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Accelerometers for the Assessment of Concussion in Male Athletes: A Systematic Review and Meta-Analysis

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Abstract

Background

Concussion is common in the sporting arena and is often challenging to diagnose. The development of wearable head impact measurement systems has enabled measurement of head kinematics in contact sports.

Objectives

The objective of this systematic review was to determine the characteristics of head kinematics measured by an accelerometer system among male athletes diagnosed with concussion.

Methods

A systematic search was conducted in July 2015. Inclusion criteria were English-language studies published after 1990 with a study population of male athletes, in any sport, where objectively measured biomechanical forces were reported in the setting of a concussive event. The random effects meta-analysis model was used to combine estimates of biomechanical force measurements in concussed athletes.

Results

Thirteen studies met the inclusion criteria, the majority of which were conducted with high school and college football teams in the US. Included studies measured a combination of linear and rotational acceleration. The meta-analysed mean peak linear head acceleration associated with a concussive episode was 98.68 g (95 % CI 82.36–115.00) and mean peak rotational head acceleration was 5776.60 rads/s2 (95 % CI 4583.53–6969.67). The estimates of the biomechanical forces were consistent across studies, with I 2 values of 0 % for both meta-analyses.

Conclusions

Head impact monitoring through accelerometery has been shown to be useful with regard to characterising the kinematic load to the head associated with concussion. Future research with improved clinical outcome measures and head kinematic data may improve accuracy when evaluating concussion, and may assist with both interpretation of biomechanical data and the development and utilisation of implementation strategies for the technology.

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References

  1. Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: a brief overview. J Head Trauma Rehabil. 2006;21(5):375–8.

    Article  PubMed  Google Scholar 

  2. O’Rance L. Disability in Australia: acquired brain injury. Canberra: Australian Institute of Health and Welfare; 2007.

    Google Scholar 

  3. Theadom A, Starkey NJ, Dowell T, et al. Sports-related brain injury in the general population: an epidemiological study. J Sci Med Sport. 2014;17(6):591–6.

    Article  PubMed  Google Scholar 

  4. McCrory P, Meeuwisse WH, Aubry M, et al. Consensus statement on concussion in sport: the 4th international conference on concussion in sport held in Zurich, November 2012. Br J Sports Med. 2013;47(5):250–8.

    Article  PubMed  Google Scholar 

  5. Rowson S, Duma SM. Brain injury prediction: assessing the combined probability of concussion using linear and rotational head acceleration. Ann Biomed Eng. 2013;41(5):873–82.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Duhaime AC, Beckwith JG, Maerlender AC, et al. Spectrum of acute clinical characteristics of diagnosed concussions in college athletes wearing instrumented helmets: clinical article. J Neurosurg. 2012;117(6):1092–9.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Williamson IJS, Goodman D. Converging evidence for the under-reporting of concussions in youth ice hockey. Br J Sports Med. 2006;40(2):128–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. McCrea M, Hammeke T, Olsen G, et al. Unreported concussion in high school football players: implications for prevention. Clin J Sport Med. 2004;14(1):13–7.

    Article  PubMed  Google Scholar 

  9. 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. 2012;40(1):237–48.

    Article  PubMed  Google Scholar 

  10. Chu JJ, Beckwith JG, Crisco JJ, et al. A novel algorithm to measure linear and rotational head acceleration using single-axis accelerometers. J Biomech. 2006;39:S534.

    Article  Google Scholar 

  11. Crisco JJ, Chu JJ, Greenwald RM. An algorithm for estimating acceleration magnitude and impact location using multiple nonorthogonal single-axis accelerometers. J Biomech Eng. 2004;126(6):849–54.

    PubMed  Google Scholar 

  12. Funk JR, Rowson S, Daniel RW, et al. Validation of concussion risk curves for collegiate football players derived from HITS data. Ann Biomed Eng. 2012;40(1):79–89.

    Article  PubMed  Google Scholar 

  13. King D, Hume PA, Brughelli M, et al. Instrumented mouthguard acceleration analyses for head impacts in amateur rugby union players over a season of matches. Am J Sports Med. 2015;43(3):614–24.

    Article  PubMed  Google Scholar 

  14. McKee AC, Cantu RC, Nowinski CJ, et al. Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. J Neuropathol Exp Neurol. 2009;68(7):709–35.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Gardner A, Iverson GL, McCrory P. Chronic traumatic encephalopathy in sport: a systematic review. Br J Sports Med. 2014;48(2):84–90.

