1
|
Luke D, Masood Z, Bondi D, Zhang C, Kenny R, Clansey A, van Donkelaar P, Rauscher A, Ji S, Wu L. On-field Head Acceleration Exposure Measurement Using Instrumented Mouthguards: Missing Data Imputation for Complete Exposure Analysis. Ann Biomed Eng 2025:10.1007/s10439-025-03747-6. [PMID: 40397312 DOI: 10.1007/s10439-025-03747-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2025] [Accepted: 04/27/2025] [Indexed: 05/22/2025]
Abstract
PURPOSE Accurate quantification of head acceleration event (HAE) exposure is critical for investigating brain injury risk in contact sports athletes. However, missing HAEs may be unavoidable in real-world data collection. This study introduces missing data imputation methods to estimate complete video- and sensor-based HAE exposure. METHODS We captured and verified university men's ice hockey HAEs using video and instrumented mouthguards (iMGs) in one varsity season (nathletes = 27, ngames = 31). A statistical mapping technique was first introduced to impute missing video-based HAEs during away games with limited camera angles. We then applied multiple imputation to impute missing iMG-based HAEs using captured data, including the complete video-based HAE exposure. This enabled estimation of complete exposure data at a per-athlete level over all games of the season. RESULTS Among 591 athlete-games, 45% did not have any recorded iMG data. We find that data imputation increased the median values of per-athlete-season video- and iMG-based HAE counts by 10% and 69%, respectively. Consequently, common head kinematics- and brain deformation-based cumulative exposure metrics also increased substantially (median per-athlete-season cumulative peak linear acceleration by 95%, peak angular acceleration by 109%, and corpus callosum strain by 69%). CONCLUSION This study highlights the potential underestimation of exposure metrics due to missing HAEs and fills a critical gap in sports HAE exposure research. Future studies should incorporate missing data imputation methods for more accurate estimation of HAE exposure in investigating acute and long-term brain trauma risks.
Collapse
Affiliation(s)
- David Luke
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Zaryan Masood
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Daniel Bondi
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Chaokai Zhang
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Rebecca Kenny
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Adam Clansey
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Paul van Donkelaar
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Alexander Rauscher
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Songbai Ji
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Lyndia Wu
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada.
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada.
| |
Collapse
|
2
|
Owen C, Roe G, Tooby J, Sawczuk T, Brown J, Cross M, Falvey É, Hendricks S, Kemp S, Starling L, Stokes K, Tucker R, Jones B. Evaluating the Probability of Head Acceleration Events in Elite Men's and Women's Rugby Union Match-Play: The Impact of Tackle Height and Body Position. Sports Med 2025:10.1007/s40279-025-02241-2. [PMID: 40335879 DOI: 10.1007/s40279-025-02241-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2025] [Indexed: 05/09/2025]
Abstract
BACKGROUND Head acceleration events (HAEs) are an increasing concern in collision sports owing to potential negative health outcomes. OBJECTIVES The objective of this study is to describe the probabilities of HAEs in tackles of differing heights and body positions in elite men's and women's rugby union. METHODS Instrumented mouthguards (iMGs) were worn in men's (n = 24 teams, 508 players, 782 observations) and women's (n = 26 teams, 350 players, 1080 observations) rugby union matches. Tackle height (i.e. point of contact on ball-carrier) and body positions of tacklers and ball-carriers were labelled for all tackles in which a player wore an iMG. HAEs from the initial impact were identified. Mean player, tackler and ball-carrier exceedance probabilities for various peak linear and angular acceleration thresholds were estimated from ordinal mixed-effects models. RESULTS Contact with ball-carriers' head/neck resulted in the highest mean HAE probabilities for both sexes. The probability of an HAE to the ball-carrier decreased as tackle height lowered. The highest probability for the tackler was initial contact to the ball-carriers upper leg. Body position influenced the probability of HAEs, with falling/diving ball-carriers resulting in higher mean probabilities. When a player, regardless of role, was bent-at-waist, elevated HAE probabilities were observed in men's competitions. Women's data demonstrated similar probabilities of an HAE for all body positions. CONCLUSIONS Initial contact to the ball-carrier's head/neck had the highest chance of an HAE, whilst role-specific differences are apparent for different tackle heights and body positions. Future player-welfare strategies targeting contact events should therefore consider HAE mechanisms along with current literature.
Collapse
Affiliation(s)
- Cameron Owen
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
- England Performance Unit, Rugby Football League, Manchester, UK.
| | - Greg Roe
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - James Tooby
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Thomas Sawczuk
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Obesity Institute, Leeds Beckett University, Leeds, UK
| | - James Brown
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- The Division of Sport and Exercise Medicine (DiSEM), Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Matt Cross
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Premiership Rugby, London, UK
| | - Éanna Falvey
- World Rugby, Dublin, Ireland
- School of Medicine and Health, University College Cork, Cork, Ireland
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Simon Kemp
- Rugby Football Union, Twickenham, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | - Lindsay Starling
- World Rugby, Dublin, Ireland
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, Bath, UK
| | - Keith Stokes
- Rugby Football Union, Twickenham, UK
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, Bath, UK
| | - Ross Tucker
- The Division of Sport and Exercise Medicine (DiSEM), Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- World Rugby, Dublin, Ireland
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Premiership Rugby, London, UK
- Faculty of Health Sciences, School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
| |
Collapse
|
3
|
Roe G, Sawczuk T, Starling L, Gilthorpe MS, Salmon D, Falvey É, Hendricks S, Rasmussen K, Stokes K, Tooby J, Owen C, Tucker R, Jones B. Contact-events and associated head acceleration events in semi-elite women's rugby union: A competition-wide instrumented mouthguard study. J Sports Sci 2025; 43:933-942. [PMID: 40130348 DOI: 10.1080/02640414.2025.2481355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2025]
Abstract
This study aimed to quantify contact-events and associated head acceleration event (HAE) probabilities in semi-elite women's rugby union. Instrumented mouthguards (iMGs) were worn by players competing in the 2023 Farah Palmer Cup season (13 teams, 217 players) during 441 player-matches. Maximum peak linear acceleration (PLA) and peak angular acceleration (PAA) per-event were used as estimates of in vivo HAE (HAEmax), linked to video analysis-derived contact-events and analysed using mixed-effects regression. Back-rows had the highest number of contact-events per full-match (44.1 [41.2 to 47.1]). No differences were apparent between front-five and centres, or between half-backs and outside-backs. The probability of higher HAEmax occurring was greatest in ball-carries, followed by tackles, defensive rucks and attacking rucks. Probability profiles were similar between positions but the difference in contact-events for each position influenced HAEmax exposure. Overall, most HAEmax were relatively low. For example, the probability of a back-row experiencing a PLA HAEmax ≥25g was 0.045 (0.037-0.054) for ball carries (1 in every 22 carries), translating to 1 in every 2.3 full games. This study presents the first in-depth analysis of contact-events and associated HAEmax in semi-elite women's rugby union. The HAEmax profiles during contact-events can help inform both policy and research into injury mitigation strategies.
