scholarly journals Video Analysis and Verification of Direct Head Impacts Recorded by Wearable Sensors in Junior Rugby League Players

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Lauchlan Carey ◽  
Douglas P. Terry ◽  
Andrew S. McIntosh ◽  
Peter Stanwell ◽  
Grant L. Iverson ◽  
...  

Abstract Background Rugby league is a high-intensity collision sport that carries a risk of concussion. Youth athletes are considered to be more vulnerable and take longer to recover from concussion than adult athletes. Purpose To review head impact events in elite-level junior representative rugby league and to verify and describe characteristics of X-patchTM-recorded impacts via video analysis. Study Design Observational case series. Methods The X-patchTM was used on twenty-one adolescent players (thirteen forwards and eight backs) during a 2017 junior representative rugby league competition. Game-day footage, recorded by a trained videographer from a single camera, was synchronised with X-patchTM-recorded timestamped events. Impacts were double verified by video review. Impact rates, playing characteristics, and gameplay situations were described. Results The X-patchTM-recorded 624 impacts ≥ 20g between game start and finish, of which 564 (90.4%) were verified on video. Upon video review, 413 (73.2%) of all verified impacts ≥ 20g where determined to be direct head impacts. Direct head impacts ≥ 20g occurred at a rate of 5.2 impacts per game hour; 7.6 for forwards and 3.0 for backs (range = 0–18.2). A defender’s arm directly impacting the head of the ball carrier was the most common event, accounting for 21.3% (n = 120) of all impacts, and 46.7% of all “hit-up” impacts. There were no medically diagnosed concussions during the competition. Conclusion The majority (90.4%) of head impacts ≥ 20g recorded by the X-patchTM sensor were verified by video. Double verification of direct head impacts in addition to cross-verification of sensor-recorded impacts using a secondary source such as synchronised video review can be used to ensure accuracy and validation of data.

2020 ◽  
Author(s):  
Lauchlan John Carey ◽  
Douglas P Terry ◽  
Andrew McIntosh ◽  
Peter Stanwell ◽  
Grant L Iverson ◽  
...  

Abstract Background: Rugby League is a high-intensity collision sport that carries a risk of concussion. Youth athletes are considered to be more vulnerable and take longer to recover from concussion than adult athletes. Purpose: To review head impact events in elite level junior representative rugby league and to verify and analyze x-patchTM recorded impacts via video analysis.Study Design: Observational case series.Methods: The x-patchTM was used on twenty-one adolescent players (thirteen forwards and eight backs) during a 2017 junior representative rugby league competition. Game day footage, recorded by a trained videographer from a single camera, was synchronized with accelerometer timestamps. Impacts were double verified by video review. Impact rates, playing characteristics, and game play situations were described.Results: The x-patchTM recorded 624 impacts 20g between game start and finish, of which 564 (90.4%) were verified on video. Upon video review, 413 (73.2%) of all verified impacts 20g where determined to be direct head impacts. Direct head impacts 20g occurred at a rate of 5.2 impacts per game hour; 7.6 for forwards and 3.0 for backs (range=0-18.2). A defender’s arm directly impacting the head of the ball carrier was the most common event, accounting for 21.3% (n=120) of all impacts, and 46.7% of all “hit-up” impacts. There were no medically diagnosed concussions during the competition.Conclusion: The majority (90.4%) of impacts 20g recorded by the x-patchTM sensor were verified by video. Double verification of direct head impacts in addition to cross-verification of sensor recorded impacts using a secondary source such as synchronized video review can be used to ensure accuracy and validation of data.


2017 ◽  
Vol 45 (10) ◽  
pp. 2379-2387 ◽  
Author(s):  
Nelson Cortes ◽  
Andrew E. Lincoln ◽  
Gregory D. Myer ◽  
Lisa Hepburn ◽  
Michael Higgins ◽  
...  