    Article  PubMed  Google Scholar 

  16. Davis GA, Castellani RJ, McCrory P. Neurodegeneration and sport. Neurosurgery. 2015;76(6):643–55 (discussion 655–6).

    Article  PubMed  Google Scholar 

  17. Maroon JC, Winkelman R, Bost J, et al. Chronic traumatic encephalopathy in contact sports: a systematic review of all reported pathological cases. PLoS One. 2015;10(2):e0117338.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Forbes JA, Awad AJ, Zuckerman S, et al. Association between biomechanical parameters and concussion in helmeted collisions in American football: a review of the literature. Neurosurg Focus. 2012;33(6):E10.

    Article  PubMed  Google Scholar 

  19. Broglio SP, Surma T, Ashton-Miller JA. High school and collegiate football athlete concussions: a biomechanical review. Ann Biomed Eng. 2012;40(1):37–46.

    Article  PubMed  Google Scholar 

  20. King D, Brughelli M, Hume P, et al. Assessment, management and knowledge of sport-related concussion: systematic review. Sports Med. 2014;44(4):449–71.

    Article  PubMed  Google Scholar 

  21. Wilcox BJ, Beckwith JG, Greenwald RM, et al. Biomechanics of head impacts associated with diagnosed concussion in female collegiate ice hockey players. J Biomech. 2015;48(10):2201–4.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.

    Article  PubMed  Google Scholar 

  24. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529–36.

    Article  PubMed  Google Scholar 

  25. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.

    Article  CAS  PubMed  Google Scholar 

  26. Rowson S, Duma SM. Development of the STAR evaluation system for football helmets: integrating player head impact exposure and risk of concussion. Ann Biomed Eng. 2011;39(8):2130–40.

    Article  PubMed  Google Scholar 

  27. Duma SM, Manoogian SJ, Bussone WR, et al. Analysis of real-time head accelerations in collegiate football players. Clin J Sport Med. 2005;15(1):3–8.

    Article  PubMed  Google Scholar 

  28. Funk JR, Duma SM, Manoogian S. Development of concussion risk curves based on head impact data from collegiate football players. Injury Biomechanics Research. In: Proceedings of the 34th international workshop. Dearborn, MI; 2006. pp. 1–15.

  29. Funk JR, Duma SM, Manoogian SJ, et al. Biomechanical risk estimates for mild traumatic brain injury. Annu Proc Assoc Adv Automot Med. 2007;51:343–61.

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Duma SM, Rowson S (eds). Every newton hertz: a macro to micro approach to investigating brain injury. In: Conf Proc IEEE Eng Med Biol Soc; 2009, pp. 1123–6.

  31. Munce TA, Dorman JC, Thompson PA, et al. Head impact exposure and neurologic function of youth football players. Med Sci Sports Exerc. 2015;47(8):1567–76.

    Article  PubMed  Google Scholar 

  32. McAllister TW, Ford JC, Ji S, et al. Maximum principal strain and strain rate associated with concussion diagnosis correlates with changes in corpus callosum white matter indices. Ann Biomed Eng. 2012;40(1):127–40.

    Article  PubMed  Google Scholar 

  33. Guskiewicz KM, Mihalik JP, Shankar V, et al. Measurement of head impacts in collegiate football players: relationship between head impact biomechanics and acute clinical outcome after concussion. Neurosurgery. 2007;61(6):1244–52 (discussion 1252–3).

    Article  PubMed  Google Scholar 

  34. Schnebel B, Gwin JT, Anderson S, et al. In vivo study of head impacts in football: a comparison of National Collegiate Athletic Association Division I versus high school impacts. Neurosurgery. 2007;60(3):490–5 (discussion 495–6).

    Article  PubMed  Google Scholar 

  35. Broglio SP, Schnebel B, Sosnoff JJ, et al. Biomechanical properties of concussions in high school football. Med Sci Sports Exerc. 2010;42(11):2064–71.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Broglio SP, Eckner JT, Surma T, et al. Post-concussion cognitive declines and symptomatology are not related to concussion biomechanics in high school football players. J Neurotrauma. 2011;28(10):2061–8.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Beckwith JG, Chu JJ, Crisco JJ, et al. Severity of head impacts resulting in mild traumatic brain injury. Am Soc Biomech. 2009;1144.

  38. Beckwith JG, Greenwald RM, Chu JJ, et al. Timing of concussion diagnosis is related to head impact exposure prior to injury. Med Sci Sports Exerc. 2013;45(4):747–54.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Brolinson PG, Manoogian S, McNeely D, et al. Analysis of linear head accelerations from collegiate football impacts. Curr Sports Med Rep. 2006;5(1):23–8.

