Sport- and Gender-Based Differences in Head Impact Exposure and Mechanism in High School Sports

Abstract

Background: Repeated head impacts sustained by athletes have been linked to short-term neurophysiologic deficits; thus, there is growing concern about the number of head impacts sustained in sports. Accurate head impact exposure data obtained via head impact sensors may help identify appropriate strategies across sports and between genders to mitigate repetitive head impacts. Purpose: To quantify sport- and gender-based differences in head impact rate and mechanism for adolescents. Study Design: Cohort study; Level of evidence, 2. Methods: High school female and male varsity soccer, basketball, lacrosse, and field hockey (female only) teams were instrumented with headband-mounted impact sensors during games over 2 seasons of soccer and 1 season of basketball, lacrosse, and field hockey. Video review was used to remove false-positive sensor-recorded events, and the head impact rate per athlete-exposure (AE) was calculated. Impact mechanism was categorized as equipment to head, fall, player to head, or head to ball (soccer only). Results: Male players had significantly higher head impact rates as compared with female players in soccer (3.08 vs 1.41 impacts/AE; rate ratio, 2.2 [95% CI, 1.8-2.6]), basketball (0.90 vs 0.25; 3.6 [2.6-4.6]), and lacrosse (0.83 vs 0.06; 12.9 [10.1-15.8]). Impact mechanism distributions were similar within sports between boys and girls. In soccer, head to ball represented 78% of impacts, whereas at least 88% in basketball were player-to-player contact. Conclusion: Across sports for boys and girls, soccer had the highest impact rate. Male high school soccer, basketball, and lacrosse teams had significantly higher head impact rates than did female teams of the same sport. For girls, basketball had a higher head impact rate than did lacrosse and field hockey, and for boys, basketball had a similar impact rate to lacrosse, a collision sport. Sport differences in the distribution of impact mechanisms create sport-specific targets for reducing head impact exposure.

Are Sex Differences in Collegiate and High School Sports-Related Concussion Reflected in the Guidelines? A Scoping Review

“…However, there was no association between neck size and previous SRC [ 30 ]. A study using head impact sensors during HS sports found that female athletes experienced significantly fewer head impacts per 1000 AEs compared to males when playing soccer, basketball and lacrosse [ 31 ]. One study found females were less likely to suffer from concussions due to contact with other players in lacrosse, basketball, ice hockey and soccer; however, they were more likely to sustain concussion while heading the ball in soccer or after coming into contact with the ball or equipment in lacrosse and soccer [ 32 ].…”

On-Field Deployment and Validation for Wearable Devices

“…A HAE is defined as an event/incident that gives rise to an acceleration response of the head caused by an external short-duration collision force applied directly to the head or indirectly via the body in sport, recreational, military, or other activities of interest. 11,14,15,27,[30][31][32]39,72 For military applications, HAEs considered herein are those that occur in the non-blast environment, though HAEs could be secondary to the blast, such as a direct head impact with a wall following a blast. Direct HAEs, i.e., head impacts, involve primary collision with the head or helmet.…”

“…Many prior studies have excluded device recordings from analysis due to uncertainty of the event, or if the event was not clearly visible in film and only evaluated impacts that could be clearly verified with video; studies have reported a range of 6-75% of events recorded by devices that were ultimately included in analyses. 15 , 18 , 21 , 30 , 41 , 50 , 55 , 67 , 76 Reasons for exclusion include insufficient film quality, 2 , 74 the event occurred outside of the field of view, 2 , 31 , 54 or the characteristic of interest (e.g., head contact) was not clearly visible. 23 In the event that a device recording was excluded because it occurred outside the field of view, there is a potential for underestimation of exposure, therefore, the methods, assumptions, and limitations need to be clearly described and acknowledged to aid in interpretation of the data by others.…”

Machine-learning-based head impact subtyping based on the spectral densities of the measurable head kinematics

“…Considering the consequences and prevalence of TBI/mTBI, various biomechanical studies have focused on the estimation of brain injury risk. 11 , 12 , 13 , 14 , 15 , 16 Physiologically, the damage is thought to be caused by the inertial movement of the brain after the head sustains a physical impact, or after rapid acceleration or deceleration. Therefore, metrics of brain deformation are effective biomechanical predictors for predicting TBI/mTBI.…”