Background: Wearable sensors are increasingly used to quantify the frequency and magnitude of head impact events in multiple sports. There is a paucity of evidence that verifies head impact events recorded by wearable sensors. Purpose: To utilize video analysis to verify head impact events recorded by wearable sensors and describe the respective frequency and magnitude. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Thirty male (mean age, 16.6 ± 1.2 years; mean height, 1.77 ± 0.06 m; mean weight, 73.4 ± 12.2 kg) and 35 female (mean age, 16.2 ± 1.3 years; mean height, 1.66 ± 0.05 m; mean weight, 61.2 ± 6.4 kg) players volunteered to participate in this study during the 2014 and 2015 lacrosse seasons. Participants were instrumented with GForceTracker (GFT; boys) and X-Patch sensors (girls). Simultaneous game video was recorded by a trained videographer using a single camera located at the highest midfield location. One-third of the field was framed and panned to follow the ball during games. Videographic and accelerometer data were time synchronized. Head impact counts were compared with video recordings and were deemed valid if (1) the linear acceleration was ≥20 g, (2) the player was identified on the field, (3) the player was in camera view, and (4) the head impact mechanism could be clearly identified. Descriptive statistics of peak linear acceleration (PLA) and peak rotational velocity (PRV) for all verified head impacts ≥20 g were calculated. Results: For the boys, a total recorded 1063 impacts (2014: n = 545; 2015: n = 518) were logged by the GFT between game start and end times (mean PLA, 46 ± 31 g; mean PRV, 1093 ± 661 deg/s) during 368 player-games. Of these impacts, 690 were verified via video analysis (65%; mean PLA, 48 ± 34 g; mean PRV, 1242 ± 617 deg/s). The X-Patch sensors, worn by the girls, recorded a total 180 impacts during the course of the games, and 58 (2014: n = 33; 2015: n = 25) were verified via video analysis (32%; mean PLA, 39 ± 21 g; mean PRV, 1664 ± 619 rad/s). Conclusion: The current data indicate that existing wearable sensor technologies may substantially overestimate head impact events. Further, while the wearable sensors always estimated a head impact location, only 48% of the impacts were a result of direct contact to the head as characterized on video. Using wearable sensors and video to verify head impacts may decrease the inclusion of false-positive impacts during game activity in the analysis.


2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110035
Author(s):  
Kyle W. Morse ◽  
Ajay Premkumar ◽  
Andrew Zhu ◽  
Rachelle Morgenstern ◽  
Edwin P. Su

Background: Femoroacetabular impingement and degenerative hip osteoarthritis (OA) affect athletes across a wide variety of sports. Hip resurfacing arthroplasty (HRA) has emerged as a surgical treatment for active individuals with end-stage hip OA to provide pain relief and allow return to high-impact activities. Return to professional sports after HRA has not been well characterized. Purpose/Hypothesis: The aim of this study was to report on a series of elite athletes in a variety of sports who underwent HRA. We hypothesized that professional and elite-level athletes would be able to return to sports after HRA for end-stage hip OA. Study Design: Case series; Level of evidence, 4. Methods: A retrospective case series was conducted on professional athletes who underwent HRA at a single institution between 2007 and 2017. All surgeries were performed by a single surgeon using the posterolateral approach. Athletes’ return to play and sport-specific performance statistics were obtained using self-reported and publicly available data sources. Athletes were matched to an age- and performance-based cohort to determine changes in performance-based metrics. Results: Eight professional athletes were identified, including 2 baseball pitchers, 1 ice hockey defenseman, 1 foil fencer, 1 men’s doubles tennis player, 1 basketball player, 1 ultramarathoner, and 1 Ironman triathlete. All 8 patients returned to sports; 6 of 8 (75%) patients were able to return for at least 1 full season at a professional level after surgery. There were no significant differences between performance statistics for athletes who returned to play and their preoperative performance measures for the years leading up to surgery or the age- and performance-matched cohort. Conclusion: HRA remains a surgical alternative for end-stage hip OA in young, high-impact, active patients. While the primary goals of surgery are pain control and quality of life improvement, it is possible to return to elite-level sporting activity after HRA.


Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S2.2-S2
Author(s):  
Mirellie Kelley ◽  
Jillian Urban ◽  
Derek Jones ◽  
Alexander Powers ◽  
Christopher T. Whitlow ◽  
...  

Approximately 1.1–1.9 million sport-related concussions among athletes ≤18 years of age occur annually in the United States, but there is limited understanding of the biomechanics and injury mechanisms associated with concussions among lower level football athletes. Therefore, the objective of this study was to combine biomechanical head impact data with video analysis to characterize youth and HS football concussion injury mechanisms. Head impact data were collected from athletes participating on 22 youth and 6 HS football teams between 2012 and 2017. Video was recorded, and head impact data were collected during all practices and games by instrumenting players with the Head Impact Telemetry (HIT) System. For each clinically diagnosed concussion, a video abstraction form was completed, which included questions concerning the context in which the injury occurred. Linear acceleration, rotational acceleration, and impact location were used to characterize the concussive event and each injured athlete's head impact exposure on the day of the concussion. A total of 9 (5 HS and 4 youth) concussions with biomechanics and video of the event were included in this study. The mean [range] linear and rotational acceleration of the concussive impacts were 62.9 [29.3–118.4] g and 3,056.7 [1,046.8–6,954.6] rad/s2, respectively. Concussive impacts were the highest magnitude impacts for 6 players and in the top quartile of impacts for 3 players on the day of injury. Concussions occurred in both practices (N = 4) and games (N = 5). The most common injury contact surface was helmet-to-helmet (N = 5), followed by helmet-to-ground (N = 3) and helmet-to-body (N = 1). All injuries occurred during player-to-player contact scenarios, including tackling (N = 4), blocking (N = 4), and collision with other players (N = 1). The biomechanics and injury mechanisms of concussions varied among athletes in our study; however, concussive impacts were among the highest severity for each player and all concussions occurred as a result of player-to-player contact.


