Differences in Head Impact Exposures Between Youth Tackle and Flag Football Games and Practices: Potential Implications for Prevention Strategies

2021 ◽  
pp. 036354652110117
Author(s):  
Kelly Sarmiento ◽  
Dana Waltzman ◽  
Owen Devine ◽  
Xinjian Zhang ◽  
Lara DePadilla ◽  
...  
Keyword(s):  
Large Population ◽  
Head Impact ◽  
Level Of Evidence ◽  
Head Impacts ◽  
Youth Football ◽  
High Magnitude ◽  
Average Impact ◽  
Tackle Football ◽  
Impact Data ◽  
Age Range

Background: Interventions designed to reduce the risk for head impacts and concussion in youth football have increased over the past decade; however, understanding of the role of regular game play on head impact exposure among youth tackle and flag football athletes is currently limited. Purpose: To explore head impact exposure among youth tackle and flag football athletes (age range, 6-14 years) during both practices and games. Study Design: Cohort study; Level of evidence, 2. Methods: Using the Vector MouthGuard sensor, the authors collected head impact data from 524 tackle and flag youth football athletes over the course of a football season. Quantities of interest were estimated from regression models using Bayesian methods. Results: For impacts ≥10 g, a tackle football athlete had an estimated 17.55 (95% CI, 10.78-28.96) times more head impacts per practice compared with a flag football athlete (6.85 [95% CI, 6.05-7.76] and 0.39 [95% CI, 0.24-0.62] head impacts, respectively). Additionally, a tackle football athlete had an estimated 19.48 (95% CI, 12.74-29.98) times more head impacts per game compared with a flag football athlete (13.59 [95% CI, 11.97-15.41] and 0.70 [95% CI, 0.46-1.05] head impacts, respectively). Among tackle football athletes, the estimated average impact rate was 6.51 (95% CI, 5.75-7.37) head impacts during a practice and 12.97 (95% CI, 11.36-14.73) impacts during a game, resulting in 2.00 (95% CI, 1.74-2.29) times more ≥10 g head impacts in games versus practices. Tackle football athletes had 2.06 (95% CI, 1.80-2.34) times more high-magnitude head impacts (≥40 g) during a game than during a practice. On average, flag football athletes experienced an estimated 0.37 (95% CI, 0.20-0.60) head impacts during a practice and 0.77 (95% CI, 0.53-1.06) impacts during a game, resulting in 2.06 (95% CI, 1.29-3.58) times more ≥10 g head impacts in games versus practices. Because of model instability caused by a large number of zero impacts for flag football athletes, a comparison of high-magnitude head impacts is not reported for practices or games. Conclusion: This study provides a characterization of the head impact exposure of practices and games among a large population of youth tackle and flag football athletes aged 6 to 14 years. These findings suggest that a greater focus on game-based interventions, such as fair play interventions and strict officiating, may be beneficial to reduce head impact exposures for youth football athletes.

scholarly journals Do American Youth Football Players Intentionally Use Their Heads for High-Magnitude Impacts?

2019 ◽  
Vol 47 (14) ◽  
pp. 3498-3504 ◽  
Author(s):  
Jaclyn Alois ◽  
Srinidhi Bellamkonda ◽  
Eamon T. Campolettano ◽  
Ryan A. Gellner ◽  
Amaris Genemaras ◽  
...  
Keyword(s):  
Head Injuries ◽  
Cross Sectional Study ◽  
Head Impact ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Impact Mechanism ◽  
Head Impacts ◽  
Youth Football ◽  
High Magnitude ◽  
The Impact

