Evaluation of head impact exposure measured from youth football game plays

View More View Less
  • 1 Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston-Salem;
  • | 2 Departments of Biomedical Engineering,
  • | 3 Radiology (Neuroradiology),
  • | 5 Biostatistical Sciences, and
  • | 7 Neurosurgery, and
  • | 8 Clinical and Translational Sciences Institute,
  • | 4 Wake Forest School of Medicine, Winston-Salem, North Carolina; and
  • | 6 Department of Radiology, University of Texas Southwestern, Dallas, Texas
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

OBJECTIVE

There is a growing body of literature informing efforts to improve the safety of football; however, research relating on-field activity to head impacts in youth football is limited. Therefore, the objective of this study was to compare head impact exposure (HIE) measured in game plays among 3 youth football teams.

METHODS

Head impact and video data were collected from athletes (ages 10–13 years) participating on 3 youth football teams. Video analysis was performed to verify head impacts and assign each to a specific play type. Each play was categorized as a down, punt, kickoff, field goal, or false start. Kickoffs and punts were classified as special teams. Downs were classified as running, passing, or other. HIE was quantified by play type in terms of mean, median, and 95th percentile linear and rotational acceleration. Mixed-effects models were used to assess differences in acceleration among play types. Contact occurring on special teams plays was evaluated using a standardized video abstraction form.

RESULTS

A total of 3003 head impacts over 27.5 games were analyzed and paired with detailed video coding of plays. Most head impacts were attributed to running (79.6%), followed by passing (14.0%), and special teams (6.4%) plays. The 95th percentile linear acceleration measured during each play type was 52.6g, 50.7g, and 65.5g, respectively. Special teams had significantly greater mean linear acceleration than running and passing plays (both p = 0.03). The most common kick result on special teams was a deep kick, of which 85% were attempted to be returned. No special teams plays resulted in a touchback, and one resulted in a fair catch. One-third of all special teams plays and 92% of all nonreturned kicks resulted in athletes diving toward the ball.

CONCLUSIONS

The results demonstrate a trend toward higher head impact magnitudes on special teams than for running and passing plays, but a greater number of impacts were measured during running plays. Deep kicks were most common on special teams, and many returned and nonreturned kicks resulted in athletes diving toward the ball. These results support policy changes to youth special teams plays, including modifying the yard line the ball is kicked from and coaching proper return technique. Further investigation into biomechanical exposure measured during game impact scenarios is needed to inform policy relevant to the youth level.

ABBREVIATIONS

AYF = American Youth Football; HIE = head impact exposure; HITS = Head Impact Telemetry System.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Correspondence Jillian E. Urban: Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston-Salem, NC. jurban@wakehealth.edu.

INCLUDE WHEN CITING Published online May 10, 2019; DOI: 10.3171/2019.2.PEDS18558.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

  • 1

    Alosco ML, Tripodis Y, Jarnagin J, Baugh CM, Martin B, Chaisson CE, et al. : Repetitive head impact exposure and later-life plasma total tau in former National Football League players. Alzheimers Dement (Amst) 7:3340, 2016

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Bahrami N, Sharma D, Rosenthal S, Davenport EM, Urban JE, Wagner B, et al. : Subconcussive head impact exposure and white matter tract changes over a single season of youth football. Radiology 281:919926, 2016

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3

    Barnett LM, Lai SK, Veldman SLC, Hardy LL, Cliff DP, Morgan PJ, et al. : Correlates of gross motor competence in children and adolescents: a systematic review and meta-analysis. Sports Med 46:16631688, 2016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Beckwith JG, Greenwald RM, Chu JJ: Measuring head kinematics in football: correlation between the head impact telemetry system and Hybrid III headform. Ann Biomed Eng 40:237248, 2012

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Beckwith JG, Greenwald RM, Chu JJ, Crisco JJ, Rowson S, Duma SM, et al. : Head impact exposure sustained by football players on days of diagnosed concussion. Med Sci Sports Exerc 45:737746, 2013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Broglio SP, Eckner JT, Martini D, Sosnoff JJ, Kutcher JS, Randolph C: Cumulative head impact burden in high school football. J Neurotrauma 28:20692078, 2011

