scholarly journals Football concussion case series using biomechanical and video analysis

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.

2017 ◽  
Vol 19 (6) ◽  
pp. 662-667 ◽  
Author(s):  
David M. O'Sullivan ◽  
Gabriel P. Fife

OBJECTIVEThe purpose of this study was to monitor head impact magnitude and characteristics, such as impact location and frequency, at high school taekwondo sparring sessions.METHODSEight male high school taekwondo athletes participated in this study. The head impact characteristics were recorded by X-Patch, a wireless accelerometer and gyroscope, during 6 taekwondo sparring sessions. The outcome measures were the peak linear acceleration (g = 9.81 msec2), peak rotational acceleration, rotational velocity, and Head Injury Criterion.RESULTSA total of 689 impacts occurred over 6 sessions involving the 8 athletes. There was an average of 24 impacts per 100 minutes, and there were significant differences in the frequency of impacts among both the sessions and individual athletes. In order of frequency, the most commonly hit locations were the side (38.2%), back (35.7%), and front (23.8%) of the head.CONCLUSIONSThe data indicate that there is a relatively high number of head impacts experienced by taekwondo athletes during sparring practice. According to the rotational acceleration predicting impact severity published in previous research, 17.1% of the impacts were deemed to be a moderate and 15.5% were deemed to be severe.


2012 ◽  
Vol 28 (2) ◽  
pp. 174-183 ◽  
Author(s):  
Joseph J. Crisco ◽  
Bethany J. Wilcox ◽  
Jason T. Machan ◽  
Thomas W. McAllister ◽  
Ann-Christine Duhaime ◽  
...  

The purpose of this study was to quantify the severity of head impacts sustained by individual collegiate football players and to investigate differences between impacts sustained during practice and game sessions, as well as by player position and impact location. Head impacts (N = 184,358) were analyzed for 254 collegiate players at three collegiate institutions. In practice, the 50th and 95th percentile values for individual players were 20.0 g and 49.5 g for peak linear acceleration, 1187 rad/s2 and 3147 rad/s2 for peak rotational acceleration, and 13.4 and 29.9 for HITsp, respectively. Only the 95th percentile HITsp increased significantly in games compared with practices (8.4%, p = .0002). Player position and impact location were the largest factors associated with differences in head impacts. Running backs consistently sustained the greatest impact magnitudes. Peak linear accelerations were greatest for impacts to the top of the helmet, whereas rotational accelerations were greatest for impacts to the front and back. The findings of this study provide essential data for future investigations that aim to establish the correlations between head impact exposure, acute brain injury, and long-term cognitive deficits.


2018 ◽  
Vol 34 (5) ◽  
pp. 354-360 ◽  
Author(s):  
Srinidhi Bellamkonda ◽  
Samantha J. Woodward ◽  
Eamon Campolettano ◽  
Ryan Gellner ◽  
Mireille E. Kelley ◽  
...  

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.


Author(s):  
Nicholas J Cecchi ◽  
Derek C Monroe ◽  
Theophil J Oros ◽  
Steven L Small ◽  
James W Hicks

The SIM-G is a waterproof head impact sensor that has been previously evaluated for use in a headband, but not yet in a mode of attachment suitable for water polo. For this study, a CADEX linear impactor was used to impact a Hybrid III headform while wearing either a headband or modified water polo cap, each housing a SIM-G. In both headgears, the SIM-G consistently underestimated peak linear acceleration ( p < .001) and peak rotational velocity ( p < .001), and consistently overestimated peak rotational acceleration ( p < .001) relative to the headform. These inaccuracies are consistent with previous evaluations of the SIM-G, but notably, impact magnitudes did not differ between the different modes of attachment ( p > .198). The proprietary SIM-G algorithm used for classifying false/true positives performed poorly at the back and crown impact locations in both the water polo cap and headband, but accuracy of this algorithm did not significantly differ between the water polo cap and headband (60.5% vs 49.4%, respectively). The SIM-G’s ability to correctly predict impact location also performed poorly in both headgears when impacts occurred at the crown location, but was significantly better overall in the water polo cap than the headband (80.2% vs 55.6%, respectively). These results demonstrate that the SIM-G exhibits shared limitations and a similar performance overall when placed in either a headband or water polo cap. Potential explanations for the inaccuracies of the SIM-G, as well as methods of optimizing its application in sports, are discussed.