Background: Concern for head injuries is widespread and has been reported by the media to be the number one cause of decreased participation in football among the American youth population. Identifying player mechanisms associated with intentional, or purposeful, head impacts should provide critical data for rule modifications, educational programs, and equipment design. Purpose: To investigate the frequency of intentional and unintentional head impacts and to examine the player mechanisms associated with intentional high-magnitude head impacts by comparing the impact mechanism distributions among session type, player position, and ball possession. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Head impact sensors and video footage of 68 players were used to analyze and classify 1319 high-magnitude impacts recorded over 1 season of youth football. Results: In total, 80% of the high-magnitude head impacts were classified as being caused by intentional use of the head. Head-to-head impact was the primary impact mechanism (n = 868; 82.7%) within the 1050 intentional high-magnitude impacts, with classifiable mechanisms, followed by head-to-body (n = 139; 13.2%), head-to-ground (n = 34; 3.2%), and head-to-equipment (n = 9; 0.9%). Head-to-head impacts also accounted for a greater proportion of impacts during practices (n = 625; 88.9%) than games, for linemen (n = 585; 90.3%) than perimeters and backs, and for ball carriers (n = 72; 79.1%) than tacklers. Conclusion: Overall, the majority of high-magnitude head impacts were intentional and resulted from head-to-head contact. The proportion of head-to-head contact was significantly higher for practices than games, linemen than backs and perimeter players, and ball carriers than tacklers.

scholarly journals Head Impact Exposures Among Youth Tackle and Flag American Football Athletes

2021 ◽  
pp. 194173812199232
Author(s):  
Dana Waltzman ◽  
Kelly Sarmiento ◽  
Owen Devine ◽  
Xinjian Zhang ◽  
Lara DePadilla ◽  
...  
Keyword(s):  
Cohort Study ◽  
Head Impact ◽  
American Football ◽  
Level Of Evidence ◽  
Head Impacts ◽  
High Magnitude ◽  
Increased Risk ◽  
Or Practice ◽  
Observational Prospective Cohort Study ◽  
Tackle Football

Background: Promoted as a safer alternative to tackle football, there has been an increase in flag football participation in recent years. However, examinations of head impact exposure in flag football as compared with tackle football are currently limited. Hypothesis: Tackle football athletes will have a greater number and magnitude of head impacts compared with flag football athletes. Study Design: Cohort study. Level of Evidence: Level 4. Methods: Using mouthguard sensors, this observational, prospective cohort study captured data on the number and magnitude of head impacts among 524 male tackle and flag football athletes (6-14 years old) over the course of a single football season. Estimates of interest based on regression models used Bayesian methods to estimate differences between tackle and flag athletes. Results: There were 186,239 head impacts recorded during the study. Tackle football athletes were 14.67 (95% CI 9.75-21.95) times more likely to sustain a head impact during an athletic exposure (game or practice) compared with flag football athletes. Magnitude of impact for the 50th and 95th percentile was 18.15 g (17.95-18.34) and 52.55 g (51.06-54.09) for a tackle football athlete and 16.84 g (15.57-18.21) and 33.51 g (28.23-39.08) for a flag football athlete, respectively. A tackle football athlete sustained 23.00 (13.59-39.55) times more high-magnitude impacts (≥40 g) per athletic exposure compared with a flag football athlete. Conclusion: This study demonstrates that youth athletes who play tackle football are more likely to experience a greater number of head impacts and are at a markedly increased risk for high-magnitude impacts compared with flag football athletes. Clinical Relevance: These results suggest that flag football has fewer head impact exposures, which potentially minimizes concussion risk, making it a safer alternative for 6- to 14-year-old youth football athletes.

scholarly journals High-magnitude head impact exposure in youth football

2017 ◽  
Vol 20 (6) ◽  
pp. 604-612 ◽  
Author(s):  
Eamon T. Campolettano ◽  
Ryan A. Gellner ◽  
Steven Rowson
Keyword(s):  
Open Field ◽  
Body Mass ◽  
Head Impact ◽  
Football Players ◽  
Head Impacts ◽  
Video Recordings ◽  
Youth Football ◽  
High Magnitude ◽  
Or Practice ◽  
The Impact

