Head impacts sustained by male collegiate water polo athletes

Cecchi, Nicholas J.; Monroe, Derek C.; Fote, Gianna M.; Small, Steven L.; Hicks, James W.

doi:10.1371/journal.pone.0216369

Cited by 26 publications

(26 citation statements)

References 23 publications

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“…Recent survey data reveal that 36% of USA Water Polo members report sustaining at least one concussion during their playing tenure (6), a lifetime incidence that is comparable to that observed in soccer (7). However, the respondents also reported sustaining an average of two asymptomatic head impacts during a typical practice or game, a rate of exposure consistent with prospective data from in vivo monitoring over three competitive seasons (8). In some contact sports (e.g., American football, soccer, hockey) the accumulation of these impacts is believed to contribute to clinically significant neurological dysfunction years after exposure has ceased (9,10).…”

Section: Introductionsupporting

confidence: 55%

A Dose Relationship Between Brain Functional Connectivity and Cumulative Head Impact Exposure in Collegiate Water Polo Players

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A growing body of evidence suggests that chronic, sport-related head impact exposure can impair brain functional integration and brain structure and function. Evidence of a robust inverse relationship between the frequency and magnitude of repeated head impacts and disturbed brain network function is needed to strengthen an argument for causality. In pursuing such a relationship, we used cap-worn inertial sensors to measure the frequency and magnitude of head impacts sustained by eighteen intercollegiate water polo athletes monitored over a single season of play. Participants were evaluated before and after the season using computerized cognitive tests of inhibitory control and resting electroencephalography. Greater head impact exposure was associated with increased phase synchrony [r (16) > 0.626, p < 0.03 corrected], global efficiency [r (16) > 0.601, p < 0.04 corrected], and mean clustering coefficient [r (16) > 0.625, p < 0.03 corrected] in the functional networks formed by slow-wave (delta, theta) oscillations. Head impact exposure was not associated with changes in performance on the inhibitory control tasks. However, those with the greatest impact exposure showed an association between changes in resting-state connectivity and a dissociation between performance on the tasks after the season [r (16) = 0.481, p = 0.043] that could also be attributed to increased slow-wave synchrony [F (4, 135) = 113.546, p < 0.001]. Collectively, our results suggest that athletes sustaining the greatest head impact exposure exhibited changes in whole-brain functional connectivity that were associated with altered information processing and inhibitory control.

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Section: Introductionsupporting

confidence: 55%

A Dose Relationship Between Brain Functional Connectivity and Cumulative Head Impact Exposure in Collegiate Water Polo Players

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“…Water polo is a contact sport that has been shown to present a risk of head impact exposure 17 and concussion, 18,19 with athletes reporting impacts from both the ball and other players. 18 A study of male collegiate water polo players utilizing head impact sensors found that a single team sustained an average of 18.4 head impacts per game.…”

Section: Introductionmentioning

confidence: 99%

“…18 A study of male collegiate water polo players utilizing head impact sensors found that a single team sustained an average of 18.4 head impacts per game. 17 An evaluation of a head impact sensor that is waterproof and compatible with a water polo cap has yet to be published. This study aimed to compare the performance of a waterproof head impact sensor in a headband attachment (for use in non-helmeted land sports) to a mode of attachment suitable for water polo.…”

Section: Introductionmentioning

confidence: 99%

Laboratory evaluation of a wearable head impact sensor for use in water polo and land sports

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et al. 2020

Proceedings of the Institution of Mechanical Engineers, Part P:

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The SIM-G is a waterproof head impact sensor that has been previously evaluated for use in a headband, but not yet in a mode of attachment suitable for water polo. For this study, a CADEX linear impactor was used to impact a Hybrid III headform while wearing either a headband or modified water polo cap, each housing a SIM-G. In both headgears, the SIM-G consistently underestimated peak linear acceleration ( p < .001) and peak rotational velocity ( p < .001), and consistently overestimated peak rotational acceleration ( p < .001) relative to the headform. These inaccuracies are consistent with previous evaluations of the SIM-G, but notably, impact magnitudes did not differ between the different modes of attachment ( p > .198). The proprietary SIM-G algorithm used for classifying false/true positives performed poorly at the back and crown impact locations in both the water polo cap and headband, but accuracy of this algorithm did not significantly differ between the water polo cap and headband (60.5% vs 49.4%, respectively). The SIM-G’s ability to correctly predict impact location also performed poorly in both headgears when impacts occurred at the crown location, but was significantly better overall in the water polo cap than the headband (80.2% vs 55.6%, respectively). These results demonstrate that the SIM-G exhibits shared limitations and a similar performance overall when placed in either a headband or water polo cap. Potential explanations for the inaccuracies of the SIM-G, as well as methods of optimizing its application in sports, are discussed.

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“…Using multiple, single observers to record head-to-ball impacts, without recording video for offline corroboration, is a limitation of the current study and prevented us from discerning impact magnitude or impact location. Our laboratory ( Cecchi et al, 2019 ) and others ( Campbell et al, 2020 ; Cortes et al, 2017 ) have demonstrated the value of using independent review of video recordings to validate head impact data, even when field-based collection is performed using wearable impact sensors. We can assume that our measure contains some degree of human error, but these inaccuracies are not likely to be systematic.…”

Section: Discussionmentioning

confidence: 98%

One season of head-to-ball impact exposure alters functional connectivity in a central autonomic network

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Repetitive head impacts represent a risk factor for neurological impairment in team-sport athletes. In the absence of symptoms, a physiological basis for acute injury has not been elucidated. A basic brain function that is disrupted after mild traumatic brain injury is the regulation of homeostasis, instantiated by activity across a specific set of brain regions that comprise a central autonomic network. We sought to relate head-to-ball impact exposure to changes in functional connectivity in a core set of central autonomic regions and then to determine the relation between changes in brain and changes in behavior, specifically cognitive control. Thirteen collegiate men’s soccer players and eleven control athletes (golf, cross-country) underwent resting-state fMRI and behavioral testing before and after the season, and a core group of cortical, subcortical, and brainstem regions was selected to represent the central autonomic network. Head-to-ball impacts were recorded for each soccer player. Cognitive control was assessed using a Dot Probe Expectancy task. We observed that head-to-ball impact exposure was associated with diffuse increases in functional connectivity across a core CAN subnetwork. Increased functional connectivity between the left insula and left medial orbitofrontal cortex was associated with diminished proactive cognitive control after the season in those sustaining the greatest number of head-to-ball impacts. These findings encourage measures of autonomic physiology to monitor brain health in contact and collision sport athletes.

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Head impacts sustained by male collegiate water polo athletes

Cited by 26 publications

References 23 publications

A Dose Relationship Between Brain Functional Connectivity and Cumulative Head Impact Exposure in Collegiate Water Polo Players

A Dose Relationship Between Brain Functional Connectivity and Cumulative Head Impact Exposure in Collegiate Water Polo Players

Laboratory evaluation of a wearable head impact sensor for use in water polo and land sports

One season of head-to-ball impact exposure alters functional connectivity in a central autonomic network

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