2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110108
Author(s):  
Andrea Bardos ◽  
Sanjeeve Sabhrawal ◽  
Graham Tytherleigh-Strong

Background: Sternal fractures are rare, and they can be treated nonoperatively. Vertical sternal fractures have rarely been reported. Purpose: To describe the management and surgical treatment of a series of elite-level athletes who presented with symptomatic nonunions of a vertical sternal fracture. Study Design: Case series; Level of evidence, 4. Methods: Patients with an established symptomatic nonunion of a vertical sternal fracture, as diagnosed by computed tomography (CT) or magnetic resonance imaging (MRI), underwent open reduction and internal fixation using autologous bone graft and cannulated lag screws. The patients were assessed preoperatively and at the final follow-up using the Rockwood sternoclavicular joint (SCJ) score; Constant score; and shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores. Bony union was confirmed on postoperative CT scan. Results: Five patients (4 men and 1 woman) were included; all were national- or international-level athletes (rugby, judo, show-jumping, and MotoGP). The mean age at surgery was 23.4 years (range, 19-27 years), the mean time from injury to referral was 13.6 months (range, 10-17 months), and the mean time from injury to surgery was 15.8 months (range, 11-20 months). The mean follow-up was 99.4 months (range, 25-168 months). There was a significant improvement after surgery in the mean Rockwood SCJ score (from 12.6 to 14.8 [ P < .05]), Constant score (from 84 to 96.4 [ P < .05]; 80% met the minimal clinically important difference [MCID] of 10.4 points), and QuickDASH (from 6.8 to 0.98 [ P < .05]; 0% met the MCID of 15.9 points). Four of the patients were able to return to sport at their preinjury level, and 1 patient retired for nonmedical reasons. All of the fractures had united on the postoperative CT scan. There were no postoperative complications. Conclusion: Vertical fractures of the sternum are very rare and tend to behave clinically like an avulsion fracture injury to the capsuloligamentous structure of the inferior SCJ. The requirement of advanced imaging to diagnose this injury means that the actual incidence and natural history are not known. For high-demand athletes, early identification, surgical reduction, and fixation are likely to achieve the best outcome.


Author(s):  
Kelly Sarmiento ◽  
Dana Waltzman ◽  
Kelley Borradaile ◽  
Andrew Hurwitz ◽  
Kara Conroy ◽  
...  

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.


2020 ◽  
Author(s):  
Charles Bernick ◽  
Tucker Hansen ◽  
Winnie Ng ◽  
Vernon Williams ◽  
Margaret Goodman ◽  
...  

AbstractObjectivesDetermine, through video reviews, how often concussions occur in combat sport matches, how well non-medical personnel can be trained to recognize concussions and how often fights are judged to continue too long.MethodsThis is a retrospective video analysis by an 8 person panel of 60 professional fights (30 boxing and 30 mixed martial arts). Through video review, medical and non-medical personnel recorded details about each probable concussion and determined if and when they would have stopped the fight compared to the official stoppage time.ResultsA concussion was recorded in 47/60 fights. The fighter that sustained the first concussion ultimately lost 98% of the time. The physician and non-physician raters had 86% agreement regarding the number of concussions that occurred to each fighter per match. The mean number of concussions per minute of fight time was 0.08 (0.06 for boxers and 0.10 for MMA). When stratifying by outcome of the bout, the mean number of concussion per minute for the winner was 0.01 compared to the loser at 0.15 concussions per minute. The physician raters judged that 24 of the 60 fights (11 boxing [37%]; 13 MMA [43 %]) should have been stopped sooner than what occurred.ConclusionRecognizing that the losing fighter almost always is concussed first and tends to sustain more concussions during the fight, along with the demonstration that non-physician personnel can be taught to recognize concussion, may guide policy changes that improve brain health in combat sports.