Collapse
Affiliation(s)
- Gregory Roe
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Thomas Sawczuk
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Lindsay Starling
- World Rugby Research Unit, Dublin, Ireland
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, Bath, UK
| | | | | | - Éanna Falvey
- World Rugby Research Unit, Dublin, Ireland
- Alan Turing Institute, British Library, London, UK
- School of Medicine & Health, University College Cork, Cork, Ireland
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Karen Rasmussen
- People Safety, New Zealand Rugby Union, Wellington, New Zealand
| | - Keith Stokes
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, Bath, UK
- Medical Department, Rugby Football Union, Twickenham, UK
| | - James Tooby
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Cameron Owen
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
| | - Ross Tucker
- World Rugby Research Unit, Dublin, Ireland
- Institute of Sport and Exercise Medicine (ISEM), Department of Exercise, University of Stellenbosch, South Africa
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- England Performance Unit, Rugby Football League, Manchester, UK
- Premiership Rugby, London, UK
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
| |
Collapse
|
4
|
Gellner R, Begonia MT, Wood M, Rockwell L, Geiman T, Jung C, Gellner B, MacMartin A, Manlapit S, Rowson S. Detecting and Salvaging Head Impacts with Decoupling Artifacts from Instrumented Mouthguards. Ann Biomed Eng 2025; 53:1095-1112. [PMID: 39922951 PMCID: PMC12006252 DOI: 10.1007/s10439-025-03689-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Accepted: 01/22/2025] [Indexed: 02/10/2025]
Abstract
In response to growing evidence that repetitive head impact exposure and concussions can lead to long-term health consequences, many research studies are attempting to quantify the frequency and severity of head impacts incurred in various sports and occupations. The most popular apparatus for doing so is the instrumented mouthguard (iMG). While these devices hold greater promise of head kinematic accuracy than their helmet-mounted predecessors, data artifacts related to iMG decoupling still plague results. We recreated iMG decoupling artifacts in a laboratory test series using an iMG fit to a dentition mounted in a NOCSAE headform. With these data, we identified time, frequency, and time-frequency features of decoupled head impacts that we used in a machine learning classification algorithm to predict decoupling in six-degree-of-freedom iMG signals. We compared our machine learning algorithm predictions on the laboratory series and 80 video-verified field head acceleration events to several other proprietary and published methods for predicting iMG decoupling. We also present a salvaging method to remove decoupling artifacts from signals and reduce peak resultant error when decoupling is detected. Future researchers should expand these methods using on-field data to further refine and enable prediction of iMG decoupling during live volunteer use. Combining the presented machine learning model and salvaging technique with other published methods, such as infrared proximity sensing, advanced triggering thresholds, and video review, may enable researchers to identify and salvage data with decoupling artifacts that previously would have had to be discarded.
Collapse
Affiliation(s)
- Ryan Gellner
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA.
| | - Mark T Begonia
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Matthew Wood
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Lewis Rockwell
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
- Carnegie Mellon (Mechanical Engineering), Pittsburgh, PA, USA
| | - Taylor Geiman
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Caitlyn Jung
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Blake Gellner
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Allison MacMartin
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
- Wayne State University (Biomedical Engineering), Detroit, MI, USA
| | - Sophia Manlapit
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
- Wayne State University (Biomedical Engineering), Detroit, MI, USA
| | - Steve Rowson
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| |
Collapse
|
5
|
Tooby J, Rowson S, Till K, Allan D, Bussey MD, Cazzola D, Falvey É, Friesen K, Gardner AJ, Owen C, Roe G, Sawczuk T, Starling L, Stokes K, Tierney G, Tucker R, Jones B. Optimising Instrumented Mouthguard Data Analysis: Video Synchronisation Using a Cross-correlation Approach. Ann Biomed Eng 2025; 53:923-933. [PMID: 39836341 PMCID: PMC11929623 DOI: 10.1007/s10439-025-03679-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Accepted: 01/07/2025] [Indexed: 01/22/2025]
Abstract
PURPOSE Head acceleration events (HAEs) are a growing concern in contact sports, prompting two rugby governing bodies to mandate instrumented mouthguards (iMGs). This has resulted in an influx of data imposing financial and time constraints. This study presents two computational methods that leverage a dataset of video-coded match events: cross-correlation synchronisation aligns iMG data to a video recording, by providing playback timestamps for each HAE, enabling analysts to locate them in video footage; and post-synchronisation event matching identifies the coded match event (e.g. tackles and ball carries) from a video analysis dataset for each HAE, this process is important for calculating the probability of match events resulting in HAEs. Given the professional context of iMGs in rugby, utilising commercial sources of coded match event datasets may expedite iMG analysis. METHODS Accuracy and validity of the methods were assessed via video verification during 60 rugby matches. The accuracy of cross-correlation synchronisation was determined by calculating synchronisation error, whilst the validity of post-synchronisation event matching was evaluated using diagnostic accuracy measures (e.g. positive predictive value [PPV] and sensitivity). RESULTS Cross-correlation synchronisation yielded mean synchronisation errors of 0.61-0.71 s, with all matches synchronised within 3 s' error. Post-synchronisation event matching achieved PPVs of 0.90-0.95 and sensitivity of 0.99-1.00 for identifying correct match events for SAEs. CONCLUSION Both methods achieved high accuracy and validity with the data sources used in this study. Implementation depends on the availability of a dataset of video-coded match events; however, integrating commercially available video-coded datasets offers the potential to expedite iMG analysis, improve feedback timeliness, and augment research analysis.
Collapse
Affiliation(s)
- James Tooby
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
| | - Steve Rowson
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA
| | - Kevin Till
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
| | - David Allan
- Sport and Exercise Sciences Research Institute, Ulster University, Belfast, UK
- Nanotechnology and Integrated Bioengineering Centre (NIBEC), School of Engineering, Ulster University, Belfast, UK
| | - Melanie Dawn Bussey
- School of Physical Education Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Dario Cazzola
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
| | | | - Kenzie Friesen
- Sports Injury Prevention Research Centre, University of Calgary, Calgary, Canada
| | - Andrew J Gardner
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Cameron Owen
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Rugby Football League, Etihad Campus, Manchester, UK
| | - Gregory Roe
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Thomas Sawczuk
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | | | - Keith Stokes
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- Medical Services, Rugby Football Union, Twickenham, UK
| | - Gregory Tierney
- Nanotechnology and Integrated Bioengineering Centre (NIBEC), School of Engineering, Ulster University, Belfast, UK
| | - Ross Tucker
- World Rugby, 8-10 Pembroke St., Dublin, Ireland
- Institute of Sport and Exercise Medicine, Department of Sport Science, University of Stellenbosch, Stellenbosch, South Africa
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Rugby Football League, Etihad Campus, Manchester, UK
- Division of Physiological Sciences and Health through Physical Activity, Lifestyle and Sport Research Centre, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
- Premiership Rugby, London, UK
| |
Collapse
|
6
|
Bussey MD, Salmon D, Nanai B, Romanchuk J, Gomez RM, Tong D, Sole G, Tucker R, Falvey É. Assessing Head Acceleration Events in Female Community Rugby Union Players: A Cohort Study Using Instrumented Mouthguards. Sports Med 2025; 55:499-512. [PMID: 39235574 PMCID: PMC11946941 DOI: 10.1007/s40279-024-02111-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND The rapid growth of women's rugby union has underscored the need for female-specific player welfare protocols, particularly regarding the risk of head injuries. Instrumented mouthguards (iMGs) play a vital role in gathering comprehensive data on head acceleration events (HAEs), including their frequency, magnitude, and spatial distribution during games and training. By doing so, iMGs offer valuable context for circumstances in women's matches that may increase player risk. OBJECTIVES The study aimed to contextualize HAEs in female community rugby players using instrumented mouthguards and video review. METHODS This prospective, observational cohort study involved 332 female rugby players across 38 matches and 80 training sessions during the 2021/2022 seasons. Players were representative of four playing grades: U13 (N = 9), U15 (N = 111), U19 (N = 95) and Premier women (N = 115). HAEs were recorded using boil-and-bite iMGs, with a single-axis recording threshold of 5 g. The incidence and prevalence of HAEs was expressed by grade, years of experience, playing positions, and session types (match or training). The effect of playing grade and previous playing experience on HAE propensity during tackles and rucks was also examined. RESULTS Throughout the study, 9151 iMG events over 5 g were recorded, with 80% verified for analysis. Overall, the incidence rate (IR) was highest for HAEs between 10 and 29 g, 12-18 times higher than the IR for > 30-g events. Premier grade players had the highest weekly HAE load (26.2 per player per week) and the highest prevalence of players (49%) exposed to events over 30 g. An inverse relationship was found between years of rugby experience and peak angular acceleration (PAA) in U13-U19 players (p = 0.002, 95% CI [47,177 rads/s2]), showing that more experienced school-age players had lower rotational acceleration during HAEs. However, propensity for HAEs in tackle events was highest in Premier players with > 9 years of experience compared with U13-U19 grade players with similar years of experience (RR = 1.21, 95% CI 1.06-1.37; p = 0.004). Ball carries consistently resulted in the highest propensity of events over 30 g, regardless of playing grade or experience. CONCLUSIONS This research presents unique information regarding head accelerations that occur during women's community rugby matches and practices. The results have significant implications for recognising populations that are at the highest risk of experiencing high cumulative and acute head accelerations. The findings may assist in managing training loads and instructing skill execution in high-risk activities, particularly for younger players who are new to the sport. Consideration of playing grade, experience, and contact phases is crucial for understanding head acceleration exposure and injury risk in female rugby players. These insights can inform injury prevention strategies.