  • 7

    Campolettano ET, Gellner RA, Rowson S: High-magnitude head impact exposure in youth football. J Neurosurg Pediatr 20:604612, 2017

  • 8

    Campolettano ET, Rowson S, Duma SM: Drill-specific head impact exposure in youth football practice. J Neurosurg Pediatr 18:536541, 2016

  • 9

    Chun IY, Mao X, Breedlove EL, Leverenz LJ, Nauman EA, Talavage TM: DTI detection of longitudinal WM abnormalities due to accumulated head impacts. Dev Neuropsychol 40:9297, 2015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Cobb BR, Urban JE, Davenport EM, Rowson S, Duma SM, Maldjian JA, et al. : Head impact exposure in youth football: elementary school ages 9–12 years and the effect of practice structure. Ann Biomed Eng 41:24632473, 2013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Comstock R, Currie D, Pierpoint L: National High School Sports-Related Injury Surveillance Study. Aurora, CO: PIPER Program, 2015

  • 12

    Crisco JJ, Chu JJ, Greenwald RM: An algorithm for estimating acceleration magnitude and impact location using multiple nonorthogonal single-axis accelerometers. J Biomech Eng 126:849854, 2004

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Crisco JJ, Wilcox BJ, Machan JT, McAllister TW, Duhaime AC, Duma SM, et al. : Magnitude of head impact exposures in individual collegiate football players. J Appl Biomech 28:174183, 2012

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Davenport EM, Apkarian K, Whitlow CT, Urban JE, Jensen JH, Szuch E, et al. : Abnormalities in diffusional kurtosis metrics related to head impact exposure in a season of high school varsity football. J Neurotrauma 33:21332146, 2016

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15

    Davenport EM, Whitlow CT, Urban JE, Espeland MA, Jung Y, Rosenbaum DA, et al. : Abnormal white matter integrity related to head impact exposure in a season of high school varsity football. J Neurotrauma 31:16171624, 2014

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16

    Dompier TP, Powell JW, Barron MJ, Moore MT: Time-loss and non-time-loss injuries in youth football players. J Athl Train 42:395402, 2007

  • 17

    Guskiewicz KM, Weaver NL, Padua DA, Garrett WE Jr: Epidemiology of concussion in collegiate and high school football players. Am J Sports Med 28:643650, 2000

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Hendricks S, den Hollander S, Tam N, Brown J, Lambert M: The relationships between rugby players’ tackle training attitudes and behaviour and their match tackle attitudes and behaviour. BMJ Open Sport Exerc Med 1:e000046, 2015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Hendricks S, O’Connor S, Lambert M, Brown JC, Burger N, Mc Fie S, et al. : Video analysis of concussion injury mechanism in under-18 rugby. BMJ Open Sport Exerc Med 2:e000053, 2016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Houck Z, Asken B, Bauer R, Pothast J, Michaudet C, Clugston J: Epidemiology of sport-related concussion in an NCAA Division I Football Bowl Subdivision sample. Am J Sports Med 44:22692275, 2016

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21

    Kelley ME, Espeland MA, Flood WC, Powers AK, Whitlow CT, Maldjian JA, et al. : Comparison of head impact exposure in practice drills among multiple youth football teams. J Neurosurg Pediatr 23:381389, 2019

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22

    Kelley ME, Kane JM, Espeland MA, Miller LE, Powers AK, Stitzel JD, et al. : Head impact exposure measured in a single youth football team during practice drills. J Neurosurg Pediatr 20:489497, 2017