2021 ◽  
Author(s):  
Andrew J Gardner ◽  
Grant Iverson ◽  
Suzi Edwards ◽  
Ross Tucker

Abstract Background The tackle is the in-game activity carrying the greatest risk for concussion in Rugby. A recent evaluation of tackle characteristics in Rugby Union precipitated a rule modification to reduce head impact risk during tackles. This study aims to replicate the work conducted in Rugby Union by examining the association between tackle characteristics and head injury events in professional Rugby League. Methods We reviewed and coded 446 tackles resulting in a head injury assessment (HIA) and 5,694 tackles that did not result in a head injury from two National Rugby League (NRL) seasons. Tackle height, body position of players, and contact area on an opponent’s body were evaluated, with the propensity of each situation to cause an HIA calculated as HIAs per 1000 events. Results The propensity for tacklers to sustain a head injury was 0.99 HIAs per 1000 tackles, 1.74-fold greater than for the ball carrier (0.57 HIAs per 1,000 tackles). There was a 3.2-fold higher risk for an HIA when the tackler was upright compared to bent-at-the-waist. The greatest risk of a tackler HIA occurred when head contact was very low (knee, boot) or high (head and elbow). HIAs were most common following head-to-head impacts. The lowest propensity for tackler HIA was found when the tackler’s head was in proximity with the ball carrier’s torso. Conclusions The result of this study replicated the findings in professional rugby union. This has implications for the injury prevention initiatives implemented to reduce HIA risk because the majority of injuries are sustained by the player initiating the action.


2021 ◽  
pp. 1-8
Author(s):  
Janie Cournoyer ◽  
David Koncan ◽  
Michael D. Gilchrist ◽  
T. Blaine Hoshizaki

Understanding the relationship between head mass and neck stiffness during direct head impacts is especially concerning in youth sports where athletes have higher proportional head mass to neck strength. This study compared 2 neck stiffness conditions for peak linear and rotational acceleration and brain tissue deformations across 3 impact velocities, 3 impact locations, and 2 striking masses. A pendulum fitted with a nylon cap was used to impact a fifth percentile hybrid III headform equipped with 9 accelerometers and fitted with a youth American football helmet. The 2 neck stiffness conditions consisted of a neckform with and without resistance in 3 planes, representing the upper trapezius, the splenius capitis, and the sternocleidomastoid muscles. Increased neck stiffness resulted in significant changes in head kinematics and maximum principal strain specific to impact velocity, impact location, and striking mass.


2019 ◽  
Vol 7 (4) ◽  
pp. 232596711983558 ◽  
Author(s):  
Shane V. Caswell ◽  
Patricia Kelshaw ◽  
Andrew E. Lincoln ◽  
Lisa Hepburn ◽  
Reginald Dunn ◽  
...  

Background: The rate of concussions in boys’ lacrosse is reported to be the third highest among high school sports in the United States, but no studies have described game-related impacts among boys’ lacrosse players. Purpose: To characterize verified game-related impacts, both overall and those directly to the head, in boys’ varsity high school lacrosse. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 77 male participants (mean age, 16.6 ± 1.2 years; mean height, 1.77 ± 0.05 m; mean weight, 73.4 ± 12.2 kg) were instrumented with sensors and were videotaped during 39 games. All verified game-related impacts ≥20 g were summarized in terms of frequency, peak linear acceleration (PLA), and peak rotational velocity (PRV). Descriptive statistics and impact rates per player-game (PG) with corresponding 95% CIs were calculated. Results: Overall, 1100 verified game-related impacts were recorded (PLA: median, 33.5 g [interquartile range (IQR), 25.7-51.2]; PRV: median, 1135.5 deg/s [IQR, 790.0-1613.8]) during 795 PGs. The rate for all verified game-related impacts was 1.38 impacts per PG (95% CI, 1.30-1.47). Of these, 680 (61.8%) impacts (PLA: median, 35.9 g [IQR, 26.7-55.5]; PRV: 1170.5 deg/s [IQR, 803.2-1672.8]) were directly to the head (impact rate, 0.86 impacts/PG [95% CI, 0.79-0.92]). Overall, midfielders (n = 514; 46.7%) sustained the most impacts, followed by attackers (n = 332; 30.2%), defenders (n = 233; 21.2%), and goalies (n = 21; 1.9%). The most common mechanisms for overall impacts and direct head impacts were contact with player (overall: n = 706 [64.2%]; head: n = 397 [58.4%]) and stick (overall: n = 303 [27.5%]; head: n = 239 [35.1%]), followed by ground (overall: n = 73 [6.6%]; head: n = 26 [3.8%]) and ball (overall: n = 15 [1.4%]; head: n = 15 [2.2%]). Direct head impacts were associated with a helmet-to-helmet collision 31.2% of the time, and they were frequently (53.7%) sustained by the players delivering the impact. Nearly half (48.8%) of players delivering contact used their helmets to initiate contact that resulted in a helmet-to-helmet impact. Players receiving a head impact from player contact were most often unprepared (75.9%) for the collision. Conclusion: The helmet is commonly used to initiate contact in boys’ high school lacrosse, often targeting defenseless opponents. Interventions to reduce head impacts should address rules and coaching messages to discourage intentional use of the helmet and encourage protection of defenseless opponents.


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