Collapse
Affiliation(s)
- Melanie D Bussey
- School of Physical Education, Sports and Exercise Sciences, University of Otago, Dunedin, New Zealand.
| | - Danielle Salmon
- New Zealand Rugby, Wellington, New Zealand
- World Rugby, Dublin, Ireland
| | - Bridie Nanai
- School of Physical Education, Sports and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Janelle Romanchuk
- School of Physical Education, Sports and Exercise Sciences, University of Otago, Dunedin, New Zealand
- New Zealand Rugby, Wellington, New Zealand
| | - Raul M Gomez
- School of Physical Education, Sports and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Darryl Tong
- School of Physical Education, Sports and Exercise Sciences, University of Otago, Dunedin, New Zealand
- New Zealand Rugby, Wellington, New Zealand
- Institute of Sport and Exercise Medicine, University of Stellenbosch, Stellenbosch, South Africa
- World Rugby, Dublin, Ireland
- School of Medicine & Health, University College Cork, Cork, Ireland
- Department of Oral Diagnostic and Surgical Science, University of Otago, Dunedin, New Zealand
| | - Gisela Sole
- School of Physical Education, Sports and Exercise Sciences, University of Otago, Dunedin, New Zealand
- New Zealand Rugby, Wellington, New Zealand
- Institute of Sport and Exercise Medicine, University of Stellenbosch, Stellenbosch, South Africa
- World Rugby, Dublin, Ireland
- School of Medicine & Health, University College Cork, Cork, Ireland
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Ross Tucker
- Institute of Sport and Exercise Medicine, University of Stellenbosch, Stellenbosch, South Africa
- World Rugby, Dublin, Ireland
| | - Éanna Falvey
- World Rugby, Dublin, Ireland
- School of Medicine & Health, University College Cork, Cork, Ireland
| |
Collapse
|
7
|
Olsen RJ, Hasan SS, Woo JJ, Nawabi DH, Ramkumar PN. The Fundamentals and Applications of Wearable Sensor Devices in Sports Medicine: A Scoping Review. Arthroscopy 2025; 41:473-492. [PMID: 38331364 DOI: 10.1016/j.arthro.2024.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 01/28/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE To (1) characterize the various forms of wearable sensor devices (WSDs) and (2) review the peer-reviewed literature of applied wearable technology within sports medicine. METHODS A systematic search of PubMed and EMBASE databases, from inception through 2023, was conducted to identify eligible studies using WSDs within sports medicine. Data extraction was performed of study demographics and sensor specifications. Included studies were categorized by application: athletic training, rehabilitation, and research. RESULTS In total, 43 studies met criteria for inclusion in this review. Forms of WSDs include pedometers, accelerometers, encoders (consisting of magnetometers and gyroscopes), force sensors, global positioning system trackers, and inertial measurement units. Outcome metrics include step counts; gait, limb motion, and angular positioning; foot and skin pressure; change of direction and inclination, including analysis of both body parts and athletes on a field; displacement and velocity of body segments and joints; heart rate; plethysmography; sport-specific kinematics; range of motion, symmetry, and alignment; head impact; sleep; throwing biomechanics; and kinetic and spatiotemporal running metrics. WSDs are used in athletic training to assess sport-specific biomechanics and workload with a goal of injury prevention and training optimization, as well as for rehabilitation monitoring and research such as for risk predicting and aiding diagnosis. CONCLUSIONS WSDs enable real-time monitoring of human performance across a variety of implementations and settings, allowing collection of metrics otherwise not achievable. WSDs are powerful tools with multiple applications within athletic training, patient rehabilitation, and orthopaedic and sports medicine research. CLINICAL RELEVANCE Wearable technology may represent the missing link to quantitatively addressing return to play and previous performance. WSDs are commercially available and portable adjuncts that allow clinicians, trainers, and individual athletes to monitor biomechanical parameters, workload, and recovery status to better contextualize personalized training, injury risk, and rehabilitation.
Collapse
Affiliation(s)
- Reena J Olsen
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, U.S.A
| | | | - Joshua J Woo
- Brown University/The Warren Alpert School of Brown University, Providence, Rhode Island, U.S.A
| | - Danyal H Nawabi
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, U.S.A
| | - Prem N Ramkumar
- Long Beach Orthopedic Institute, Long Beach, California, U.S.A..
| |
Collapse
|
8
|
Gellner RA, Begonia MT, Wood M, Rockwell L, Geiman T, Jung C, Rowson S. Instrumented Mouthguard Decoupling Affects Measured Head Kinematic Accuracy. Ann Biomed Eng 2024; 52:2854-2871. [PMID: 38955890 PMCID: PMC11402849 DOI: 10.1007/s10439-024-03550-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/20/2024] [Indexed: 07/04/2024]
Abstract
Many recent studies have used boil-and-bite style instrumented mouthguards to measure head kinematics during impact in sports. Instrumented mouthguards promise greater accuracy than their predecessors because of their superior ability to couple directly to the skull. These mouthguards have been validated in the lab and on the field, but little is known about the effects of decoupling during impact. Decoupling can occur for various reasons, such as poor initial fit, wear-and-tear, or excessive impact forces. To understand how decoupling influences measured kinematic error, we fit a boil-and-bite instrumented mouthguard to a 3D-printed dentition mounted to a National Operating Committee on Standards for Athletic Equipment (NOCSAE) headform. We also instrumented the headform with linear accelerometers and angular rate sensors at its center of gravity (CG). We performed a series of pendulum impact tests, varying impactor face and impact direction. We measured linear acceleration and angular velocity, and we calculated angular acceleration from the mouthguard and the headform CG. We created decoupling conditions by varying the gap between the lower jaw and the bottom face of the mouthguard. We tested three gap conditions: 0 mm (control), 1.6 mm, and 4.8 mm. Mouthguard measurements were transformed to the CG and compared to the reference measurements. We found that gap condition, impact duration, and impact direction significantly influenced mouthguard measurement error. Error was higher for larger gaps and in frontal (front and front boss) conditions. Higher errors were also found in padded conditions, but the mouthguards did not collect all rigid impacts due to inherent limitations. We present characteristic decoupling time history curves for each kinematic measurement. Exemplary frequency spectra indicating characteristic decoupling frequencies are also described. Researchers using boil-and-bite instrumented mouthguards should be aware of their limitations when interpreting results and should seek to address decoupling through advanced post-processing techniques when possible.
