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 1990s helmet performance (baseline) and 1,564 were on the 17 different helmet models. Differences from the 1990s 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 1990s 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 1990s baseline and one had significantly poorer performance. Of the 17 helmet models, four provided a significant reduction in head responses compared to 1990s helmets.     

Measuring Head Kinematics in Football: Correlation Between the Head Impact Telemetry System and Hybrid III Headform

Over the last decade, advances in technology have enabled researchers to evaluate concussion biomechanics through measurement of head impacts sustained during play using two primary methods: (1) laboratory reconstruction of open-field head contact, and (2) instrumented helmets. The purpose of this study was to correlate measures of head kinematics recorded by the Head Impact Telemetry (HIT) System (Simbex, NH) with those obtained from a Hybrid III (HIII) anthropometric headform under conditions that mimicked impacts occurring in the NFL. Linear regression analysis was performed to correlate peak linear acceleration, peak rotational acceleration, Gadd Severity Index (GSI), and Head Injury Criterion (HIC₁₅) obtained from the instrumented helmet and HIII. The average absolute location error between instrumented helmet impact location and the direction of HIII head linear acceleration were also calculated. The HIT System overestimated Hybrid III peak linear acceleration by 0.9% and underestimated peak rotational acceleration by 6.1% for impact sites and velocities previously identified by the NFL as occurring during play. Acceleration measures for all impacts were correlated; however, linear was higher (r ² = 0.903) than rotational (r ² = 0.528) primarily due to lower HIT System rotational acceleration estimates at the frontal facemask test site. Severity measures GSI and HIC were also found to be correlated, albeit less than peak linear acceleration, with the overall difference between the two systems being less than 6.1% for either measure. Mean absolute impact location difference between systems was 31.2 ± 46.3° (approximately 0.038 ± 0.050 m), which was less than the diameter of the impactor surface in the test. In instances of severe helmet deflection (2.54–7.62 cm off the head), the instrumented helmet accurately measured impact location but overpredicted all severity metrics recorded by the HIII. Results from this study indicate that measurements from the two methods of study are correlated and provide a link that can be used to better interpret findings from future study using either technology.     

Age has a Minimal Effect on the Impact Performance of Field-Used Bicycle Helmets

Helmet manufacturers recommend replacing a bicycle helmet after an impact or after anywhere from 2 to 10 years of use. The goal of this study was to quantify the effect of helmet age on peak headform acceleration during impact attenuation testing of field-used bicycle helmets. Helmets were acquired by donation from consumers and retail stores, and were included in the study if they were free of impact-related damage, had a legible manufacture date label, and were certified to at least one helmet standard. Helmets (n = 770) spanning 0–26 years old were drop tested to measure peak linear headform acceleration during impacts to the right and left front regions of the helmets at two impact speeds (3.0 and 6.2 m/s). General linear mixed models were used to assess the effect of age and three covariates (helmet style, size and certification impact speed) on peak acceleration. Overall, age was related to either no difference or a statistically significant but small increase (≤0.76 g/year of helmet age) in peak headform acceleration. Extrapolated across 20 years, age-related differences were less than both style- (traditional vs. BMX) and size-related differences. The age-related differences were also less than the variability observed between different helmets after accounting for style, size and certification effects. These findings mean that bicycle helmets (up to 26-year-old traditional helmets and 13-year-old BMX helmets) do not lose their ability to attenuate impacts with age; however, other helmet features that may change with age were not evaluated in this study.     

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.     

Dynamic Response and Residual Helmet Liner Crush Using Cadaver Heads and Standard Headforms

Biomechanical headforms are used for helmet certification testing and reconstructing helmeted head impacts; however, their biofidelity and direct applicability to human head and helmet responses remain unclear. Dynamic responses of cadaver heads and three headforms and residual foam liner deformations were compared during motorcycle helmet impacts. Instrumented, helmeted heads/headforms were dropped onto the forehead region against an instrumented flat anvil at 75, 150, and 195 J. Helmets were CT scanned to quantify maximum liner crush depth and crush volume. General linear models were used to quantify the effect of head type and impact energy on linear acceleration, head injury criterion (HIC), force, maximum liner crush depth, and liner crush volume and regression models were used to quantify the relationship between acceleration and both maximum crush depth and crush volume. The cadaver heads generated larger peak accelerations than all three headforms, larger HICs than the International Organization for Standardization (ISO), larger forces than the Hybrid III and ISO, larger maximum crush depth than the ISO, and larger crush volumes than the DOT. These significant differences between the cadaver heads and headforms need to be accounted for when attempting to estimate an impact exposure using a helmet’s residual crush depth or volume.     

