugby Union ◽  
American Football ◽  
Head Impacts ◽  
Major Disadvantage ◽  
Protection Strategies ◽  
Biomechanical Forces

Due to the physical and high-impact nature of rugby, head impacts can occur within the game which can result in concussion injuries as well as other moderate-to-severe head injuries 1. Concussion has been defined as “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces”1 and was found to be one of the more common brain injuries throughout the world.2 This is particularly true in sport; it has been estimated that over half of all concussions are sports related.3 A systematic review of the incidence of concussion in contact sports found that rugby union has a higher incidence rate compared with other sports such as American football and soccer.4 Unlike other sports injuries, detecting a concussion is difficult as the neuropathological changes cannot be recognized on standard neuroimaging technology.5,6 \Therefore, if a player is suspected of having a concussion, they are removed from play for a Head Injury Assessment (HIA). The HIA is a standardized tool for the medical assessment of concussion injuries in rugby and aims to improve detection and patient education.7 The HIA assesses a range of degenerative concussive symptoms including memory, cognitive ability, balance and player discomfort. This concussion diagnosis protocol therefore relies heavily on side-line medical staff to identify if a player is exhibiting concussive symptoms. A major disadvantage to this is that concussion has a variable natural history, with transient, fluctuating, delayed and evolving signs or symptoms.8) This means that symptoms can take up to 48 hours to become apparent.8 It has therefore been acknowledged that the content of the HIA will be modified as the research around concussion diagnosis evolves.8 The reliance on side-line medical staff to accurately identify concussive symptoms means that there is a possibility a concussed player may remain on the field; this is one problem that biomechanical research into concussion is trying to overcome.  This study will give an overview of concussion in rugby union with a focus on incidence, severity and protection strategies. It will discuss current biomechanical research and further biomechanical research required in the area of concussion injuries in rugby union.

scholarly journals Structural brain injury in sports-related concussion

2012 ◽  
Vol 33 (6) ◽  
pp. E6 ◽  
Author(s):  
Scott L. Zuckerman ◽  
Andrew Kuhn ◽  
Michael C. Dewan ◽  
Peter J. Morone ◽  
Jonathan A. Forbes ◽  
...  
Keyword(s):  
Brain Injury ◽  
Literature Review ◽  
Brain Injuries ◽  
Case Reports ◽  
Head Injuries ◽  
Health Concern ◽  
Prevalence Data ◽  
Small Series ◽  
Structural Brain

Object Sports-related concussions (SRCs) represent a significant and growing public health concern. The vast majority of SRCs produce mild symptoms that resolve within 1–2 weeks and are not associated with imaging-documented changes. On occasion, however, structural brain injury occurs, and neurosurgical management and intervention is appropriate. Methods A literature review was performed to address the epidemiology of SRC with a targeted focus on structural brain injury in the last half decade. MEDLINE and PubMed databases were searched to identify all studies pertaining to structural head injury in sports-related head injuries. Results The literature review yielded a variety of case reports, several small series, and no prospective cohort studies. Conclusions The authors conclude that reliable incidence and prevalence data related to structural brain injuries in SRC cannot be offered at present. A prospective registry collecting incidence, management, and follow-up data after structural brain injuries in the setting of SRC would be of great benefit to the neurosurgical community.

scholarly journals A Qualitative Study of Youth Football Coaches’ Perception of Concussion Safety in American Youth Football and Their Experiences With Implementing Tackling Interventions

2020 ◽  
pp. 1-9
Author(s):  
Kelly Sarmiento ◽  
Dana Waltzman ◽  
Kelley Borradaile ◽  
Andrew Hurwitz ◽  
Kara Conroy ◽  
...  
Keyword(s):  
Head Injuries ◽  
Young Age ◽  
Long Term Effects ◽  
Head Impacts ◽  
Football Coaches ◽  
Youth Athletes ◽  
Risks And Benefits ◽  
Youth Football ◽  
Tackle Football

Due in part to concern about the potential long-term effects of concussion and repetitive head injuries in football, some programs have implemented tackling interventions. This paper explores youth football coaches’ perception of football safety and their experiences implementing these interventions aimed at athlete safety. Using a qualitative approach, coaches were interviewed by means of a semi-structured protocol that covered: (a) demographics; (b) background and experiences with contact sports; (c) perceived concussion risks and benefits of youth football; (d) experiences with tackling technique; (e) experiences with mouth guard sensors; and (f) personal sources of training related to football safety. Most coaches felt that learning tackling at a young age helped prepare them for their playing later in life and believed that youth should begin playing tackle football at a young age. Coaches were mixed regarding their concerns about the risk for concussion and subconcussive head impacts. Still, most were receptive to changes in rules and policies aimed at making football safer. Findings from this study demonstrate that youth football coaches are important stakeholders to consider when implementing changes to youth football. Understanding coach perceptions and experiences may inform future efforts aimed to educate coaches on rules and policies to make the game safer for youth athletes.

scholarly journals Computation of history-dependent mechanical damage of axonal fiber tracts in the brain: towards tracking sub-concussive and occupational damage to the brain

2018 ◽  
Author(s):  
Jesse I. Gerber ◽  
Harsha T. Garimella ◽  
Reuben H. Kraft
Keyword(s):  
Fiber Bundle ◽  
Brain Injuries ◽  
Mechanical Response ◽  
Head Injuries ◽  
Mechanical Damage ◽  
Tissue Level ◽  
Internal Damage ◽  
Damage Models ◽  
Axonal Fiber ◽  
The Brain

ABSTRACTFinite element models are frequently used to simulate traumatic brain injuries. However, current models are unable to capture the progressive damage caused by repeated head trauma. In this work, we propose a method for computing the history-dependent mechanical damage of axonal fiber bundle tracts in the brain. Through the introduction of multiple damage models, we provide the ability to link consecutive head impact simulations, so that potential injury to the brain can be tracked over time. In addition, internal damage variables are used to degrade the mechanical response of each axonal fiber bundle element. As a result, the stiffness of the aggregate tissue decreases as damage evolves. To counteract this degenerative process, we have also introduced a preliminary healing model that reverses the accumulated damage, based on a user-specified healing duration. Using two detailed examples, we demonstrate that damage produces a significant decrease in fiber stress, which ultimately propagates to the tissue level and produces a measurable decrease in overall stiffness. These results suggest that damage modeling has the potential to enhance current brain simulation techniques and lead to new insights, especially in the study of repetitive head injuries.

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