Collapse
Affiliation(s)
- Ryan A Gellner
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA.
| | - Mark T Begonia
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Matthew Wood
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Lewis Rockwell
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Taylor Geiman
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Caitlyn Jung
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| | - Steve Rowson
- Virginia Tech (Biomedical Engineering and Mechanics), Blacksburg, VA, USA
| |
Collapse
|
9
|
Pritchard NS, Brandt KM, Bullock GS, Kruse DW, Miles CM, Moore JB, Stitzel JD, Urban JE. The effect of safety modifications on head kinematics experienced during common skills in women's artistic gymnastics. J Sports Sci 2024; 42:1439-1452. [PMID: 39259820 PMCID: PMC11578227 DOI: 10.1080/02640414.2024.2394747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 08/14/2024] [Indexed: 09/13/2024]
Abstract
The objective of this study was to evaluate the effect of skill modifications on head motion experienced during women's artistic gymnastics skills. Nine gymnasts (four beginner and five advanced) completed three trials of up to 24 skill progressions, each consisting of a skill and two progressive safety modifications. Gymnasts were instrumented with mouthpiece sensors embedded with an accelerometer and gyroscope collecting motion data at 200, 300, and 500 Hz during each skill performance. Peak-to-peak linear and rotational kinematics during contact phases and peak rotational kinematics during non-contact phases were computed. A mixed-effects model was used to compare differences in modification status nested within skill categories. Timer skills (i.e. drills that simulate performance of a gymnastics skill) resulted in the highest median ΔLA and ΔRA of all skill categories, and 132 skill performances exceeded 10 g ΔLA during a contact phase. Modifications were associated with significant reductions in head kinematics during contact phases of timers, floor skills, bar releases, and vault skills. Gymnasts can be exposed to direct and indirect head accelerations at magnitudes consistent with other youth contact sports, and common safety modifications may be effective at reducing head motion during contact and non-contact phases of gymnastics skills.
Collapse
Affiliation(s)
- N Stewart Pritchard
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, USA
- School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Winston-Salem, USA
| | - Kambrie M Brandt
- Department of Biological, Biomedical, and Chemical Engineering, University of Missouri, Columbia, USA
| | - Garrett S Bullock
- Department of Orthopaedic Surgery & Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, USA
| | - David W Kruse
- Orthopaedic Specialty Institute, Primary Care Sports Medicine, Irvine, CA, USA
| | - Christopher M Miles
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, USA
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Justin B Moore
- Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Joel D Stitzel
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, USA
- School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Winston-Salem, USA
| | - Jillian E Urban
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, USA
- School of Biomedical Engineering and Sciences, Virginia Tech - Wake Forest University, Winston-Salem, USA
| |
Collapse
|
10
|
Woodward J, Tooby J, Tucker R, Falvey ÉC, Salmon DM, Starling L, Tierney G. Instrumented mouthguards in elite-level men's and women's rugby union: characterising tackle-based head acceleration events. BMJ Open Sport Exerc Med 2024; 10:e002013. [PMID: 39104376 PMCID: PMC11298745 DOI: 10.1136/bmjsem-2024-002013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2024] [Indexed: 08/07/2024] Open
Abstract
Objectives To examine the propensity of tackle height and the number of tacklers that result in head acceleration events (HAEs) in elite-level male and female rugby tackles. Methods Instrumented mouthguard data were collected from women (n=67) and men (n=72) elite-level rugby players from five elite and three international teams. Peak linear acceleration and peak angular acceleration were extracted from HAEs. Propensities for HAEs at a range of thresholds were calculated as the proportion of tackles/carries that resulted in an HAE exceeding a given magnitude for coded tackle height (low, medium, high) and number of tacklers. Propensity ratios with 95% CIs were calculated for tackle heights and number of tacklers. Results High tackles had a 32.7 (95% CI=6.89 to 155.02) and 41.2 (95% CI=9.22 to 184.58) propensity ratio to cause ball carrier HAEs>30 g compared with medium tackles for men and women, respectively. Low tackles had a 2.6 (95% CI=1.91 to 3.42) and 5.3 (95% CI=3.28 to 8.53) propensity ratio to cause tackler HAEs>30 g compared with medium tackles for men and women, respectively. In men, multiple tacklers had a higher propensity ratio (6.1; 95% CI=3.71 to 9.93) than singular tacklers to cause ball carrier HAEs>30 g but a lower propensity ratio (0.4; 95% CI=0.29 to 0.56) to cause tackler HAEs>30 g. No significant differences were observed in female tacklers or carriers for singular or multiple tacklers. Conclusion To limit HAE exposure, rule changes and coaching interventions that promote tacklers aiming for the torso (medium tackle) could be explored, along with changes to multiple tackler events in the male game.
Collapse
Affiliation(s)
| | - James Tooby
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK
| | - Ross Tucker
- Institute of Sport and Exercise Medicine, University of Stellenbosch, Stellenbosch, South Africa
| | - Éanna C Falvey
- World Rugby Limited, Dublin, Ireland
- Department of Medicine, University College Cork, Cork, Ireland
| | - Danielle M Salmon
- World Rugby Limited, Dublin, Ireland
- Auckland University of Technology, Auckland, New Zealand
| | | | | |
Collapse
|
11
|
Tooby J, Till K, Gardner A, Stokes K, Tierney G, Weaving D, Rowson S, Ghajari M, Emery C, Bussey MD, Jones B. When to Pull the Trigger: Conceptual Considerations for Approximating Head Acceleration Events Using Instrumented Mouthguards. Sports Med 2024; 54:1361-1369. [PMID: 38460080 PMCID: PMC11239719 DOI: 10.1007/s40279-024-02012-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2024] [Indexed: 03/11/2024]
Abstract
Head acceleration events (HAEs) are acceleration responses of the head following external short-duration collisions. The potential risk of brain injury from a single high-magnitude HAE or repeated occurrences makes them a significant concern in sport. Instrumented mouthguards (iMGs) can approximate HAEs. The distinction between sensor acceleration events, the iMG datum for approximating HAEs and HAEs themselves, which have been defined as the in vivo event, is made to highlight limitations of approximating HAEs using iMGs. This article explores the technical limitations of iMGs that constrain the approximation of HAEs and discusses important conceptual considerations for stakeholders interpreting iMG data. The approximation of HAEs by sensor acceleration events is constrained by false positives and false negatives. False positives occur when a sensor acceleration event is recorded despite no (in vivo) HAE occurring, while false negatives occur when a sensor acceleration event is not recorded after an (in vivo) HAE has occurred. Various mechanisms contribute to false positives and false negatives. Video verification and post-processing algorithms offer effective means for eradicating most false positives, but mitigation for false negatives is less comprehensive. Consequently, current iMG research is likely to underestimate HAE exposures, especially at lower magnitudes. Future research should aim to mitigate false negatives, while current iMG datasets should be interpreted with consideration for false negatives when inferring athlete HAE exposure.