Head Impact Biomechanics in Youth Hockey: Comparisons Across Playing Position, Event Types, and Impact Locations

The age at which young hockey players should safely body check is unknown. We sought to determine if playing position (defensemen vs. forwards), event type (practice vs. game), or head impact location (top vs. back vs. front vs. sides) had an effect on head impact biomechanics in youth hockey. A total of 52 Bantam (13–14 years old) and Midget (15–16 years old) ice hockey players wore accelerometer-instrumented helmets for two seasons. Biomechanical data were captured for 12,253 head impacts during 151 games and 137 practices. Random intercepts general mixed linear models were employed to analyze differences in linear acceleration, rotational acceleration, and HITsp by player position, event type, and head impact location. Head impacts sustained during games resulted in greater rotational acceleration and HITsp than those sustained during practices. No event type or playing position differences in linear acceleration were observed. Impacts to the top of the head resulted in greater linear acceleration, but lower rotational acceleration and HITsp, than impacts to back, front, or side of the head. Side head impacts yielded greater rotational acceleration and HITsp compared to the other head impact locations. Since linear and rotational accelerations were observed in all impacts, future hockey helmet design standards should include rotational acceleration limits in addition to the current linear acceleration standards.     

Validation of Concussion Risk Curves for Collegiate Football Players Derived from HITS Data

For several years, Virginia Tech and other schools have measured the frequency and severity of head impacts sustained by collegiate American football players in real time using the Head Impact Telemetry (HIT) System of helmet-mounted accelerometers. In this study, data from 37,128 head impacts collected at Virginia Tech during games from 2006 to 2010 were analyzed. Peak head acceleration exceeded 100 g in 516 impacts, and the Head Injury Criterion (HIC) exceeded 200 in 468 impacts. Four instrumented players in the dataset sustained a concussion. These data were used to develop risk curves for concussion as a function of peak head acceleration and HIC. The validity of this biomechanical approach was assessed using epidemiological data on concussion incidence from other sources. Two specific aspects of concussion incidence were addressed: the variation by player position, and the frequency of repeat concussions. The HIT System data indicated that linemen sustained the highest overall number of head impacts, while skill positions sustained a higher number of more severe head impacts (peak acceleration > 100 g or HIC > 200). When weighted using injury risk curves, the HIT System data predicted a higher incidence of concussion in skill positions compared to linemen at rates that were in strong agreement with the epidemiological literature (Pearson’s r = 0.72–0.87). The predicted rates of repeat concussions (21–39% over one season and 33–50% over five seasons) were somewhat higher than the ranges reported in the epidemiological literature. These analyses demonstrate that simple biomechanical parameters that can be measured by the HIT System possess a high level of power for predicting concussion.     

Nano-Composite Foam Sensor System in Football Helmets

American football has both the highest rate of concussion incidences as well as the highest number of concussions of all contact sports due to both the number of athletes and nature of the sport. Recent research has linked concussions with long term health complications such as chronic traumatic encephalopathy and early onset Alzheimer’s. Understanding the mechanical characteristics of concussive impacts is critical to help protect athletes from these debilitating diseases and is now possible using helmet-based sensor systems. To date, real time on-field measurement of head impacts has been almost exclusively measured by devices that rely on accelerometers or gyroscopes attached to the player’s helmet, or embedded in a mouth guard. These systems monitor motion of the head or helmet, but do not directly measure impact energy. This paper evaluates the accuracy of a novel, multifunctional foam-based sensor that replaces a portion of the helmet foam to measure impact. All modified helmets were tested using a National Operating Committee Standards for Athletic Equipment-style drop tower with a total of 24 drop tests (4 locations with 6 impact energies). The impacts were evaluated using a headform, instrumented with a tri-axial accelerometer, mounted to a Hybrid III neck assembly. The resultant accelerations were evaluated for both the peak acceleration and the severity indices. These data were then compared to the voltage response from multiple Nano Composite Foam sensors located throughout the helmet. The foam sensor system proved to be accurate in measuring both the HIC and Gadd severity index, as well as peak acceleration while also providing additional details that were previously difficult to obtain, such as impact energy.     

