Abstract
American-style football participation poses a high risk of repetitive head impact (RHI) exposure leading to acute and chronic brain injury. The complex nature of symptom expression, human predisposition, and neurological consequences of RHI limits our understanding of what constitutes as an injurious impact affecting the integrity of brain tissue. Video footage of professional football games was reviewed and documentation made of all head contact. Frequency of impact, tissue strain magnitude, and time interval between impacts was used to quantify RHI exposure, specific to player field position. Differences in exposure characteristics were found between eight different positions; where three unique profiles can be observed. Exposure profiles provide interpretation of the relationship between the traumatic event(s) and how tissue injury is manifested and expressed. This study illustrates and captures an objective measurement of RHI on the field, a critical component in guiding public policy and guidelines for managing exposure.
Highlights
Various levels of impact severity associated with head injury have been studied for over a century where knowledge and reporting reflected current periods’ public concern and environmental context[1]
The vulnerabilities associated with duration of exposure to repetitive head impact (RHI) are implicated in a number of reports showing higher plasma tau concentrations, increased cognitive impairments and reduced microstructural integrity of the corpus callosum found in retired NFL players compared to their age matched controls[4,16,18,21,22]
Suspected impacts accounted for approx. 15% of the total impacts recorded; Running Back (RB) with the greatest number recorded, followed by LB and Defensive Line (DL)
Summary
Various levels of impact severity associated with head injury have been studied for over a century where knowledge and reporting reflected current periods’ public concern and environmental context[1]. A recent quantitative risk assessment concluded that CTE poses a public health concern, and suggests that regardless of the limited data on causation, incidence, and/or the dose-response relationship, reducing the exposure to RHI in ASF would result in a reduction in the occurrence of brain disease[27] It is the societal impact of RHI that will govern how public health is managed and public policy and clinical guide lines are set. Wearable head impact sensors allow for large amounts of data collection in real-time and can provide information in terms of impact count/frequency, pose valid concerns regarding their accuracy for measuring dynamic magnitudes and duration, evident for rotational head motion[43] These technologies are limited in predicting the brain’s response[44,45], present challenges for interpreting exposure results. Physical head impact event reconstruction and finite element analysis provide useful information to investigate the link between head motion and brain tissue strain[46,47]
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