Collapse
Affiliation(s)
- James Tooby
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
| | - Kevin Till
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
| | - Andrew Gardner
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Keith Stokes
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- Medical Services, Rugby Football Union, Twickenham, UK
| | - Gregory Tierney
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Sport and Exercise Sciences Research Institute, School of Sport, Ulster University, Belfast, UK
| | - Daniel Weaving
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Steve Rowson
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA
- Leeds Beckett University, Leeds, UK
| | - Mazdak Ghajari
- Dyson School of Design Engineering, Imperial College London, London, UK
| | - Carolyn Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Melanie Dawn Bussey
- School of Physical Education Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town and Sports Science Institute of South Africa, Cape Town, South Africa
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
- Rugby Football League, England Performance Unit, Red Hall, Leeds, UK
- Premiership Rugby, London, UK
| |
Collapse
|
12
|
Roe G, Sawczuk T, Owen C, Tooby J, Starling L, Gilthorpe MS, Falvey É, Hendricks S, Rasmussen K, Readhead C, Salmon D, Stokes K, Tucker R, Jones B. Head Acceleration Events During Tackle, Ball-Carry, and Ruck Events in Professional Southern Hemisphere Men's Rugby Union Matches: A Study Using Instrumented Mouthguards. Scand J Med Sci Sports 2024; 34:e14676. [PMID: 38867444 DOI: 10.1111/sms.14676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/24/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVES Describe head acceleration events (HAEs) experienced by professional male rugby union players during tackle, ball-carry, and ruck events using instrumented mouthguards (iMGs). DESIGN Prospective observational cohort. METHODS Players competing in the 2023 Currie Cup (141 players) and Super Rugby (66 players) seasons wore iMGs. The iMG-recorded peak linear acceleration (PLA) and peak angular acceleration (PAA) were used as in vivo HAE approximations and linked to contact-event data captured using video analysis. Using the maximum PLA and PAA per contact event (HAEmax), ordinal mixed-effects regression models estimated the probabilities of HAEmax magnitude ranges occurring, while accounting for the multilevel data structure. RESULTS As HAEmax magnitude increased the probability of occurrence decreased. The probability of a HAEmax ≥15g was 0.461 (0.435-0.488) (approximately 1 in every 2) and ≥45g was 0.031 (0.025-0.037) (1 in every 32) during ball carries. The probability of a HAEmax >15g was 0.381 (0.360-0.404) (1 in every 3) and >45g 0.019 (0.015-0.023) (1 in every 53) during tackles. The probability of higher magnitude HAEmax occurring was greatest during ball carries, followed by tackles, defensive rucks and attacking rucks, with some ruck types having similar profiles to tackles and ball carries. No clear differences between positions were observed. CONCLUSION Higher magnitude HAEmax were relatively infrequent in professional men's rugby union players. Contact events appear different, but no differences were found between positions. The occurrence of HAEmax was associated with roles players performed within contact events, not their actual playing position. Defending rucks may warrant greater consideration in injury prevention research.
Collapse
Affiliation(s)
- Gregory Roe
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Thomas Sawczuk
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Cameron Owen
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
| | - James Tooby
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Lindsay Starling
- World Rugby, Dublin, Ireland
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, Bath, UK
| | | | - Éanna Falvey
- World Rugby, Dublin, Ireland
- School of Medicine & Health, University College Cork, Cork, Ireland
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences and Health through Physical Activity, Department of Human Biology, Faculty of Health Sciences, Lifestyle and Sport Research Centre, University of Cape Town, Cape Town, South Africa
| | - Karen Rasmussen
- New Zealand Rugby Union, People Safety & Wellbeing, Wellington, New Zealand
| | - Clint Readhead
- Division of Physiological Sciences and Health through Physical Activity, Department of Human Biology, Faculty of Health Sciences, Lifestyle and Sport Research Centre, University of Cape Town, Cape Town, South Africa
- South Africa Rugby Union, Cape Town, South Africa
| | | | - Keith Stokes
- Centre for Health and Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Bath, Bath, UK
- Rugby Football Union, Twickenham, UK
| | - Ross Tucker
- World Rugby, Dublin, Ireland
- Department of Exercise, Institute of Sport and Exercise Medicine (ISEM), University of Stellenbosch, Stellenbosch, South Africa
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Manchester, UK
- Division of Physiological Sciences and Health through Physical Activity, Department of Human Biology, Faculty of Health Sciences, Lifestyle and Sport Research Centre, University of Cape Town, Cape Town, South Africa
- Premiership Rugby, London, UK
- Faculty of Health Sciences, School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
| |
Collapse
|
13
|
Tooby J, Woodward J, Tucker R, Jones B, Falvey É, Salmon D, Bussey MD, Starling L, Tierney G. Instrumented Mouthguards in Elite-Level Men's and Women's Rugby Union: The Incidence and Propensity of Head Acceleration Events in Matches. Sports Med 2024; 54:1327-1338. [PMID: 37906425 PMCID: PMC11127838 DOI: 10.1007/s40279-023-01953-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVES The aim of this study was to examine head acceleration event (HAE) propensity and incidence during elite-level men's and women's rugby union matches. METHODS Instrumented mouthguards (iMGs) were fitted in 92 male and 72 female players from nine elite-level clubs and three international teams. Data were collected during 406 player matches (239 male, 167 female) using iMGs and video analysis. Incidence was calculated as the number of HAEs per player hour and propensity as the proportion of contact events resulting in an HAE at a range of linear and angular thresholds. RESULTS HAE incidence above 10 g was 22.7 and 13.2 per hour in men's forwards and backs and 11.8 and 7.2 per hour in women's forwards and backs, respectively. Propensity varied by contact event, with 35.6% and 35.4% of men's tackles and carries and 23.1% and 19.6% of women's tackles and carries producing HAEs above 1.0 krad/s2. Tackles produced significantly more HAEs than carries, and incidence was greater in forwards compared with backs for both sexes and in men compared with women. Women's forwards were 1.6 times more likely to experience a medium-magnitude HAE from a carry than women's backs. Propensity was similar from tackles and carries, and between positional groups, while significantly higher in men than women. The initial collision stage of the tackle had a higher propensity than other stages. CONCLUSION This study quantifies HAE exposures in elite rugby union players using iMGs. Most contact events in rugby union resulted in lower-magnitude HAEs, while higher-magnitude HAEs were comparatively rare. An HAE above 40 g occurred once every 60-100 min in men and 200-300 min in women. Future research on mechanisms for HAEs may inform strategies aimed at reducing HAEs.