    Article  PubMed  Google Scholar 

  40. Rowson S, Duma SM, Beckwith JG, et al. Rotational head kinematics in football impacts: an injury risk function for concussion. Ann Biomed Eng. 2012;40(1):1–13.

    Article  PubMed  Google Scholar 

  41. Guskiewicz KM, Register-Mihalik J, McCrory P, et al. Evidence-based approach to revising the SCAT2: introducing the SCAT3. Br J Sports Med. 2013;47(5):289–93.

    Article  PubMed  Google Scholar 

  42. Beckwith JG, Greenwald RM, Chu JJ, et al. Head impact exposure sustained by football players on days of diagnosed concussion. Med Sci Sports Exerc. 2013;45(4):737–46.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Manoogian S, McNeely D, Duma S, et al. Head acceleration is less than 10 percent of helmet acceleration in football impacts. Biomed Sci Instrum. 2006;42:383–8.

    PubMed  Google Scholar 

  44. Higgins M, Halstead PD, Snyder-Mackler L, et al. Measurement of impact acceleration: mouthpiece accelerometer versus helmet accelerometer. J Athl Train. 2007;42(1):5–10.

    PubMed  PubMed Central  Google Scholar 

  45. Beckwith JG, Chu JJ, Greenwald RM. Validation of a noninvasive system for measuring head acceleration for use during boxing competition. J Appl Biomech. 2007;23(3):238–44.

    Article  PubMed  Google Scholar 

  46. Pellman EJ, Viano DC, Tucker AM, et al. Concussion in professional football: reconstruction of game impacts and injuries. Neurosurgery. 2003;53(4):799–812 (discussion 1340–1).

    PubMed  Google Scholar 

  47. McIntosh AS, Patton DA, Fréchède B, et al. The biomechanics of concussion in unhelmeted football players in Australia: a case–control study. BMJ Open. 2014;4(5):e005078.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Greenwald RM, Gwin JT, Chu JJ, et al. Head impact severity measures for evaluating mild traumatic brain injury risk exposure. Neurosurgery. 2008;62(4):789–98.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Patton DA, McIntosh AS, Kleiven S. The biomechanical determinants of concussion: finite element simulations to investigate brain tissue deformations during sporting impacts to the unprotected head. J Appl Biomech. 2013;29(6):721–30.

    Article  PubMed  Google Scholar 

  50. Patton DA, McIntosh AS, Kleiven S. The biomechanical determinants of concussion: finite element simulations to investigate tissue-level predictors of injury during sporting impacts to the unprotected head. J Appl Biomech. 2015;31(4):264–8.

    Article  PubMed  Google Scholar 

  51. Jinguji TM, Bompadre V, Harmon KG, et al. Sport Concussion Assessment Tool—2: baseline values for high school athletes. Br J Sports Med. 2012;46(5):365–70.

    Article  PubMed  Google Scholar 

  52. Valovich McLeod TC, Bay RC, Lam KC, et al. Representative baseline values on the Sport Concussion Assessment Tool 2 (SCAT2) in adolescent athletes vary by gender, grade, and concussion history. Am J Sports Med. 2012;40(4):927–33.

    Article  PubMed  Google Scholar 

  53. Eckner JT, Sabin M, Kutcher JS, et al. No evidence for a cumulative impact effect on concussion injury threshold. J Neurotrauma. 2011;28(10):2079–90.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Wilcox BJ, Machan JT, Beckwith JG, et al. Head-impact mechanisms in men’s and women’s collegiate ice hockey. J Athl Train. 2014;49(4):514–20.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Cobb BR, Urban JE, Davenport EM, et al. Head impact exposure in youth football: elementary school ages 9-12 years and the effect of practice structure. Ann Biomed Eng. 2013;41(12):2463–73.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Daniel RW, Rowson S, Duma SM. Head impact exposure in youth football. Ann Biomed Eng. 2012;40(4):976–81.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Daniel RW, Rowson S, Duma SM. Head impact exposure in youth football: middle school ages 12-14 years. J Biomech Eng. 2014;136(9):094501.

    PubMed  Google Scholar 

  58. McPherson MN, Montelpare WJ, Keightley M, et al. An analysis of head impact profiles and safe hockey behaviors in youth hockey players. J ASTM Int. 2009;6(10):1–7.

