Best Practices for Conducting Physical Reconstructions of Head Impacts in Sport.

Physical reconstructions are a valuable methodology for quantifying head kinematics in sports impacts. By recreating the motion of human heads observed in video using instrumented test dummies in a laboratory, physical reconstructions allow for in-depth study of real-world head impacts using well-established surrogates such as the Hybrid III crash test dummy. The purpose of this paper is to review all aspects of the physical reconstruction methodology and discuss the advantages and limitations associated with different choices in case selection, study design, test surrogate, test apparatus, text matrix, instrumentation, and data processing. Physical reconstructions require significant resources to perform and are therefore typically limited to small sample sizes and a case series or case-control study design. Their accuracy may also be limited by a lack of dummy biofidelity. The accuracy, repeatability, and sensitivity of the reconstruction process can be characterized and improved by good laboratory practices and iterative testing. Because wearable sensors have their own limitations and are not available or practical for many sports, physical reconstructions will continue to provide a useful and complementary approach to measuring head acceleration in sport for the foreseeable future.

Analysis and comparison of lateral head impacts using various golf discs and a Hybrid III head form.

The potential for head injuries from discs specifically designed for the sport of disc golf has increased as more disc golf courses are constructed in municipal parks where there is an inherent risk to park users of being struck by a golf disc. This study investigated the potential for head injury of various golf discs used in the sport of disc golf at 18 m/s (40 mph) and 27 m/s (60 mph) using a Hybrid III head form. A matrix of eight modern golf discs were tested to determine if velocity, mass, disc type, or flexibility has a significant effect on the potential for head injury as indicated by peak linear acceleration, peak angular acceleration, Head Injury Criteria (HIC) and Severity Index (SI) values. Regression analyses indicated peak linear acceleration, peak rotational acceleration, HIC, and SI varied by velocity, mass, type, and flexibility. The highest mean linear and rotational acceleration results, 38.5 g and 2512 rad/s2 respectively, both associated with a less than 10% likelihood of sustaining a concussion. The findings should be of interest to both researchers and practitioners who seek to balance use and safety of public parks.

Development and Evaluation of a Test Method for Assessing the Performance of American Football Helmets.

As more is learned about injury mechanisms of concussion and scenarios under which injuries are sustained in football games, methods used to evaluate protective equipment must adapt. A combination of video review, videogrammetry, and laboratory reconstructions was used to characterize concussive impacts from National Football League games during the 2015-2017 seasons. Test conditions were generated based upon impact locations and speeds from this data set, and a method for scoring overall helmet performance was created. Head kinematics generated using a linear impactor and sliding table fixture were comparable to those from laboratory reconstructions of concussive impacts at similar impact conditions. Impact tests were performed on 36 football helmet models at two laboratories to evaluate the reproducibility of results from the resulting test protocol. Head acceleration response metric, a head impact severity metric, varied 2.9-5.6% for helmet impacts in the same lab, and 3.8-6.0% for tests performed in a separate lab when averaged by location for the models tested. Overall inter-lab helmet performance varied by 1.1 ± 0.9%, while the standard deviation in helmet performance score was 7.0%. The worst helmet performance score was 33% greater than the score of the best-performing helmet evaluated by this study.

Correction to: Impact Performance of Modern Football Helmets.

This erratum is to correct headings listing the impact location and speed in Figs. 5 and 6. The following provides corrected Figs. 5 and 6. The data is unchanged. The authors apologize for any inconvenience this might have caused.

Impact performance of modern football helmets.

Linear impact tests were conducted on 17 modern football helmets. The helmets were placed on the Hybrid III head with the neck attached to a sliding table. The head was instrumented with an array of 3-2-2-2 accelerometers to determine translational acceleration, rotational acceleration, and HIC. Twenty-three (23) different impacts were conducted on four identical helmets of each model at eight sites on the shell and facemask, four speeds (5.5, 7.4, 9.3, and 11.2 m/s) and two temperatures (22.2 and 37.8 °C). There were 1,850 tests in total; 276 established the 1990 s helmet performance (baseline) and 1,564 were on the 17 different helmet models. Differences from the 1990 s baseline were evaluated using the Student t test (p < 0.05 as significant). Four of the helmets had significantly lower HICs and head accelerations than the 1990 s baseline with average reductions of 14.6-21.9% in HIC, 7.3-14.0% in translational acceleration, and 8.4-15.9% in rotational acceleration. Four other helmets showed some improvements. Eight were not statistically different from the 1990 s baseline and one had significantly poorer performance. Of the 17 helmet models, four provided a significant reduction in head responses compared to 1990 s helmets.

Football helmet drop tests on different fields using an instrumented Hybrid III head.

