MEASUREMENT ACCURACY OF HEAD IMPACT MONITORING SENSOR IN SPORT

Head injury and brain trauma exposure in sport have been recognized as potential contributors to long-term neurological disorders. As a result sensors have been proposed as an impact severity monitoring tool for on-field measurement of head accelerations. The purpose of this study was to characterize the accuracy of a head impact monitoring sensor system. Peak acceleration responses from a Smart lmpact Monitor (SIM) sensor were compared against reference sensors from a Hodgson-WSU headform. The headform with SIM was impacted for 7 impact conditions and 3 inbound energies. Moderate to strong positive correlations were found between the SIM and reference sensors for all impact conditions. At higher inbound energy the SIM overestimated, suggesting that under higher risk conditions the SIM represents a conservative tool in identifying dangerous impacts

IMPACT FREQUENCY VALIDATION OF HEAD IMPACT SENSOR TECHNOLOGY FOR USE IN SPORT

Head impact frequency has been identified as a contributing factor to long-term trauma experienced by the brain. A peak linear acceleration greater than 20g has been proposed as defining a single impact. The purpose of this study was to examine the accuracy of a single head impact sensor to identify 209 impacts under short

CORRELATIONS BETWEEN HEAD ROTATIONAL KINEMATICS AND BRAIN TISSUE STRAIN FOR LOW AND HIGH LEVEL FOOTBALL HELMET IMPACTS

This study examined the correlation between head angular velocity and acceleration with brain strain for low and high level impacts. Impacts at 2.4m/s (low) and 11m/s (high) were delivered to a American football helmeted Hybrid III headform using a centric/non-centric protocol. A finite element model calculated strain from headform accelerations. The lowlevel impact data were obtained from a previous subset eliciting angular responses occurring at 20g, therefore linear acceleration relationships were not examined. High correlations (r=>0.8) existed for non-centric conditions between strain with angular acceleration and velocity, while centric conditions had moderate relationships (r=0.50.68). This research demonstrates that kinematic-strain relationships are dependent on the impact event, and that a single variable may not represent strain under all conditi

Proceedings from the Ice Hockey Summit III: Action on Concussion

Objectives The Ice Hockey Summit III provided updated scientific evidence on concussions in hockey to inform these five objectives: (1) describe sport related concussion (SRC) epidemiology, (2) classify prevention strategies, (3) define objective, diagnostic tests, (4) identify treatment and (5) integrate science and clinical care into prioritized action plans and policy. Methods Our action plan evolved from 40 scientific presentations. The 155 attendees (physicians, athletic trainers, physical therapists, nurses, neuropsychologists, scientists, engineers, coaches and officials) voted to prioritize these action items in the final Summit session. Results (1) establish a national and international hockey data base for SRCs at all levels; (2) eliminate body checking in Bantam youth hockey games; (3) expand a behavior modification program (Fair Play) to all youth hockey levels; (4) enforce game ejection penalties for fighting in Junior A and professional hockey leagues; (5) establish objective tests to diagnose concussion at point of care (POC); and (6) mandate baseline testing to improve concussion diagnosis for all age groups. Conclusions Expedient implementation of the Summit III prioritized action items is necessary to reduce the risk, severity and consequences of concussion in the sport of ice hockey

The influence of impact angle on the dynamic response of a Hybrid III headform and brain tissue deformation

ASTM Symposium on the Mechanism of Concussion in Sports, Atlanta, Georgia, USA, 13 November 2012The objective of this study was to investigate the influence of impact angle on the dynamic response of a Hybrid III headform and brain tissue deformation by impacting the front and side of the headform using four angle conditions (0°, at the impact site and 5, 10 and 15° rightward rotations of the headform from 0°) as well as three additional angle conditions of -5, - 10 and -15° (leftward rotations from 0°) at the side location to examine the effects of the neckform. The acceleration-time curves were used as input into a finite element model of the brain where maximum principal strain was calculated. The study found that an impact angle of 15° significantly influencesthe results when measured using linear and rotational acceleration and maximum principal strain. When developing sophisticated impact protocols and undertaking head injury reconstruction research, it is important to be aware of impact angle.Deposited by bulk importkpw11/10/1

