@article{6b22fe542eb44b299a87bc3ec5f585da,
title = "High Energy Side and Rear American Football Head Impacts Cause Obvious Performance Decrement on Video",
abstract = "The objective of this study was to compare head impact data acquired with an impact monitoring mouthguard (IMM) to the video-observed behavior of athletes{\textquoteright} post-collision relative to their pre-collision behaviors. A total of n = 83 college and high school American football players wore the IMM and were video-recorded over 260 athlete-exposures. Ex-athletes and clinicians reviewed the video in a two-step process and categorized abnormal post-collision behaviors according to previously published Obvious Performance Decrement (OPD) definitions. Engineers qualitatively reviewed datasets to check head impact and non-head impact signal frequency and magnitude. The ex-athlete reviewers identified 2305 head impacts and 16 potential OPD impacts, 13 of which were separately categorized as Likely-OPD impacts by the clinical reviewers. All 13 Likely-OPD impacts were in the top 1% of impacts measured by the IMM (ranges 40–100 g, 3.3–7.0 m/s and 35–118 J) and 12 of the 13 impacts (92%) were to the side or rear of the head. These findings require confirmation in a larger data set before proposing any type of OPD impact magnitude or direction threshold exists. However, OPD cases in this study compare favorably with previously published impact monitoring studies in high school and college American football players that looked for OPD signs, impact magnitude and direction. Our OPD findings also compare well with NFL reconstruction studies for ranges of concussion and sub-concussive impact magnitudes in side/rear collisions, as well as prior theory, analytical models and empirical research that suggest a directional sensitivity to brain injury exists for single high-energy impacts.",
keywords = "American football, Concussion, Head impact sensor, Mouthguard, Obvious performance decrement, Video review",
author = "Bartsch, {Adam J.} and Daniel Hedin and Jay Alberts and Benzel, {Edward C.} and Jason Cruickshank and Gray, {Robert S.} and Kenneth Cameron and Houston, {Megan N.} and Tyler Rooks and Gerald McGinty and Erick Kozlowski and Steven Rowson and Maroon, {Joseph C.} and Miele, {Vincent J.} and Ashton, {J. Chris} and Siegmund, {Gunter P.} and Alok Shah and Michael McCrea and Brian Stemper",
note = "Funding Information: This research was supported by DOD BAA W81XWH-17-1-0019 to Prevent Biometrics (PI: A. Bartsch), NIH SBIR R44HD090763-01A1 to Advanced Medical Electronics (PI: D. Hedin) and performed in conjunction with the NCAA-DOD Grand Alliance CARE Consortium award from the Office of the Assistant Secretary of Defense for Health Affairs, W81XWH-14-2-0151 (PI: M. McCrea). Drs. Jason Mihalik and Joel Stitzel reviewed the manuscript and the data as part of their roles on the Advisory Panel for the DOD BAA award. The authors acknowledge the participation and efforts of individuals at colleges and high schools, including Alexa Wild, Rachel Chiarello, Jennifer Hill, Dominic Calhoun, Lauren Hatch, Jeremy Ross, and Michael Aderman. Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the DOD or NIH. Its contents are solely the responsibility of the authors. Drew Goodger and Jack Sill assisted with the extensive video review. Dr. Jeff Crandall, Dr. Andrew Gardner, Dr. Declan Patton, and Dr. Scott Zuckerman provided guidance on prior studies and video review. Funding Information: This research was supported by DOD BAA W81XWH-17-1-0019 to Prevent Biometrics (PI: A. Bartsch), NIH SBIR R44HD090763-01A1 to Advanced Medical Electronics (PI: D. Hedin) and performed in conjunction with the NCAA-DOD Grand Alliance CARE Consortium award from the Office of the Assistant Secretary of Defense for Health Affairs, W81XWH-14-2-0151 (PI: M. McCrea). Drs. Jason Mihalik and Joel Stitzel reviewed the manuscript and the data as part of their roles on the Advisory Panel for the DOD BAA award. The authors acknowledge the participation and efforts of individuals at colleges and high schools, including Alexa Wild, Rachel Chiarello, Jennifer Hill, Dominic Calhoun, Lauren Hatch, Jeremy Ross, and Michael Aderman. Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the DOD or NIH. Its contents are solely the responsibility of the authors. Drew Goodger and Jack Sill assisted with the extensive video review. Dr. Jeff Crandall, Dr. Andrew Gardner, Dr. Declan Patton, and Dr. Scott Zuckerman provided guidance on prior studies and video review. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of the manuscript. Cleveland Clinic has entered into an exclusive license agreement with Prevent Biometrics for instrumented mouthguard technology on which AB, EB and VM are inventors. AB is also an employee of Prevent Biometrics. The conflicts disclosed here are managed by the Cleveland Clinic Conflict Management Board. Complete details can be found at https://my.clevelandclinic.org/ccf/media/files/About/COI.pdf. Publisher Copyright: {\textcopyright} 2020, Biomedical Engineering Society.",
year = "2020",
month = nov,
doi = "10.1007/s10439-020-02640-8",
language = "English",
volume = "48",
pages = "2667--2677",
journal = "Annals of Biomedical Engineering",
issn = "0090-6964",
number = "11",
}