Impairments in the initial horizontal vestibulo-ocular reflex of older humans

To determine age-related changes, the initial horizontal vestibulo-ocular reflex (VOR) of 11 younger normal subjects (aged 20–32 years) was compared with that of 12 older subjects (aged 58–69 years) in response to random transients of whole-body acceleration of 1,000 and 2,800°/s² delivered around eccentric vertical axes ranging from 10 cm anterior to 20 cm posterior to the eyes. Eye and head positions were sampled at 1,200 Hz using magnetic search coils. Subjects fixed targets 500 cm or 15 cm distant immediately before the unpredictable onset of rotation in darkness. For all testing conditions, younger subjects exhibited compensatory VOR slow phases with early gain (eye velocity/head velocity, interval 35–45 ms from onset of rotation) of 0.90±0.02 (mean ± SEM) for the higher head acceleration, and 0.79±0.02 for the lower acceleration. Older subjects had significantly (P<0.0001) lower early gain of 0.77±0.04 for the higher head acceleration and 0.70±0.02 for the lower acceleration. Late gain (125–135 ms from onset of rotation) was similar for the higher and lower head accelerations in younger subjects. Older subjects had significantly lower late gain at the higher head acceleration, but gain similar to the younger subjects at the lower acceleration. All younger subjects maintained slow-phase VOR eye velocity to values ≥200°/s throughout the 250-ms rotation, but, after an average of 120 ms rotation (mean eccentricity 13°), 8 older subjects consistently had abrupt declines (ADs) in slow-phase VOR velocity to 0°/s or even the anticompensatory direction. These ADs were failures of the VOR slow phase rather than saccades and were more frequent with the near target at the higher acceleration. Slow-phase latencies were 14.4±0.4 ms and 16.8±0.4 ms for older subjects at the higher and lower accelerations, significantly longer than comparable latencies of 10.0±0.5 ms and 12.0±0.6 ms for younger subjects. Late VOR gain modulation with target distance was significantly attenuated in older subjects only for the higher head acceleration. Electronic Publication     

Comparison of Ice Hockey Goaltender Helmets for Concussion Type Impacts

Concussions are among the most common injuries sustained by ice hockey goaltenders and can result from collisions, falls and puck impacts. However, ice hockey goaltender helmet certification standards solely involve drop tests to a rigid surface. This study examined how the design characteristics of different ice hockey goaltender helmets affect head kinematics and brain strain for the three most common impact events associated with concussion for goaltenders. A NOCSAE headform was impacted under conditions representing falls, puck impacts and shoulder collisions while wearing three different types of ice hockey goaltender helmet models. Resulting linear and rotational acceleration as well as maximum principal strain were measured for each impact condition. The results indicate that a thick liner and stiff shell material are desirable design characteristics for falls and puck impacts to reduce head kinematic and brain tissue responses. However for collisions, the shoulder being more compliant than the materials of the helmet causes insufficient compression of the helmet materials and minimizing any potential performance differences. This suggests that current ice hockey goaltender helmets can be optimized for protection against falls and puck impacts. However, given collisions are the leading cause of concussion for ice hockey goaltenders and the tested helmets provided little to no protection, a clear opportunity exists to design new goaltender helmets which can better protect ice hockey goaltenders from collisions.     

Effect of helmet liner systems and impact directions on severity of head injuries sustained in ballistic impacts: a finite element (FE) study

The current study aims to investigate the effectiveness of two different designs of helmet interior cushion, (Helmet 1: strap-netting; Helmet 2: Oregon Aero foam-padding), and the effect of the impact directions on the helmeted head during ballistic impact. Series of ballistic impact simulations (frontal, lateral, rear, and top) of a full-metal-jacketed bullet were performed on a validated finite element head model equipped with the two helmets, to assess the severity of head injuries sustained in ballistic impacts using both head kinematics and biomechanical metrics. Benchmarking with experimental ventricular and intracranial pressures showed that there is good agreement between the simulations and experiments. In terms of extracranial injuries, top impact had the highest skull stress, still without fracturing the skull. In regard to intracranial injuries, both the lateral and rear impacts generally gave the highest principal strains as well as highest shear strains, which exceed the injury thresholds. Off-cushion impacts were found to be at higher risk of intracranial injuries. The study also showed that the Oregon Aero foam pads helped to reduce impact forces. It also suggested that more padding inserts of smaller size may offer better protection. This provides some insights on future’s helmet design against ballistic threats.     