OBJECTIVEEven in the absence of a clinically diagnosed concussion, research suggests that neurocognitive changes may develop in football players as a result of frequent head impacts that occur during football games and practices. The objectives of this study were to determine the specific situations in which high-magnitude impacts (accelerations exceeding 40g) occur in youth football games and practices and to assess how representative practice activities are of games with regard to high-magnitude head impact exposure.METHODSA total of 45 players (mean age 10.7 ± 1.1 years) on 2 youth teams (Juniors [mean age 9.9 ± 0.6 years; mean body mass 38.9 ± 9.9 kg] and Seniors [mean age 11.9 ± 0.6 years; mean body mass 51.4 ± 11.8 kg]) wore helmets instrumented with accelerometer arrays to record head impact accelerations for all practices and games. Video recordings from practices and games were used to verify all high-magnitude head impacts, identify specific impact characteristics, and determine the amount of time spent in each activity.RESULTSA total of 7590 impacts were recorded, of which 571 resulted in high-magnitude head impact accelerations exceeding 40g (8%). Impacts were characterized based on the position played by the team member who received the impact, the part of the field where the impact occurred, whether the impact occurred during a game or practice play, and the cause of the impact. High-magnitude impacts occurred most frequently in the open field in both games (59.4%) and practices (67.5%). “Back” position players experienced a greater proportion of high-magnitude head impacts than players at other positions. The 2 teams in this study structured their practice sessions similarly with respect to time spent in each drill, but impact rates differed for each drill between the teams.CONCLUSIONSHigh-magnitude head impact exposure in games and practice drills was quantified and used as the basis for comparison of exposure in the 2 settings. In this cohort, game impact rates exceeded those for practice. Back players, who were often positioned in the open field, were shown to experience elevated levels of head impact exposure relative to players at other positions. The analysis also suggests that practice intensity, which may be influenced by coaching style, may also affect high-magnitude head impact exposure. Future studies should investigate this aspect as a factor affecting head impact exposure.

scholarly journals BIOMECHANIC DATA-DRIVEN BEHAVIOR MODIFICATION TO REDUCE CONCUSSION RISK IN HIGH SCHOOL FOOTBALL ATHLETES

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0010 ◽  
Author(s):  
Patricia R. Combs ◽  
Cassie B. Ford ◽  
Maryalice Nocera ◽  
Kody R. Campbell ◽  
Stephen W. Marshall ◽  
...  
Keyword(s):  
High School ◽  
High Risk ◽  
Intervention Program ◽  
Head Impact ◽  
Impact Frequency ◽  
High School Football ◽  
Post Intervention ◽  
Head Impacts ◽  
High Magnitude ◽  
Impact Data

Background: Each year, between 1.1 and 1.9 million sports and recreation-related concussions occur annually in US children aged =18 years. Football has a high concussion incidence relative to other youth sports. This is particularly concerning given recent evidence suggesting sport-related concussions are associated with late-life cognitive and psychological dysfunction in former athletes. Unfortunately, there are currently few proven interventions to prevent concussion in football. The purpose of this study was to evaluate a mentored intervention program designed to teach safe play techniques and thereby reduce head impact frequency and severity in high school football players. Methods: In a clustered quasi-experimental study design, the player education intervention program was provided to two out of three teams in year one, two out of four teams in year two, and all four teams in year three. Head impacts were measured using in-helmet accelerometers worn by all players. Head impact data and game video were used to identify “high risk” players on intervention teams to receive individualized mentoring. Players were identified as candidates for intervention based on three criteria: 1) greater than 20% of head impacts sustained to the top of the head, 2) greater than 7% of impacts exceeded 60 g in peak linear acceleration, and 3) player sustained a concussion. High-risk players attended 3 individual or small-group education sessions over 3 weeks with a mentor who analyzed game film to teach safer playing techniques. Intervention effects were evaluated by comparing post-intervention to pre-intervention head impact data. Coach and player satisfaction were assessed to evaluate the program’s acceptability and impact. Results: 220 athletes (143 intervention; 77 control) participated. Of these, 32 (14%) were classified “high risk” with playing techniques amenable to intervention. Overall, 21 (66%) of mentored athletes demonstrated a reduction in top-of-head impacts (considered a high-risk impact zone) and 17 (53%) of mentored athletes demonstrated a reduction in high magnitude (>60 g) hits. On average, the proportion of top-of-head impacts dropped 2.75% in mentored players, and 2.04% in non-mentored players. The proportion of head impacts classified as high-magnitude (>60 g) dropped 1.07% from pre- to post-intervention in mentored players. There was minimal (<1%) change in high magnitude impacts in non-mentored players. In post-season exit surveys, most mentored players “agreed” (n=18, 69%) that his playing behaviors improved because of the study. Most intervention team coaches thought the study was “effective” (n=31, 97%). Conclusions/Significance: Mentoring effects were modest; however, athletes and coaches viewed the program as effective. Behavioral interventions have potential to reduce head impact frequency and severity in football but may require more intensive mentoring than the 3-session model tested in this study. Tables/Figures: [Table: see text][Table: see text]

scholarly journals Drill-specific head impact exposure in youth football practice