Examination of the relationship between peak linear and angular accelerations to brain deformation metrics in hockey helmet impacts

Ice hockey is a contact sport which has a high incidence of brain injury. The current methods of evaluating protective devices use peak resultant linear acceleration as their pass/fail criteria, which are not fully representative of brain injuries as a whole. The purpose of this study was to examine how the linear and angular acceleration loading curves from a helmeted impact influence currently used brain deformation injury metrics. A helmeted Hybrid III headform was impacted in five centric and non-centric impact sites to elicit linear and angular acceleration responses. These responses were examined through the use of a brain model. The results indicated that when the helmet is examined using peak resultant linear acceleration alone, they are similar and protective, but when a 3D brain deformation response is used to examine the helmets, there are risks of brain injury with lower linear accelerations which would pass standard certifications for safety.Deposited by bulk impor

The influence of centric and non-centric impacts to American football helmets on the correlation between commonly metrics in brain injury research

IRCOBI Conference 2012, 12 - 14 September 2012, Dublin (Ireland)Concussion has become recognized as an injury which can be a source of long term neurological damage. This has led to research into which metrics may be more appropriate to define risk of injury. Some researchers support the use of linear acceleration as a metric for concussion, while others suggest the use of linear and rotational acceleration as well as brain deformation metrics. The purpose of this study was to examine the relationships between these metrics using a centric and non‐centric impact protocol. A linear impactor was used to impact a Hybrid III headform fitted with different models of American football helmet using a centric and non‐centric protocol. The dynamic response was then used as input to the FE model for analysis of brain deformations. The results showed that linear acceleration was correlated to rotational acceleration and brain deformation for centric conditions, but under non‐centric conditions it was not. These results indicate that the type of methodology used will influence the relationship between the variables used to assign risk of concussion. These results also support the use of a centric/non‐centric protocol and measurement of rotational acceleration and brain deformation when it comes to the development of helmet technologies.Deposited by bulk import16/10/13 R

A Comparison of the Head Dynamic Response and Brain Tissue Deformation from Impacts Resulting in Concussion, Concussion with Persistent Post-Concussive Symptoms, and Subdural Hematoma

Objective: Concussions typically resolve within a few days however in a few cases the symptoms last for a month or longer and are termed persistent post-concussive symptoms (PPCS) with more serious brain trauma resulting in bleeds, such as subdural hematoma (SDH). Dynamic response and brain tissue deformation characteristics may provide a means of distinguishing between these three types of injuries. Methods: Reconstruction cases were recruited from sports medicine clinics and hospitals along with medical reports, video footage, and medical imaging. All subjects received a direct blow to the head resulting in head trauma symptoms, those that resolved in 9 days were termed concussions, those with symptoms longer than 18 months were PPCS and those presenting with subdural hematoma (SDH). An anthropometric dummy headform was dropped onto various impact surfaces using a monorail drop rig. Headform dynamic response data was collected and used as input into the University College Dublin Brain Trauma Model to obtain maximum principal strain and von Mises stress. Results: Both linear and rotational acceleration of the head increased in magnitude with an increase in injury severity (from concussion, to PPCS, and SDH). The PPCS group had peak resultant rotational accelerations similar to SDH and significantly higher than concussions. There were no significant differences for peak resultant linear accelerations between the two concussion groups however they were both significantly lower than the SDH group. Brain tissue deformation measures however, did not follow the same trend as dynamic response and resulted with SDH having the lowest values of stress and strain. PPCS had significantly higher values of strain than the SDH group, where both the concussion and PPCS groups had significantly higher stress values than the SDH group. Conclusion: This study supports the notion that there is a positive relationship between an increase in the dynamic response and the risk for more serious brain injury. Peak resultant linear acceleration may be more related to SDH meanwhile rotational acceleration may be more relatedto severity of concussion. Despite SDH being the more severe brain injury, on average this group had the lowest values for stress and strain as compared to concussion and PPCS. Finite element analysis of the SDH injuries examined brain tissue values for the group of elements in the model than corresponded to the location of the bleed which may not be reflective of the highest values if the entire cerebrum was considered. More importantly, SDH injuries are vascular injuries and may not necessarily result in damage to the brain. In summary, this study found that the dynamic response of an impact is reflective of injury severity. Understanding the relationship between the dynamic response and the nature of the injury provides important information for developing strategies for injury prevention.Canadian Institutes of Health Research Strategic Team Grant in Applied Injury ResearchOntario Neurotrauma Foundatio