An instrumented Hybrid III head was placed in a Schutt ION 4D football helmet and dropped on different turfs to study field types and temperature on head responses. The head was dropped 0.91 and 1.83 m giving impacts of 4.2 and 6.0 m/s on nine different football fields (natural, Astroplay, Fieldturf, or Gameday turfs) at turf temperatures of -2.7 to 23.9 °C. Six repeat tests were conducted for each surface at 0.3 m (1') intervals. The Hybrid III was instrumented with triaxial accelerometers to determine head responses for the different playing surfaces. For the 0.91-m drops, peak head acceleration varied from 63.3 to 117.1 g and HIC(15) from 195 to 478 with the different playing surfaces. The lowest response was with Astroplay, followed by the engineered natural turf. Gameday and Fieldturf involved higher responses. The differences between surfaces decreased in the 1.83 m tests. The cold weather testing involved higher accelerations, HIC(15) and delta V for each surface. The helmet drop test used in this study provides a simple and convenient means of evaluating the compliance and energy absorption of football playing surfaces. The type and temperature of the playing surface influence head responses.

Effect of mouthguards on head responses and mandible forces in football helmet impacts.

The potential for mouthguards to change the risk of concussion was studied in football helmet impacts. The Hybrid III head was modified with an articulating mandible, dentition, and compliant temporomandibular joints (TMJ). It was instrumented for triaxial head acceleration and triaxial force at the TMJs and upper dentition. Mandible force and displacement were validated against cadaver impacts to the chin. In phase 1, one of five mouthguards significantly lowered HIC in 6.7 m/s impacts (p = 0.025) from the no mouthguard condition but not in 9.5 m/s tests. In phase 2, eight mouthguards increased HIC from +1 to +17% in facemask impacts that loaded the chinstraps and mandible; one was statistically higher (p = 0.018). Peak head acceleration was +1 to +15% higher with six mouthguards and 2-3% lower with two others. The differences were not statistically significant. Five of eight mouthguards significantly reduced forces on the upper dentition by 40.8-63.9%. Mouthguards tested in this study with the Hybrid III articulating mandible lowered forces on the dentition and TMJ, but generally did not influence HIC or concussion risks.

Concussion in professional football: performance of newer helmets in reconstructed game impacts--Part 13.

OBJECTIVE: The performance of five newer helmets was compared with the baseline VSR-4 helmet in 10 reconstructed cases of National Football League (NFL) collisions causing concussion. The laboratory reconstructions were conducted to determine changes in concussion risk with newer football helmets. METHODS: In 60 laboratory tests, translational and rotational head accelerations were measured in the striking and struck players represented by Hybrid III dummies. Six-axis upper neck loads and moments were measured in five cases with the struck player and five with the striking player. Biomechanical responses and concussion risks were evaluated for each collision to determine changes with newer helmet designs. RESULTS: Thirty-two out of 50 reconstructed cases showed greater than 10% reduction in severity index with newer helmets compared with the VSR-4; four cases increased. The average reduction in concussion risk with newer helmets was 10.8% (range, 6.9-16.7%) based on severity index. The reduction was 9.7% (range, 6.5-13.9%) based on translational acceleration and 18.9% (range, 10.6-23.4%) with rotational acceleration. Neck responses in the struck player showed a general reduction in moment and force with newer helmets. CONCLUSION: With newer football helmets, there was a trend toward 10 to 20% lower risks of concussion in reconstructed National Football League game collisions. However, a few designs and cases showed increased responses. The evaluation of football helmets to the proposed National Operating Committee on Standards for Athletic Equipment concussion standard should lead to more uniform reductions in concussion risk with future football helmets.

Concussion in professional football: helmet testing to assess impact performance--part 11.

OBJECTIVE: National Football League (NFL) concussions occur at an impact velocity of 9.3 +/- 1.9 m/s (20.8 +/- 4.2 mph) oblique on the facemask, side, and back of the helmet. There is a need for new testing to evaluate helmet performance for impacts causing concussion. This study provides background on new testing methods that form a basis for supplemental National Operating Committee on Standards for Athletic Equipment (NOCSAE) helmet standards. METHODS: First, pendulum impacts were used to simulate 7.4 and 9.3 m/s impacts causing concussion in NFL players. An instrumented Hybrid III head was helmeted and supported on the neck, which was fixed to a sliding table for frontal and lateral impacts. Second, a linear pneumatic impactor was used to evaluate helmets at 9.3 m/s and an elite impact condition at 11.2 m/s. The upper torso of the Hybrid III dummy was used. It allowed interactions with shoulder pads and other equipment. The severity of the head responses was measured by a severity index, translational and rotational acceleration, and other biomechanical responses. High-speed videos of the helmet kinematics were also recorded. The tests were evaluated for their similarity to conditions causing NFL concussions. Finally, a new linear impactor was developed for use by NOCSAE. RESULTS: The pendulum test closely simulated the conditions causing concussion in NFL players. Newer helmet designs and padding reduced the risk of concussion in 7.4 and 9.3 m/s impacts oblique on the facemask and lateral on the helmet shell. The linear impactor provided a broader speed range for helmet testing and more interactions with safety equipment. NOCSAE has prepared a draft supplemental standard for the 7.4 and 9.3 m/s impacts using a newly designed pneumatic impactor. No helmet designs currently address the elite impact condition at 11.2 m/s, as padding bottoms out and head responses dramatically increase. CONCLUSIONS: The proposed NOCSAE standard is the first to address helmet performance in reducing concussion risks in football. Helmet performance has improved with thicker padding and fuller coverage by the shell. However, there remains a challenge for innovative designs that reduce risks in the 11.2 m/s elite impact condition.