Collapse
Affiliation(s)
- James Tooby
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - James Woodward
- Sport and Exercise Sciences Research Institute, Ulster University, Belfast, UK
| | - Ross Tucker
- Department of Sport Science, Institute of Sport and Exercise Medicine, University of Stellenbosch, Stellenbosch, South Africa
- World Rugby, 8-10 Pembroke St., Dublin, Ireland
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences and Health Through Physical Activity, Department of Human Biology, Faculty of Health Sciences, Lifestyle and Sport Research Centre, University of Cape Town, Cape Town, South Africa
- England Performance Unit, Rugby Football League, Manchester, UK
- Premiership Rugby, London, UK
- Faculty of Health Sciences, School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
| | - Éanna Falvey
- World Rugby, 8-10 Pembroke St., Dublin, Ireland
- School of Medicine & Health, University College Cork, Cork, Ireland
| | - Danielle Salmon
- World Rugby, 8-10 Pembroke St., Dublin, Ireland
- New Zealand Rugby, Auckland, New Zealand
| | - Melanie Dawn Bussey
- School of Physical Education Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | | | - Gregory Tierney
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
- Sport and Exercise Sciences Research Institute, Ulster University, Belfast, UK.
| |
Collapse
|
14
|
Bussey MD, Salmon D, Romanchuk J, Nanai B, Davidson P, Tucker R, Falvey E. Head Acceleration Events in Male Community Rugby Players: An Observational Cohort Study across Four Playing Grades, from Under-13 to Senior Men. Sports Med 2024; 54:517-530. [PMID: 37676621 PMCID: PMC10933157 DOI: 10.1007/s40279-023-01923-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVES The aim of this study was to examine the cumulative head acceleration event (HAE) exposure in male rugby players from the Under-13 (U13) to senior club level over 4 weeks of matches and training during the 2021 community rugby season. METHODS This prospective, observational cohort study involved 328 male rugby players. Players were representative of four playing grades: U13 (N = 60, age 12.5 ± 0.6 years), U15 (N = 100, age 14.8 ± 0.9 years), U19 (N = 78, age 16.9 ± 0.7 years) and Premier senior men (N = 97, age 22.5 ± 3.1 years). HAE exposure was tracked across 48 matches and 113 training sessions. HAEs were recorded using boil-and-bite instrumented mouthguards (iMGs). The study assessed the incidence and prevalence of HAEs by ages, playing positions, and session types (match or training). RESULTS For all age grades, weekly match HAE incidence was highest at lower magnitudes (10-29 g). Proportionally, younger players experienced higher weekly incidence rates during training. The U19 players had 1.36 times the risk of high-magnitude (> 30 g) events during matches, while the U13 players had the lowest risk compared with all other grades. Tackles and rucks accounted for the largest HAE burden during matches, with forwards having 1.67 times the risk of > 30 g HAEs in rucks compared with backs. CONCLUSIONS This study provides novel data on head accelerations during rugby matches and training. The findings have important implications for identifying populations at greatest risk of high cumulative and acute head acceleration. Findings may guide training load management and teaching of skill execution in high-risk activities, particularly for younger players who may be exposed to proportionally more contact during training and for older players during matches.
Collapse
Affiliation(s)
- Melanie D Bussey
- School of Physical Education, Sports and Exercise Sciences, University of Otago, Dunedin, New Zealand.
| | | | - Janelle Romanchuk
- School of Physical Education, Sports and Exercise Sciences, University of Otago, Dunedin, New Zealand
- New Zealand Rugby, Wellington, New Zealand
| | - Bridie Nanai
- School of Physical Education, Sports and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Peter Davidson
- School of Physical Education, Sports and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Ross Tucker
- Institute of Sport and Exercise Medicine, University of Stellenbosch, Stellenbosch, South Africa
- World Rugby, Dublin, Ireland
| | - Eanna Falvey
- World Rugby, Dublin, Ireland
- School of Medicine & Health, University College Cork, Cork, Ireland
| |
Collapse
|
15
|
Kenny R, Elez M, Clansey A, Virji-Babul N, Wu LC. Individualized monitoring of longitudinal heading exposure in soccer. Sci Rep 2024; 14:1796. [PMID: 38245604 PMCID: PMC10799858 DOI: 10.1038/s41598-024-52163-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 01/15/2024] [Indexed: 01/22/2024] Open
Abstract
There is growing concern that repetitive soccer headers may have negative long-term consequences on brain health. However, inconsistent and low-quality heading exposure measurements limit past investigations of this effect. Here we conducted a comprehensive heading exposure analysis across all players on a university women's soccer team for over two calendar years (36 unique athletes), quantifying both game and practice exposure during all in-season and off-season periods, with over ten thousand video-confirmed headers. Despite an average of approximately 2 headers per day, players' daily exposures ranged from 0 to 45 headers, accumulating to highly variable total exposure of 2-223 headers over each in-season/off-season period. Overall, practices and off-season periods accounted for 70% and 45% of headers, respectively. Impact sensor data showed that heading kinematics fell within a tight distribution, but sensors could not capture full heading exposure due to factors such as compliance. With first-of-its-kind complete heading exposure data, we recommend exposure assessments be made on an individual level and include practice/off-season collection in addition to games and competitive seasons. Commonly used group statistics do not capture highly variable exposures, and individualized complete heading exposure tracking needs to be incorporated in future study designs for confirming the potential brain injury risk associated with soccer heading.
Collapse
Affiliation(s)
- Rebecca Kenny
- Department of Mechanical Engineering, University of British Columbia, 6250 Applied Science Ln Room 2054, Vancouver, BC, V6T 1Z4, Canada
| | - Marko Elez
- Department of Integrated Sciences, University of British Columbia, 6356 Agricultural Rd Room 464, Vancouver, BC, V6T 1Z2, Canada
| | - Adam Clansey
- Department of Mechanical Engineering, University of British Columbia, 6250 Applied Science Ln Room 2054, Vancouver, BC, V6T 1Z4, Canada
| | - Naznin Virji-Babul
- Department of Physical Therapy, The University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Lyndia C Wu
- Department of Mechanical Engineering, University of British Columbia, 6250 Applied Science Ln Room 2054, Vancouver, BC, V6T 1Z4, Canada.
| |
Collapse
|
16
|
Field B, Waddington G, McKune A, Goecke R, Gardner AJ. Validation of an instrumented mouthguard in rugby union-a pilot study comparing impact sensor technology to video analysis. Front Sports Act Living 2023; 5:1230202. [PMID: 38053522 PMCID: PMC10694248 DOI: 10.3389/fspor.2023.1230202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 10/25/2023] [Indexed: 12/07/2023] Open
Abstract
Background To better understand the biomechanical profile of direct head impacts and the game scenarios in which they occur in Rugby Union, there is a need for an on-field validation of a new instrumented mouthguard (IMG) against the reference standard. This study considers the potential of a combined biomechanical (IMG) and video analysis approach to direct head impact recognition, both of which in isolation have limitations. The aim of this study is to assess the relationship between an instrumented mouthguard and video analysis in detection of direct head impacts in rugby union. Design Pilot Study - Observational Cohort design. Methods The instrumented mouthguard was worn by ten (3 backs, 7 forwards) professional Rugby Union players during the 2020-21 Gallagher Premiership (UK) season. Game-day video was synchronized with timestamped head acceleration events captured from the instrumented mouthguard. Direct Head Impacts were recorded in a 2 × 2 contingency table to determine sensitivity. Impact characteristics were also collected for all verified head impacts to further the understanding of head biomechanics during the game. Results There were 2018 contact events that were reviewed using video analysis. Of those 655 were categorized as direct head impacts which also correlated with a head acceleration event captured by the IMG. Sensitivity analysis showed an overall sensitivity of 93.6% and a positive predictive value (PPV of 92.4%). When false positives were excluded due to ball out of play, mouthguard removal or handling after a scoring situation or stoppage, PPV was improved (98.3%). Most verified head impacts occurred in and around the ruck contest (31.2%) followed by impacts to the primary tackler (28.4%). Conclusion This pilot validation study demonstrates that this IMG provides a highly accurate measurement device that could be used to complement video verification in the recognition of on-field direct head impacts. The frequency and magnitude of direct head impacts derived from specific game scenarios has been described and allows for greater recognition of high-risk situations. Further studies with larger sample sizes and in different populations of Rugby Union players are required to develop our understanding of head impact and enable strategies for injury mitigation.