Multiple Head Rotations Result in Persistent Gait Alterations in Piglets

Multiple/repeated mild traumatic brain injury (mTBI) in young children can cause long-term gait impairments and affect the developmental course of motor control. Using our swine model for mTBI in young children, our aim was to (i) establish a reference range (RR) for each parameter to validate injury and track recovery, and (ii) evaluate changes in gait patterns following a single and multiple (5×) sagittal rapid non-impact head rotation (RNR). Gait patterns were studied in four groups of 4-week-old Yorkshire swine: healthy (n = 18), anesthesia-only sham (n = 8), single RNR injury (n = 12) and multiple RNR injury (n = 11). Results were evaluated pre-injury and at 1, 4, and 7 days post-injury. RR reliability was validated using additional healthy animals (n = 6). Repeated mTBI produced significant increases in gait time, cycle time, and stance time, as well as decreases in gait velocity and cadence, on Day One post-injury compared to pre-injury, and these remained significantly altered at Day Four and Day Seven post-injury. The gait metrics of the repeated TBI group also significantly fell outside the healthy RR on Day One, with some recovery by Day Four, while many remained altered at Day Seven. Only a bilateral decrease in hind stride length was observed at Day Four in our single RNR group compared to pre-injury. In sum, repeated and single sagittal TBI can significantly impair motor performance, and gait metrics can serve as reliable, objective, quantitative functional assessments in a juvenile porcine RNR TBI model

Pupillary Light Response Deficits in 4-Week-Old Piglets and Adolescent Children after Low-Velocity Head Rotations and Sports-Related Concussions

Neurological disorders and traumatic brain injury (TBI) are among the leading causes of death and disability. The pupillary light reflex (PLR) is an emerging diagnostic tool for concussion in humans. We compared PLR obtained with a commercially available pupillometer in the 4 week old piglet model of the adolescent brain subject to rapid nonimpact head rotation (RNR), and in human adolescents with and without sports-related concussion (SRC). The 95% PLR reference ranges (RR, for maximum and minimum pupil diameter, latency, and average and peak constriction velocities) were established in healthy piglets (N = 13), and response reliability was validated in nine additional healthy piglets. PLR assessments were obtained in female piglets allocated to anesthetized sham (N = 10), single (sRNR, N = 13), and repeated (rRNR, N = 14) sagittal low-velocity RNR at pre-injury, as well as days 1, 4, and 7 post injury, and evaluated against RRs. In parallel, we established human PLR RRs in healthy adolescents (both sexes, N = 167) and compared healthy PLR to values obtained <28 days from a SRC (N = 177). In piglets, maximum and minimum diameter deficits were greater in rRNR than sRNR. Alterations peaked on day 1 post sRNR and rRNR, and remained altered at day 4 and 7. In SRC adolescents, the proportion of adolescents within the RR was significantly lower for maximum pupil diameter only (85.8%). We show that PLR deficits may persist in humans and piglets after low-velocity head rotations. Differences in timing of assessment after injury, developmental response to injury, and the number and magnitude of impacts may contribute to the differences observed between species. We conclude that PLR is a feasible, quantifiable involuntary physiological metric of neurological dysfunction in pigs, as well as humans. Healthy PLR porcine and human reference ranges established can be used for neurofunctional assessments after TBI or hypoxic exposures (e.g., stroke, apnea, or cardiac arrest)