2021 ◽  
pp. 036354652110266
Author(s):  
Landon B. Lempke ◽  
Rachel S. Johnson ◽  
Rachel K. Le ◽  
Melissa N. Anderson ◽  
Julianne D. Schmidt ◽  
...  

Background: Youth flag football participation has rapidly grown and is a potentially safer alternative to tackle football. However, limited research has quantitatively assessed youth flag football head impact biomechanics. Purpose: To describe head impact biomechanics outcomes in youth flag football and explore factors associated with head impact magnitudes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We monitored 52 player-seasons among 48 male flag football players (mean ± SD; age, 9.4 ± 1.1 years; height, 138.6 ± 9.5 cm; mass, 34.7 ± 9.2 kg) across 3 seasons using head impact sensors during practices and games. Sensors recorded head impact frequencies, peak linear ( g) and rotational (rad/s2) acceleration, and estimated impact location. Impact rates (IRs) were calculated as 1 impact per 10 player-exposures; IR ratios (IRRs) were used to compare season, event type, and age group IRs; and 95% CIs were calculated for IRs and IRRs. Weekly and seasonal cumulative head impact frequencies and magnitudes were calculated. Mixed-model regression models examined the association between player characteristics, event type, and seasons and peak linear and rotational accelerations. Results: A total of 429 head impacts from 604 exposures occurred across the study period (IR, 7.10; 95% CI, 4.81-10.50). Weekly and seasonal cumulative median head impact frequencies were 1.00 (range, 0-2.63) and 7.50 (range, 0-21.00), respectively. The most frequent estimated head impact locations were the skull base (n = 96; 22.4%), top of the head (n = 74; 17.2%), and back of the head (n = 66; 15.4%). The combined event type IRs differed among the 3 seasons (IRR range, 1.45-2.68). Games produced greater IRs (IRR, 1.24; 95% CI, 1.01-1.53) and peak linear acceleration (mean difference, 5.69 g; P = .008) than did practices. Older players demonstrated greater combined event–type IRs (IRR, 1.46; 95% CI, 1.12-1.90) and increased head impact magnitudes than did younger players, with every 1-year age increase associated with a 3.78 g and 602.81-rad/s2 increase in peak linear and rotational acceleration magnitude, respectively ( P≤ .005). Conclusion: Head IRs and magnitudes varied across seasons, thus highlighting multiple season and cohort data are valuable when providing estimates. Head IRs were relatively low across seasons, while linear and rotational acceleration magnitudes were relatively high.


Author(s):  
Ann R Harlos ◽  
Steven Rowson

In the United States, all bicycle helmets must comply with the standard created by the Consumer Product Safety Commission (CPSC). In this standard, bike helmets are only required to by tested above an established test line. Unregulated helmet performance below the test line could pose an increased risk of head injury to riders. This study quantified the impact locations of damaged bike helmets from real-world accidents and tested the most commonly impacted locations under CPSC bike helmet testing protocol. Ninety-five real-world impact locations were quantified. The most common impact locations were side-middle (31.6%), rear boss-rim (13.7%), front boss-rim (9.5%), front boss-middle (9.5%), and rear boss-middle (9.5%). The side-middle, rear boss-rim, and front boss (front boss-middle and front boss-rim regions combined) were used for testing. Two of the most commonly impacted regions were below the test line (front boss-rim and rear boss-rim). Twelve purchased helmet models were tested under CPSC protocol at each location for a total of 36 impacts. An ANOVA test showed that impact location had a strong influence on the variance of peak linear acceleration (PLA) ( p = 0.002). A Tukey HSD post hoc test determined that PLA at the side-middle (214.9 ± 20.8 g) and front boss (228.0 ± 39.6 g) locations were significantly higher than the PLA at the rear boss-rim (191.5 ± 24.2 g) location. The highest recorded PLA (318.8 g) was at the front boss-rim region. This was the only test that exceeded the 300 g threshold. This study presented a method for quantifying real-world impact locations of damaged bike helmets. Higher variance in helmet performance was found at the regions on or below the test line than at the region above the test line.


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.