Collapse
Affiliation(s)
- Byron Field
- Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Gordon Waddington
- Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Andrew McKune
- Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, ACT, Australia
- Discipline of Biokinetics, Exercise, and Leisure Sciences, School of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Roland Goecke
- Research Institute for Sport and Exercise, Faculty of Science and Technology, University of Canberra, Canberra, ACT, Australia
| | - Andrew J. Gardner
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| |
Collapse
|
17
|
Bussey MD, Davidson P, Salmon D, Romanchuk J, Tong D, Sole G. Influence of the frame of reference on head acceleration events recorded by instrumented mouthguards in community rugby players. BMJ Open Sport Exerc Med 2022; 8:e001365. [PMID: 36249488 PMCID: PMC9557771 DOI: 10.1136/bmjsem-2022-001365] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2022] [Indexed: 11/04/2022] Open
Abstract
Objectives To highlight the need for standardisation in the communication of head impact telemetry from instrumented mouthguards (iMG). The purpose of this study is to examine how the frame of reference for reporting head acceleration events (HAE) may affect the interpretation of head impacts recorded from iMGs in community rugby players. Methods An analytical investigation of 825 video verified HAEs recorded from male community players during 5 rugby match exposures. HAEs were captured with an iMG, known to be reliable and valid for this purpose. The linear and angular head acceleration at the centre of mass (head_CG) was calculated from filtered iMG accelerometer and gyroscope data, and the location of impact was estimated. The iMG and head_CG data were examined for systematic bias, geometric differences and the degree of concordance. Finally, mixed model analyses were fitted to assess the differences in peak resultant acceleration (PLA) by impact locations and directions of head motion while controlling for intra-athlete correlations. Results The degree of concordance between the iMG versus head_CG measures varied by impact location. The mixed model confirmed differences in the PLA by location (F(8,819) = 16.55, p<0.001) and by direction of head motion (F(5,417) = 7.78, p<0.001). Conclusion The head acceleration reported at the iMG is not proportional to measurements that have been transformed to the head_CG. Depending on the impact location and direction of head motion, the acceleration measured at the iMG may overestimate, underestimate or miss entirely the PLA with respect to the head_CG. We recommend standardising the reporting of iMG data within the head_CG frame of reference.
Collapse
Affiliation(s)
- Melanie Dawn Bussey
- School of Physical Education Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Peter Davidson
- School of Physical Education Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | | | - Janelle Romanchuk
- School of Physical Education Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand,New Zealand Rugby, Dunedin, New Zealand
| | - Darryl Tong
- Department of Oral Diagnostic and Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Gisela Sole
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| |
Collapse
|
18
|
Consensus Head Acceleration Measurement Practices (CHAMP): Laboratory Validation of Wearable Head Kinematic Devices. Ann Biomed Eng 2022; 50:1356-1371. [PMID: 36104642 PMCID: PMC9652295 DOI: 10.1007/s10439-022-03066-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/25/2022] [Indexed: 12/15/2022]
Abstract
Wearable devices are increasingly used to measure real-world head impacts and study brain injury mechanisms. These devices must undergo validation testing to ensure they provide reliable and accurate information for head impact sensing, and controlled laboratory testing should be the first step of validation. Past validation studies have applied varying methodologies, and some devices have been deployed for on-field use without validation. This paper presents best practices recommendations for validating wearable head kinematic devices in the laboratory, with the goal of standardizing validation test methods and data reporting. Key considerations, recommended approaches, and specific considerations were developed for four main aspects of laboratory validation, including surrogate selection, test conditions, data collection, and data analysis. Recommendations were generated by a group with expertise in head kinematic sensing and laboratory validation methods and reviewed by a larger group to achieve consensus on best practices. We recommend that these best practices are followed by manufacturers, users, and reviewers to conduct and/or review laboratory validation of wearable devices, which is a minimum initial step prior to on-field validation and deployment. We anticipate that the best practices recommendations will lead to more rigorous validation of wearable head kinematic devices and higher accuracy in head impact data, which can subsequently advance brain injury research and management.
Collapse
|
19
|
Kuo C, Patton D, Rooks T, Tierney G, McIntosh A, Lynall R, Esquivel A, Daniel R, Kaminski T, Mihalik J, Dau N, Urban J. On-Field Deployment and Validation for Wearable Devices. Ann Biomed Eng 2022; 50:1372-1388. [PMID: 35960418 DOI: 10.1007/s10439-022-03001-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 06/24/2022] [Indexed: 11/01/2022]
Abstract
Wearable sensors are an important tool in the study of head acceleration events and head impact injuries in sporting and military activities. Recent advances in sensor technology have improved our understanding of head kinematics during on-field activities; however, proper utilization and interpretation of data from wearable devices requires careful implementation of best practices. The objective of this paper is to summarize minimum requirements and best practices for on-field deployment of wearable devices for the measurement of head acceleration events in vivo to ensure data evaluated are representative of real events and limitations are accurately defined. Best practices covered in this document include the definition of a verified head acceleration event, data windowing, video verification, advanced post-processing techniques, and on-field logistics, as determined through review of the literature and expert opinion. Careful use of best practices, with accurate acknowledgement of limitations, will allow research teams to ensure data evaluated is representative of real events, will improve the robustness of head acceleration event exposure studies, and generally improve the quality and validity of research into head impact injuries.
Collapse
Affiliation(s)
- Calvin Kuo
- The University of British Columbia, Vancouver, Canada
| | - Declan Patton
- Children's Hospital of Philadelphia, Philadelphia, USA
| | - Tyler Rooks
- United States Army Aeromedical Research Laboratory, Fort Rucker, USA
| | | | - Andrew McIntosh
- McIntosh Consultancy and Research, Sydney, Australia.,Monash University Accident Research Centre Monash University, Melbourne, Australia.,School of Engineering Edith Cowan University, Perth, Australia
| | | | | | - Ray Daniel
- United States Army Aeromedical Research Laboratory, Fort Rucker, USA
| | | | - Jason Mihalik
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Nate Dau
- Biocore, LLC, Charlottesville, USA
| | - Jillian Urban
- Wake Forest University School of Medicine, 575 Patterson Ave, Suite 530, Winston-Salem, NC, 27101, USA.
| |
Collapse
|
20
|
Rezaei A, Wu LC. Automated soccer head impact exposure tracking using video and deep learning. Sci Rep 2022; 12:9282. [PMID: 35661123 PMCID: PMC9166706 DOI: 10.1038/s41598-022-13220-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/18/2022] [Indexed: 12/05/2022] Open
Abstract
Head impacts are highly prevalent in sports and there is a pressing need to investigate the potential link between head impact exposure and brain injury risk. Wearable impact sensors and manual video analysis have been utilized to collect impact exposure data. However, wearable sensors suffer from high deployment cost and limited accuracy, while manual video analysis is a long and resource-intensive task. Here we develop and apply DeepImpact, a computer vision algorithm to automatically detect soccer headers using soccer game videos. Our data-driven pipeline uses two deep learning networks including an object detection algorithm and temporal shift module to extract visual and temporal features of video segments and classify the segments as header or nonheader events. The networks were trained and validated using a large-scale professional-level soccer video dataset, with labeled ground truth header events. The algorithm achieved 95.3% sensitivity and 96.0% precision in cross-validation, and 92.9% sensitivity and 21.1% precision in an independent test that included videos of five professional soccer games. Video segments identified as headers in the test data set correspond to 3.5 min of total film time, which can be reviewed through additional manual video verification to eliminate false positives. DeepImpact streamlines the process of manual video analysis and can help to collect large-scale soccer head impact exposure datasets for brain injury research. The fully video-based solution is a low-cost alternative for head impact exposure monitoring and may also be expanded to other sports in future work.