2016 ◽  
Vol 18 (5) ◽  
pp. 536-541 ◽  
Author(s):  
Eamon T. Campolettano ◽  
Steven Rowson ◽  
Stefan M. Duma
Keyword(s):  
United States ◽  
The United States ◽  
High Impact ◽  
Head Impact ◽  
Football Players ◽  
Head Impacts ◽  
Youth Football ◽  
Impact Rate ◽  
High Magnitude ◽  
Specific Activities

OBJECTIVE Although 70% of football players in the United States are youth players (6–14 years old), most research on head impacts in football has focused on high school, collegiate, or professional populations. The objective of this study was to identify the specific activities associated with high-magnitude (acceleration > 40g) head impacts in youth football practices. METHODS A total of 34 players (mean age 9.9 ± 0.6 years) on 2 youth teams were equipped with helmet-mounted accelerometer arrays that recorded head accelerations associated with impacts in practices and games. Videos of practices and games were used to verify all head impacts and identify specific drills associated with each head impact. RESULTS A total of 6813 impacts were recorded, of which 408 had accelerations exceeding 40g (6.0%). For each type of practice drill, impact rates were computed that accounted for the length of time that teams spent on each drill. The tackling drill King of the Circle had the highest impact rate (95% CI 25.6–68.3 impacts/hr). Impact rates for tackling drills (those conducted without a blocker [95% CI 14.7–21.9 impacts/hr] and those with a blocker [95% CI 10.5–23.1 impacts/hr]) did not differ from game impact rates (95% CI 14.2–21.6 impacts/hr). Tackling drills were observed to have a greater proportion (between 40% and 50%) of impacts exceeding 60g than games (25%). The teams in this study participated in tackling or blocking drills for only 22% of their overall practice times, but these drills were responsible for 86% of all practice impacts exceeding 40g. CONCLUSIONS In youth football, high-magnitude impacts occur more often in practices than games, and some practice drills are associated with higher impact rates and accelerations than others. To mitigate high-magnitude head impact exposure in youth football, practices should be modified to decrease the time spent in drills with high impact rates, potentially eliminating a drill such as King of the Circle altogether.

scholarly journals Comparison of head impact exposure in practice drills among multiple youth football teams

2019 ◽  
Vol 23 (3) ◽  
pp. 381-389 ◽  
Author(s):  
Mireille E. Kelley ◽  
Mark A. Espeland ◽  
William C. Flood ◽  
Alexander K. Powers ◽  
Christopher T. Whitlow ◽  
...  
Keyword(s):  
Open Field ◽  
Linear Models ◽  
Linear Acceleration ◽  
Head Impact ◽  
Head Acceleration ◽  
Head Impacts ◽  
Youth Football ◽  
Impact Rate ◽  
Full Speed ◽  
Impact Data