Rotational Head Kinematics in Football Impacts: An Injury Risk Function for Concussion

Recent research has suggested a possible link between sports-related concussions and neurodegenerative processes, highlighting the importance of developing methods to accurately quantify head impact tolerance. The use of kinematic parameters of the head to predict brain injury has been suggested because they are indicative of the inertial response of the brain. The objective of this study is to characterize the rotational kinematics of the head associated with concussive impacts using a large head acceleration dataset collected from human subjects. The helmets of 335 football players were instrumented with accelerometer arrays that measured head acceleration following head impacts sustained during play, resulting in data for 300,977 sub-concussive and 57 concussive head impacts. The average sub-concussive impact had a rotational acceleration of 1230 rad/s² and a rotational velocity of 5.5 rad/s, while the average concussive impact had a rotational acceleration of 5022 rad/s² and a rotational velocity of 22.3 rad/s. An injury risk curve was developed and a nominal injury value of 6383 rad/s² associated with 28.3 rad/s represents 50% risk of concussion. These data provide an increased understanding of the biomechanics associated with concussion and they provide critical insight into injury mechanisms, human tolerance to mechanical stimuli, and injury prevention techniques.     

Head Impact Exposure in Youth Football: High School Ages 14 to 18 Years and Cumulative Impact Analysis

Sports-related concussion is the most common athletic head injury with football having the highest rate among high school athletes. Traditionally, research on the biomechanics of football-related head impact has been focused at the collegiate level. Less research has been performed at the high school level, despite the incidence of concussion among high school football players. The objective of this study is to twofold: to quantify the head impact exposure in high school football, and to develop a cumulative impact analysis method. Head impact exposure was measured by instrumenting the helmets of 40 high school football players with helmet mounted accelerometer arrays to measure linear and rotational acceleration. A total of 16,502 head impacts were collected over the course of the season. Biomechanical data were analyzed by team and by player. The median impact for each player ranged from 15.2 to 27.0 g with an average value of 21.7 (±2.4) g. The 95th percentile impact for each player ranged from 38.8 to 72.9 g with an average value of 56.4 (±10.5) g. Next, an impact exposure metric utilizing concussion injury risk curves was created to quantify cumulative exposure for each participating player over the course of the season. Impacts were weighted according to the associated risk due to linear acceleration and rotational acceleration alone, as well as the combined probability (CP) of injury associated with both. These risks were summed over the course of a season to generate risk weighted cumulative exposure. The impact frequency was found to be greater during games compared to practices with an average number of impacts per session of 15.5 and 9.4, respectively. However, the median cumulative risk weighted exposure based on combined probability was found to be greater for practices vs. games. These data will provide a metric that may be used to better understand the cumulative effects of repetitive head impacts, injury mechanisms, and head impact exposure of athletes in football.     

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 HIC₁₅ 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, HIC₁₅ 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.     

Changes in muscle fascicles of tibialis anterior during anisometric contractions are not associated with motor-output variability of the ankle dorsiflexors in young and old adults

This study examined the associations between the fluctuations of foot acceleration during shortening and lengthening contractions with the electromyographic (EMG) activity of lower leg muscles and ultrasound measures of tibialis anterior fascicle length and pennation angle. Young (24.9 ± 4.17 years) and old (74.8 ± 3.31 years) adults lifted and lowered a submaximal load with the foot at different speeds (3°/s–50°/s). The standard deviation (SD) of foot acceleration normalized to the load lifted was similar for young (12.2 ± 7.22 cm s⁻²/kg) and old adults (14.3 ± 8.03 cm s⁻²/kg; P = 0.093). The changes in tibialis anterior muscle fascicle length and pennation angle were similar for young and old adults (P ≥ 0.233), but greater for shortening (fascicle length: 0.937 ± 0.633 cm, pennation angle: 1.61 ± 0.918o) than for lengthening contractions (fascicle length: 0.806 ± 0.521 cm, pennation angle: 0.966 ± 0.632o; P ≤ 0.014). The changes in fascicle length and pennation angle were not associated with the SD of foot acceleration (r ² ≤ 0.031; P ≥ 0.092). The surface EMG of tibialis anterior was greater for the shortening contractions than for the lengthening contractions (P < 0.001), but triceps surae EMG was similar for the two types of contractions (P = 0.304). The results suggested that the influence of movement speed on variability in performance was similar for shortening and lengthening contractions with the dorsiflexor muscles; furthermore, old adults were able to match the performance of young adults.     

