A Novel Testing Device to Assess the Effect of Neck Strength on Risk of Concussion
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Annals of Biomedical Engineering (Ó 2020) https://doi.org/10.1007/s10439-020-02504-1
Original Article
A Novel Testing Device to Assess the Effect of Neck Strength on Risk of Concussion MILAD NAZARAHARI, JORDAN ARTHUR, and HOSSEIN ROUHANI Department of Mechanical Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada (Received 14 November 2019; accepted 30 March 2020) Associate Editor Joel Stitzel oversaw the review of this article.
Abstract—Concussion awareness has become more prevalent in the past decade, leading to growing calls for prevention programs such as neck strengthening. However, previous research work has shown that not all training programs have been effective, and there is a need for a reliable testing device to measure cervical strength dynamically before and after training. Therefore, this work proposes a novel Concussion Active Prevention Testing Device composed of inertial measurement units mounted on the head and a customdesigned frame to measure head kinematics during controlled sub-concussive impacts. Through an experimental study with able-bodied participants, the proposed testing device demonstrated high intra-participant repeatability between waveforms of the head acceleration and angular velocity in the sagittal plane (multiple correlation coefficient of 80%). Similarly, good and excellent intra-class correlation coefficients were obtained for head injury metrics, including range, peak, Gadd severity index, head injury criterion, and range of motion. Finally, the results showed that significantly higher head injury metrics were measured for female participants, which was in line with the findings of previous research works. We conclude that the proposed testing device can be used to measure repeatable and informative metrics for evaluating the effectiveness of athletes’ neck strengthening program. Keywords—Dynamic neck strength measurement, Head injury metrics, Head kinematics, Inertial measurement units.
ABBREVIATIONS HIM GSI BIC
Head injury criterion Gadd severity index Brain injury criterion
Address correspondence to Hossein Rouhani, Department of Mechanical Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada. Electronic mail: [email protected]
IMU CAPTD CG ROM CMC ICC
Inertial measurement unit Concussion active prevention testing device Head center of gravity Head range of motion The coefficient of multiple correlations The intra-class correlation coefficient
INTRODUCTION Estimations by the Centers for Disease and Prevention show that 300,000 sport-related mild traumatic brain injuries, also known as concussions, were occurring annually in the United States,35 and concussions have become a growing concern around the world in recent years.16 Repetitive concussions can cause long-term neurodegenerative processes among athletes.34 In most grading systems, the identification of concussion is based on symptoms. According to the ‘‘Evidence-Based Cantu Grading System for Concussion,’’ the severity of the concussion can be categorized as one of the following: (1) gra
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