A Review of On-Field Investigations into the Biomechanics of Concussion in Football and Translation to Head Injury Mitig
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Annals of Biomedical Engineering, Vol. 48, No. 12, December 2020 (Ó 2020) pp. 2734–2750 https://doi.org/10.1007/s10439-020-02684-w
Review
A Review of On-Field Investigations into the Biomechanics of Concussion in Football and Translation to Head Injury Mitigation Strategies BETHANY ROWSON
and STEFAN M. DUMA
Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA (Received 19 June 2020; accepted 27 October 2020; published online 16 November 2020) Associate Editor Jane Grande-Allen oversaw the review of this article.
INTRODUCTION
Abstract—This review paper summarizes the scientific advancements in the field of concussion biomechanics in American football throughout the past five decades. The focus is on-field biomechanical data collection, and the translation of that data to injury metrics and helmet evaluation. On-field data has been collected with video analysis for laboratory reconstructions or wearable head impact sensors. Concussion biomechanics have been studied across all levels of play, from youth to professional, which has allowed for comparison of head impact exposure and injury tolerance between different age groups. In general, head impact exposure and injury tolerance increase with increasing age. Average values for concussive head impact kinematics are lower for youth players in both linear and rotational acceleration. Head impact data from concussive and non-concussive events have been used to develop injury metrics and risk functions for use in protective equipment evaluation. These risk functions have been used to evaluate helmet performance for each level of play, showing substantial differences in the ability of different helmet models to reduce concussion risk. New advances in head impact sensor technology allow for biomechanical measurements in helmeted and non-helmeted sports for a more complete understanding of concussion tolerance in different demographics. These sensors along with advances in finite element modeling will lead to a better understanding of the mechanisms of injury and human tolerance to head impact.
The biomechanics of head impacts and concussion in American football (referred to as ‘‘football’’ throughout this review) have been studied for nearly 60 years. The ability to measure on-field concussion biomechanics has long been a goal. This was first noted by Colonel John Paul Stapp who commented in 1975 that we should instrument football players as soon as miniature sensors become available.9,126 A number of different factors have motivated this research, including desired improvement in protective equipment,33,38,146 changes in rules and regulations to increase player safety,4,60,68 and translation of knowledge to other fields such as motor vehicle and military safety.21,65 Instrumenting football players on the field provides a method for collecting real-world head impact data in an ethical manner to better understand human tolerance to head impacts. Advances in sensor technology have made it possible to collect on-field head impact data from football
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