2012 ◽  
Vol 23 (4) ◽  
pp. 199-203 ◽  
Author(s):  
Qingli Zhang ◽  
Wei Ji ◽  
Zhongqin Guo ◽  
Zhenjiang Bai ◽  
Noni E MacDonald

OBJECTIVE: To compare clinical features and outcomes of children hospitalized in China with pandemic (p)H1N1 between 2009 and 2010 versus seasonal influenza A between 2008 and 2009.METHODS: Systematic review of laboratory-confirmed admissions to the Children’s Hospital, Soochow University (Suzhou, China).RESULTS: Seventy-five children younger than 14 years of age were admitted with pH1N1, 70 with H3N2 and three with seasonal H1N1. With pH1N1, the mean age was older (36 months versus seven months), the length of stay was longer (nine days versus seven days), underlying conditions were more common (29% versus 15%), anemia was more common (11% versus 0%) (P<0.05), with trends toward more secondary bacterial pneumonia and intensive care unit care, compared with seasonal influenza. Two of the 75 children with pH1N1 died versus no deaths in children with seasonal influenza. None of the children had received pH1N1, seasonal influenza, conjugated pneumococal orHaemophilus influenzaeb vaccines.CONCLUSION: In China, children hospitalized with pH1N1 influenza differed from case series in Canada, Argentina and the United States, suggesting that locale, background and health care system influenced the presentation and outcomes of pandemic and seasonal influenza.


2020 ◽  
Author(s):  
Kyle Kercher ◽  
Jesse A. Steinfeldt ◽  
Jonathan T. Macy ◽  
Keisuke Ejima ◽  
Keisuke Kawata

ABSTRACTPurposeUSA Football established five levels of contact (LOC) to guide the intensity of high school football practices. However, it remains unclear whether head impact exposure differs by LOC. The purpose of this study was to examine head impact frequency and magnitude by LOC in the overall sample and three position groups.MethodsThis longitudinal observational study included 24 high school football players during all practices and games in the 2019 season. Players wore a sensor-installed mouthguard that monitored head impact frequency, peak linear acceleration (PLA), and rotational head acceleration (PRA). Practice/game drills were filmed and categorized into 5 LOCs (air, bags, control, thud, live), and head impact data were assigned into 5 LOCs. Player position was categorized into linemen, hybrid, and skill.ResultsA total of 6016 head impacts were recorded during 5 LOCs throughout the season. In the overall sample, total number of impacts, sum of PLA, and PRA per player increased in an incremental manner (air<bags<control<thud<live), with the most head impacts in live (113.7±17.8 hits/player) and the least head impacts in air (7.7±1.9 hits/player). The linemen and hybrid groups had consistently higher impact exposure than the skill group. Average head impact magnitudes by position group were higher during live drills (PLA (41.0-45.9g) and PRA (3.3-4.6 krad/s2) per head impact), whereas other LOCs had lower magnitudes (PLA (18.2-23.2g) and PRA (1.6-2.3krad/s2) per impact).ConclusionOur data suggest that LOC may influence cumulative head impact exposure in high school football, with players incurring frequent head impacts during live, thud, and control. The data indicate the importance of considering LOCs to refine practice guidelines and policies to minimize head impact burden in high school football athletes.


2019 ◽  
Vol 47 (14) ◽  
pp. 3469-3475 ◽  
Author(s):  
Connor Montgomery ◽  
David E. O’Briain ◽  
Eoghan T. Hurley ◽  
Leo Pauzenberger ◽  
Hannan Mullett ◽  
...  

Background: Mechanisms previously described for traumatic shoulder injuries in rugby may not adequately describe all the mechanisms that result in shoulder dislocations. Purpose: To investigate the mechanism of shoulder dislocation events in professional rugby players through use of systematic video analysis. Study Design: Case series; Level of evidence, 4. Methods: In our series, 39 cases of shoulder dislocations from games played in top professional leagues and international matches across a 2-year period were available for video analysis. All cases were independently assessed by 2 analysts to identify the sequence of events occurring during shoulder dislocation. This included injury circumstance such as contact with another player or the ground, game scenario, injury timing, and the movements and force vectors involved in the dislocation mechanism. Results: We identified 4 distinct injury mechanisms. The previously described mechanisms “try scorer,”“tackler,” and “direct impact” were identified in 67% of cases. We describe a new injury mechanism occurring in the “poach position,” accounting for 18% of all shoulder dislocations studied. The remaining 15% could not be categorized. Shoulder dislocations occurred to a ball carrier in 15% of cases (n = 6) and a non–ball carrier in 85% of cases (n = 33). The injury most commonly occurred during a tackle (49%; n = 19) followed by ruck/maul (26%; n = 10). Time of injury showed that 36% (n = 14) of cases occurred in the last quarter of the game. Conclusion: Shoulder dislocations have now been shown to occur predominantly as a result of 1 of 4 distinct mechanisms, most frequently in the second half of the game. A new mechanism for shoulder dislocation has been described in this series, termed the poach position.


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