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23

    Kelley ME, Urban JE, Miller LE, Jones DA, Espeland MA, Davenport EM, et al. : Head impact exposure in youth football: comparing age- and weight-based levels of play. J Neurotrauma 34:19391947, 2017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Kerr ZY, Dalton SL, Roos KG, Djoko A, Phelps J, Dompier TP: Comparison of Indiana high school football injury rates by inclusion of the USA Football “Heads Up Football” player safety coach. Orthop J Sports Med 4:2325967116648441, 2016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Kerr ZY, Simon JE, Grooms DR, Roos KG, Cohen RP, Dompier TP: Epidemiology of football injuries in the National Collegiate Athletic Association, 2004-2005 to 2008-2009. Orthop J Sports Med 4:2325967116664500, 2016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Lynall RC, Campbell KR, Wasserman EB, Dompier TP, Kerr ZY: Concussion mechanisms and activities in youth, high school, and college football. J Neurotrauma 34:26842690, 2017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Martini D, Eckner J, Kutcher J, Broglio SP: Subconcussive head impact biomechanics: comparing differing offensive schemes. Med Sci Sports Exerc 45:755761, 2013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Montenigro PH, Alosco ML, Martin BM, Daneshvar DH, Mez J, Chaisson CE, et al. : Cumulative head impact exposure predicts later-life depression, apathy, executive dysfunction, and cognitive impairment in former high school and college football players. J Neurotrauma 34:328340, 2017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    North JS, Hope E, Williams AM: The relative importance of different perceptual-cognitive skills during anticipation. Hum Mov Sci 49:170177, 2016

  • 30

    Ocwieja KE, Mihalik JP, Marshall SW, Schmidt JD, Trulock SC, Guskiewicz KM: The effect of play type and collision closing distance on head impact biomechanics. Ann Biomed Eng 40:9096, 2012

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Pellman EJ, Powell JW, Viano DC, Casson IR, Tucker AM, Feuer H, et al. : Concussion in professional football: epidemiological features of game injuries and review of the literature—part 3. Neurosurgery 54:8196, 2004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    Ruestow PS, Duke TJ, Finley BL, Pierce JS: Effects of the NFL’s Amendments to the Free Kick rule on injuries during the 2010 and 2011 seasons. J Occup Environ Hyg 12:875882, 2015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33

    Schmidt JD, Guskiewicz KM, Mihalik JP, Blackburn JT, Siegmund GP, Marshall SW: Head impact magnitude in American high school football. Pediatrics 138:e20154231, 2016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34

    Schmidt JD, Pierce AF, Guskiewicz KM, Register-Mihalik JK, Pamukoff DN, Mihalik JP: Safe-play knowledge, aggression, and head-impact biomechanics in adolescent ice hockey players. J Athl Train 51:366372, 2016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35

    Sports Marketing Surveys USA: 2013 Sports, Fitness and Leisure Activities Topline Participation Report. Silver Spring, MD: Sports & Fitness Industry Association, 2013

    • Search Google Scholar
    • Export Citation
  • 36

    Stamm JM, Bourlas AP, Baugh CM, Fritts NG, Daneshvar DH, Martin BM, et al. : Age of first exposure to football and later-life cognitive impairment in former NFL players. Neurology 84:11141120, 2015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37

    Tagge CA, Fisher AM, Minaeva OV, Gaudreau-Balderrama A, Moncaster JA, Zhang XL, et al. : Concussion, microvascular injury, and early tauopathy in young athletes after impact head injury and an impact concussion mouse model. Brain 141:422458, 2018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38

    Tierney GJ, Denvir K, Farrell G, Simms CK: The effect of tackler technique on head injury assessment risk in elite rugby union. Med Sci Sports Exerc 50:603608, 2018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39

    Urban JE, Davenport EM, Golman AJ, Maldjian JA, Whitlow CT, Powers AK, et al. : Head impact exposure in youth football: high school ages 14 to 18 years and cumulative impact analysis. Ann Biomed Eng 41:24742487, 2013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40

    Urban JE, Kelley ME, Espeland MA, Davenport EM, Whitlow CT, Powers AK, et al. : In-season variations in head impact exposure among youth football players. J Neurotrauma 36:275281, 2019

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41

    Vänttinen T, Blomqvist M, Luhtanen P, Häkkinen K: Effects of age and soccer expertise on general tests of perceptual and motor performance among adolescent soccer players. Percept Mot Skills 110:675692, 2010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42

    Viano DC, Casson IR, Pellman EJ: Concussion in professional football: biomechanics of the struck player—part 14. Neurosurgery 61:313328, 2007

  • 43

    Williams AM, Ericsson KA: Perceptual-cognitive expertise in sport: some considerations when applying the expert performance approach. Hum Mov Sci 24:283307, 2005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 1013 322 47
Full Text Views 177 52 5
PDF Downloads 118 28 5
EPUB Downloads 0 0 0