Reducing Head Impact Exposure in Hawaii High School Football

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.

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Head Impact Exposure in American High School Football and Ice Hockey: A Longitudinal Prospective Cohort Study

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2021.07.773 ◽

2021 ◽

Vol 102 (10) ◽

pp. e99

Author(s):

Danielle Ransom ◽

Luis Ahumada ◽

Jennifer Katzenstein ◽

Neil Goldenberg ◽

P Patrick Mularoni

Keyword(s):

High School ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Head Impact ◽

Ice Hockey ◽

High School Football

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

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00105 ◽

2019 ◽

Vol 7 (3_suppl) ◽

pp. 2325967119S0010 ◽

Cited By ~ 1

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]

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