Temporal dynamics of semicircular canal and otolith function following acute unilateral vestibular deafferentation in humans

Dynamic changes of deficits in canal and otolith vestibulo-ocular reflexes (VORs) to high acceleration, eccentric yaw rotations were investigated in five subjects aged 25–65 years before and at frequent intervals 3–451 days following unilateral vestibular deafferentation (UVD) due to labyrinthectomy or vestibular neurectomy. Eye and head movements were recorded using magnetic search coils during transients of directionally random, whole-body rotation in darkness at peak acceleration 2,800°/s². Canal VORs were characterized during rotation about a mid-otolith axis, viewing a target 500 cm distant until rotation onset in darkness. Otolith VOR responses were characterized by the increase in VOR gain during identical rotation about an axis 13 cm posterior to the otoliths, initially viewing a target 15 cm distant. Pre-UVD canal gain was directionally symmetrical, averaging 0.87 ± 0.02 (±SEM). Contralesional canal gain declined from pre-UVD by an average of 22% in the first 3–5 days post-UVD, before recovering to an asymptote of close 90% of pre-UVD level at 1–3 months. This recovery corresponded to resolution of spontaneous nystagmus. Ipsilesional gain declined to 59%, and showed no consistent recovery afterwards. Pre-UVD otolith gain was directionally symmetrical, averaging 0.56 ± 0.02. Immediately after UVD, the contralesional otolith gain declined to 0.30 ± 0.02, and did not recover. Ipsilesional otolith gain declined profoundly to 0.08 ± 0.03 (P < 0.01), and never recovered. In contrast to the modest and directionally symmetrical effect of UVD on the human otolith VOR during pure translational acceleration, otolith gain during eccentric yaw rotation exhibited a profound and lasting deficit that might be diagnostically useful in lateralizing otolith pathology. Most recovery of the human canal gain to high acceleration transients following UVD is for contralesional head rotation, occurring within 3 months as spontaneous nystagmus resolves. Grant support: United States Public Health Service grants DC-02952 and AG-09693. JLD is Leonard Apt Professor of Ophthalmology.     

Head impact exposure in youth football

The head impact exposure for athletes involved in football at the college and high school levels has been well documented; however, the head impact exposure of the youth population involved with football has yet to be investigated, despite its dramatically larger population. The objective of this study was to investigate the head impact exposure in youth football. Impacts were monitored using a custom 12 accelerometer array equipped inside the helmets of seven players aged 7–8 years old during each game and practice for an entire season. A total of 748 impacts were collected from the 7 participating players during the season, with an average of 107 impacts per player. Linear accelerations ranged from 10 to 100 g, and the rotational accelerations ranged from 52 to 7694 rad/s². The majority of the high level impacts occurred during practices, with 29 of the 38 impacts above 40 g occurring in practices. Although less frequent, youth football can produce high head accelerations in the range of concussion causing impacts measured in adults. In order to minimize these most severe head impacts, youth football practices should be modified to eliminate high impact drills that do not replicate the game situations.     

An Instrumented Mouthguard for Measuring Linear and Angular Head Impact Kinematics in American Football

The purpose of this study was to evaluate a novel instrumented mouthguard as a research device for measuring head impact kinematics. To evaluate kinematic accuracy, laboratory impact testing was performed at sites on the helmet and facemask for determining how closely instrumented mouthguard data matched data from an anthropomorphic test device. Laboratory testing results showed that peak linear acceleration (r ² = 0.96), peak angular acceleration (r ² = 0.89), and peak angular velocity (r ² = 0.98) measurements were highly correlated between the instrumented mouthguard and anthropomorphic test device. Normalized root-mean-square errors for impact time traces were 9.9 ± 4.4% for linear acceleration, 9.7 ± 7.0% for angular acceleration, and 10.4 ± 9.9% for angular velocity. This study demonstrates the potential of an instrumented mouthguard as a research tool for measuring in vivo impacts, which could help uncover the link between head impact kinematics and brain injury in American football.