OBJECTIVELimiting contact in football practice can reduce the number of head impacts a player receives, but further research is needed to inform the modification of optimal drills that mitigate head impact exposure (HIE) while the player develops the skills needed to safely play the game. This study aimed to compare HIE in practice drills among 6 youth football teams and to evaluate the effect of a team on HIE.METHODSOn-field head impact data were collected from athletes (ages 10–13 years) playing on 6 local youth football teams (teams A–F) during all practices using the Head Impact Telemetry System. Video was recorded and analyzed to verify and assign impacts to a specific drill. Drills were identified as follows: dummy/sled tackling, half install, install, install walk through, multiplayer tackle, Oklahoma, one-on-one, open field tackling, other, passing, position skill work, scrimmage, special teams, tackling drill stations, and technique. HIE was quantified in terms of impacts per player per minute (ppm) and peak linear and rotational head acceleration. Generalized linear models were used to assess differences in head impact magnitude and frequency among drills as well as among teams within the most common drills.RESULTSAmong 67 athlete-seasons, a total of 14,718 impacts during contact practices were collected and evaluated in this study. Among all 6 teams, the mean linear (p < 0.0001) and rotational (p < 0.0001) acceleration varied significantly among all drills. Open field tackling had significantly (p < 0.001) higher mean linear acceleration than all other drills. Multiplayer tackle had the highest mean impact rate (0.35 ppm). Significant variations in linear acceleration and impact rate were observed among teams within specific drills. Team A had the highest mean linear acceleration in install, one-on-one, and open field tackling and the highest mean impact rate in Oklahoma and position skill work. Although team A spent the greatest proportion of their practice on minimal- or no-player versus player contact drills (27%) compared to other teams, they had the highest median (20.2g) and 95th percentile (56.4g) linear acceleration in practice.CONCLUSIONSFull-speed tackling and blocking drills resulted in the highest HIE. Reducing time spent on contact drills relative to minimal or no contact drills may not lower overall HIE. Instead, interventions such as reducing the speed of players engaged in contact, correcting tackling technique, and progressing to contact may reduce HIE more effectively.

scholarly journals Head Impact Exposure in Practices Correlates With Exposure in Games for Youth Football Players

2018 ◽  
Vol 34 (5) ◽  
pp. 354-360 ◽  
Author(s):  
Srinidhi Bellamkonda ◽  
Samantha J. Woodward ◽  
Eamon Campolettano ◽  
Ryan Gellner ◽  
Mireille E. Kelley ◽  
...  
Keyword(s):  
Linear Acceleration ◽  
The United States ◽  
Head Impact ◽  
Football Players ◽  
Valuable Insight ◽  
Head Impacts ◽  
Youth Football ◽  
Exposure Profile ◽  
Impact Data ◽  
Insight Into

This study aimed to compare head impact exposures between practices and games in football players ages 9 to 14 years, who account for approximately 70% of all football players in the United States. Over a period of 2 seasons, 136 players were enrolled from 3 youth programs, and 49,847 head impacts were recorded from 345 practices and 137 games. During the study, individual players sustained a median of 211 impacts per season, with a maximum of 1226 impacts. Players sustained 50th (95th) percentile peak linear acceleration of 18.3 (46.9) g, peak rotational acceleration of 1305.4 (3316.6) rad·s−2, and Head Impact Technology Severity Profile of 13.7 (24.3), respectively. Overall, players with a higher frequency of head impacts at practices recorded a higher frequency of head impacts at games (P < .001,r2 = .52), and players who sustained a greater average magnitude of head impacts during practice also recorded a greater average magnitude of head impacts during games (P < .001). The youth football head impact data quantified in this study provide valuable insight into the player exposure profile, which should serve as a key baseline in efforts to reduce injury.

scholarly journals Head impact exposure measured in a single youth football team during practice drills

2017 ◽  
Vol 20 (5) ◽  
pp. 489-497 ◽  
Author(s):  
Mireille E. Kelley ◽  
Joeline M. Kane ◽  
Mark A. Espeland ◽  
Logan E. Miller ◽  
Alexander K. Powers ◽  
...  
Keyword(s):  
Open Field ◽  
Injury Risk ◽  
Linear Models ◽  
Head Impact ◽  
Head Impacts ◽  
Wald Tests ◽  
Impact Location ◽  
Youth Football ◽  
Football Team ◽  
Impact Data