Collapse
Affiliation(s)
- Ahmad Rezaei
- Department of Mechanical Engineering, University of British Columbia, Vancouver, V6T 1Z4, Canada
| | - Lyndia C Wu
- Department of Mechanical Engineering, University of British Columbia, Vancouver, V6T 1Z4, Canada.
| |
Collapse
|
21
|
Wu S, Zhao W, Ji S. Real-time dynamic simulation for highly accurate spatiotemporal brain deformation from impact. COMPUTER METHODS IN APPLIED MECHANICS AND ENGINEERING 2022; 394:114913. [PMID: 35572209 PMCID: PMC9097909 DOI: 10.1016/j.cma.2022.114913] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Real-time dynamic simulation remains a significant challenge for spatiotemporal data of high dimension and resolution. In this study, we establish a transformer neural network (TNN) originally developed for natural language processing and a separate convolutional neural network (CNN) to estimate five-dimensional (5D) spatiotemporal brain-skull relative displacement resulting from impact (isotropic spatial resolution of 4 mm with temporal resolution of 1 ms). Sequential training is applied to train (N = 5184 samples) the two neural networks for estimating the complete 5D displacement across a temporal duration of 60 ms. We find that TNN slightly but consistently outperforms CNN in accuracy for both displacement and the resulting voxel-wise four-dimensional (4D) maximum principal strain (e.g., root mean squared error (RMSE) of ~1.0% vs. ~1.6%, with coefficient of determination, R 2 >0.99 vs. >0.98, respectively, and normalized RMSE (NRMSE) at peak displacement of 2%-3%, based on an independent testing dataset; N = 314). Their accuracies are similar for a range of real-world impacts drawn from various published sources (dummy, helmet, football, soccer, and car crash; average RMSE/NRMSE of ~0.3 mm/~4%-5% and average R 2 of ~0.98 at peak displacement). Sequential training is effective for allowing instantaneous estimation of 5D displacement with high accuracy, although TNN poses a heavier computational burden in training. This work enables efficient characterization of the intrinsically dynamic brain strain in impact critical for downstream multiscale axonal injury model simulation. This is also the first application of TNN in biomechanics, which offers important insight into how real-time dynamic simulations can be achieved across diverse engineering fields.
Collapse
Affiliation(s)
- Shaoju Wu
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, United States of America
| | - Wei Zhao
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, United States of America
| | - Songbai Ji
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, United States of America
- Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, MA, United States of America
| |
Collapse
|
22
|
Head Impact Exposure and Biomechanics in University Varsity Women's Soccer. Ann Biomed Eng 2022; 50:1461-1472. [PMID: 35041117 PMCID: PMC8765100 DOI: 10.1007/s10439-022-02914-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/01/2022] [Indexed: 11/17/2022]
Abstract
Soccer is a unique sport where players purposefully and voluntarily use their unprotected heads to manipulate the direction of the ball. There are limited soccer head impact exposure data to further study brain injury risks. The objective of the current study was to combine validated mouthpiece sensors with comprehensive video analysis methods to characterize head impact exposure and biomechanics in university varsity women’s soccer. Thirteen female soccer athletes were instrumented with mouthpiece sensors to record on-field head impacts during practices, scrimmages, and games. Multi-angle video was obtained and reviewed for all on-field activity to verify mouthpiece impacts and identify contact scenarios. We recorded 1307 video-identified intentional heading impacts and 1011 video-verified sensor impacts. On average, athletes experienced 1.83 impacts per athlete-exposure, with higher exposure in practices than games/scrimmages. Median and 95th percentile peak linear and peak angular accelerations were 10.0, 22.2 g, and 765, 2296 rad/s2, respectively. Long kicks, top of the head impacts and jumping headers resulted in the highest impact kinematics. Our results demonstrate the importance of investigating and monitoring head impact exposure during soccer practices, as well as the opportunity to limit high-kinematics impact exposure through heading technique training and reducing certain contact scenarios.
Collapse
|
23
|
Tooby J, Weaving D, Al-Dawoud M, Tierney G. Quantification of Head Acceleration Events in Rugby League: An Instrumented Mouthguard and Video Analysis Pilot Study. SENSORS (BASEL, SWITZERLAND) 2022; 22:584. [PMID: 35062545 PMCID: PMC8781372 DOI: 10.3390/s22020584] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 05/31/2023]
Abstract
Instrumented mouthguards (iMG) were used to collect head acceleration events (HAE) in men's professional rugby league matches. Peak linear acceleration (PLA), peak angular acceleration (PAA) and peak change in angular velocity (ΔPAV) were collected using custom-fit iMG set with a 5 g single iMG-axis recording threshold. iMG were fitted to ten male Super League players for thirty-one player matches. Video analysis was conducted on HAE to identify the contact event; impacted player; tackle stage and head loading type. A total of 1622 video-verified HAE were recorded. Approximately three-quarters of HAE (75.7%) occurred below 10 g. Most (98.2%) HAE occurred during tackles (59.3% to tackler; 40.7% to ball carrier) and the initial collision stage of the tackle (43.9%). The initial collision stage resulted in significantly greater PAA and ΔPAV than secondary contact and play the ball tackle stages (p < 0.001). Indirect HAE accounted for 29.8% of HAE and resulted in significantly greater ΔPAV (p < 0.001) than direct HAE, but significantly lower PLA (p < 0.001). Almost all HAE were sustained in the tackle, with the majority occurring during the initial collision stage, making it an area of focus for the development of player protection strategies for both ball carriers and tacklers. League-wide and community-level implementation of iMG could enable a greater understanding of head acceleration exposure between playing positions, cohorts, and levels of play.
Collapse
Affiliation(s)
- James Tooby
- School of Biomedical Sciences, University of Leeds, Leeds LS2 9JT, UK
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds LS1 3HE, UK; (D.W.); (G.T.)
| | - Dan Weaving
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds LS1 3HE, UK; (D.W.); (G.T.)
- Leeds Rhinos Rugby League Club, Leeds LS5 3BW, UK;
| | | | - Gregory Tierney
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds LS1 3HE, UK; (D.W.); (G.T.)
- Sport and Exercise Sciences Research Institute, School of Sport, Faculty of Life and Health Sciences, Ulster University, Belfast BT15 1ED, UK
| |
Collapse
|