  59. Mihalik JP, Blackburn JT, Greenwald RM, et al. Collision type and player anticipation affect head impact severity among youth ice hockey players. Pediatrics. 2010;125(6):e1394–401.

    Article  PubMed  Google Scholar 

  60. Mihalik JP, Greenwald RM, Blackburn JT, et al. Effect of infraction type on head impact severity in youth ice hockey. Med Sci Sports Exerc. 2010;42(8):1431–8.

    Article  PubMed  Google Scholar 

  61. Mihalik JP, Guskiewicz KM, Marshall SW, et al. Head impact biomechanics in youth hockey: comparisons across playing position, event types, and impact locations. Ann Biomed Eng. 2012;40(1):141–9.

    Article  PubMed  Google Scholar 

  62. Reed N, Taha T, Keightley M, et al. Measurement of head impacts in youth ice hockey players. Int J Sports Med. 2010;31(11):826–33.

    Article  CAS  PubMed  Google Scholar 

  63. Urban JE, Davenport EM, Golman AJ, et al. Head impact exposure in youth football: high school ages 14 to 18 years and cumulative impact analysis. Ann Biomed Eng. 2013;41(12):2474–87.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Young TJ, Daniel RW, Rowson S, et al. Head impact exposure in youth football: elementary school ages 7-8 years and the effect of returning players. Clin J Sport Med. 2014;24(5):416–21.

    Article  PubMed  Google Scholar 

  65. Young TJ, Rowson S, Duma SM, et al. High magnitude head impacts experienced during youth football practices. In: 51st annual rocky mountain bioengineering symposium, RMBS 2014, and 51st international ISA biomedical sciences instrumentation symposium 2014; 2014.

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Acknowledgments

The authorship team would like to acknowledge Ms. Lisa Kruesi and Ms. Penny Presta for their assistance in the development of the search strategy.

Author information

Authors and Affiliations

  1. National Trauma Research Institute, Commercial Rd, Melbourne, VIC, 3004, Australia

    James H. Brennan, Biswadev Mitra & Anneliese Synnot

  2. Emergency and Trauma Centre, The Alfred Hospital, Melbourne, VIC, Australia

    James H. Brennan & Biswadev Mitra

  3. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    Biswadev Mitra

  4. Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, VIC, Australia

    Anneliese Synnot

  5. Cochrane Consumers and Communication Review Group, Centre for Health Communication and Participation, La Trobe University, Melbourne, VIC, Australia

    Anneliese Synnot

  6. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    Joanne McKenzie

  7. Monash-Epworth Rehabilitation Research Centre, Melbourne, VIC, Australia

    Catherine Willmott

  8. School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Melbourne, VIC, Australia

    Catherine Willmott

  9. Australian Centre for Research into Injury in Sport and its Prevention, Federation University, Ballarat, VIC, Australia

    Andrew S. McIntosh

  10. Monash Injury Research Institute, Monash University, Melbourne, VIC, Australia

    Andrew S. McIntosh

  11. Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia

    Jerome J. Maller

  12. Department of Neurosurgery, The Alfred Hospital, Melbourne, VIC, Australia

    Jeffrey V. Rosenfeld

  13. Department of Surgery, Monash University, Melbourne, VIC, Australia

    Jeffrey V. Rosenfeld

  14. Department of Surgery, F. Edward Hébert School of Medicine, Uniformed Services University of The Health Sciences (USUHS), Bethesda, MD, USA

    Jeffrey V. Rosenfeld

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  1. James H. Brennan
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  2. Biswadev Mitra
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  3. Anneliese Synnot
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  4. Joanne McKenzie
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  5. Catherine Willmott
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  6. Andrew S. McIntosh
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  7. Jerome J. Maller
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  8. Jeffrey V. Rosenfeld
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Corresponding author

Correspondence to James H. Brennan.

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Funding

James Brennan received a scholarship from Monash University to undertake this systematic review. Joanne McKenzie holds a National Health and Medical Research Council (NHMRC) Australian Public Health Fellowship (1072366).

Conflict of interest

James H. Brennan, Biswadev Mitra, Anneliese Synnot, Joanne McKenzie, Catherine Willmott, Andrew S. McIntosh, Jerome J. Maller and Jeffrey V. Rosenfeld declare that they have no conflicts of interest relevant to the content of this review.

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Brennan, J.H., Mitra, B., Synnot, A. et al. Accelerometers for the Assessment of Concussion in Male Athletes: A Systematic Review and Meta-Analysis. Sports Med 47, 469–478 (2017). https://doi.org/10.1007/s40279-016-0582-1

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