OBJECTIVEThis study evaluated the frequency, magnitude, and location of head impacts in practice drills within a youth football team to determine how head impact exposure varies among different types of drills.METHODSOn-field head impact data were collected from athletes participating in a youth football team for a single season. Each athlete wore a helmet instrumented with a Head Impact Telemetry (HIT) System head acceleration measurement device during all preseason, regular season, and playoff practices. Video was recorded for all practices, and video analysis was performed to verify head impacts and assign each head impact to a specific drill. Eleven drills were identified: dummy/sled tackling, install, special teams, Oklahoma, one-on-one, open-field tackling, passing, position skill work, multiplayer tackle, scrimmage, and tackling drill stations. Generalized linear models were fitted to log-transformed data, and Wald tests were used to assess differences in head accelerations and impact rates.RESULTSA total of 2125 impacts were measured during 30 contact practices in 9 athletes (mean age 11.1 ± 0.6 years, mean mass 44.9 ± 4.1 kg). Open-field tackling had the highest median and 95th percentile linear accelerations (24.7g and 97.8g, respectively) and resulted in significantly higher mean head accelerations than several other drills. The multiplayer tackle drill resulted in the highest head impact frequency, with an average of 0.59 impacts per minute per athlete, but the lowest 95th percentile linear accelerations of all drills. The front of the head was the most common impact location for all drills except dummy/sled tackling.CONCLUSIONSHead impact exposure varies significantly in youth football practice drills, with several drills exposing athletes to high-magnitude and/or high-frequency head impacts. These data suggest that further study of practice drills is an important step in developing evidence-based recommendations for modifying or eliminating certain high-intensity drills to reduce head impact exposure and injury risk for all levels of play.

Does tackling form affect head acceleration in youth football players?

2020 ◽  
Vol 234 (3) ◽  
pp. 257-267 ◽  
Author(s):  
Ryan A Gellner ◽  
Eamon T Campolettano ◽  
Steven Rowson
Keyword(s):  
Football Players ◽  
Head Acceleration ◽  
Head Impacts ◽  
Youth Football ◽  
High Magnitude ◽  
Close Range ◽  
Agreement Coefficient ◽  
Reduce Risk ◽  
Effectiveness Of Training ◽  
Age Range

To reduce head impact exposure, a number of youth football organizations have begun teaching tackling technique. This study sought to develop and utilize a set of tackling form grading criteria for both tacklers and ball carriers as well as to relate tackling form to head acceleration outcome. It was hypothesized that players exhibiting better form would experience lower head accelerations in individual tackles. Three teams consisting of 67 players (20, 29, and 18 players per team; age 12.7 ± 0.95, age range 11–14 years, body mass 55.1 ± 16.2 kg) were instrumented with helmet-mounted accelerometer arrays for one season. Videos of close-range tackling drills were used to develop tackling form criteria. Two raters used these criteria to each score 105 impacts. Six of the seven categories were found to have good inter-rater reliability metrics (total percent agreement ≥ 79%, agreement coefficient ≥ 0.65). Bending at both the hips and knees, leading with the shoulder or arm, and initiating contact were found to reduce risk of high-magnitude (>40 g) head impacts in tacklers. Keeping the eyes up and avoiding dropping the head reduced the risk of high-magnitude head impacts in ball carriers. This study shows the potential effectiveness of training both tacklers and ball carriers in proper technique for collisions in youth football to minimize head impacts.

The Effect of Player Contact Characteristics on Head Impact Exposure in Youth Football Games

2020 ◽  
pp. 1-11
Author(s):  
Daniella M. DiGuglielmo ◽  
Mireille E. Kelley ◽  
Mark A. Espeland ◽  
Zachary A. Gregory ◽  
Tanner D. Payne ◽  
...  
Keyword(s):  
Injury Risk ◽  
Body Position ◽  
Mixed Effects ◽  
Head Impact ◽  
Mixed Effects Models ◽  
Rotational Acceleration ◽  
Head Impacts ◽  
Factors Influencing ◽  
Youth Football ◽  
Impact Data

To reduce head impact exposure (HIE) in youth football, further understanding of the context in which head impacts occur and the associated biomechanics is needed. The objective of this study was to evaluate the effect of contact characteristics on HIE during player versus player contact scenarios in youth football. Head impact data and time-synchronized video were collected from 4 youth football games over 2 seasons in which opposing teams were instrumented with the Head Impact Telemetry (HIT) System. Coded contact characteristics included the player’s role in the contact, player speed and body position, contact height, type, and direction, and head contact surface. Head accelerations were compared among the contact characteristics using mixed-effects models. Among 72 instrumented athletes, 446 contact scenarios (n = 557 impacts) with visible opposing instrumented players were identified. When at least one player had a recorded impact, players who were struck tended to have higher rotational acceleration than players in striking positions. When both players had a recorded impact, lighter players and taller players experienced higher mean head accelerations compared with heavier players and shorter players. Understanding the factors influencing HIE during contact events in football may help inform methods to reduce head injury risk.

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