A Two-Phased Approach to Quantifying Head Impact Sensor Accuracy: In-Laboratory and On-Field Assessments
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Annals of Biomedical Engineering ( 2020) https://doi.org/10.1007/s10439-020-02647-1
Concussion Biomechanics in Football
A Two-Phased Approach to Quantifying Head Impact Sensor Accuracy: In-Laboratory and On-Field Assessments EMILY E. KIEFFER , MARK T. BEGONIA, ABIGAIL M. TYSON, and STEVE ROWSON Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA (Received 2 September 2020; accepted 1 October 2020) Associate Editor Stefan M. Duma oversaw the review of this article.
Abstract—Measuring head impacts in sports can further our understanding of brain injury biomechanics and, hopefully, advance concussion diagnostics and prevention. Although there are many head impact sensors available, skepticism on their utility exists over concerns related to measurement error. Previous studies report mixed reliability in head impact sensor measurements, but there is no uniform approach to assessing accuracy, making comparisons between sensors and studies difficult. The objective of this paper is to introduce a two-phased approach to evaluating head impact sensor accuracy. The first phase consists of in-lab impact testing on a dummy headform at varying impact severities under loading conditions representative of each sensor’s intended use. We quantify in-lab accuracy by calculating the concordance correlation coefficient (CCC) between a sensor’s kinematic measurements and headform reference measurements. For sensors that performed reasonably well in the lab (CCC ‡ 0.80), we completed a second phase of evaluation onfield. Through video validation of impacts measured by sensors on athletes, we classified each sensor measurement as either true-positive and false-positive impact events and computed positive predictive value (PPV) to summarize realworld accuracy. Eight sensors were tested in phase one, but only four sensors were assessed in phase two. Sensor accuracy varied greatly. CCC from phase one ranged from 0.13 to 0.97, with an average value of 0.72. Overall, the four devices that were implemented on-field had PPV that ranged from 16.3 to 91.2%, with an average value of 60.8%. Performance in-lab was not always indicative of the device’s performance on-field. The methods proposed in this paper aim to establish a comprehensive approach to the evaluation of sensors so that users can better interpret data collected from athletes. Keywords—Concussion, Biomechanics, Accelerometer, Wearable devices, Helmet, Data, Linear, Rotational.
Address correspondence to Emily E. Kieffer, Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA. Electronic mail: [email protected]
INTRODUCTION Measuring head impacts in sports can further our understanding of brain injury biomechanics and, hopefully, advance concussion diagnostics and prevention. To date, researchers have extensively deployed sensor systems in large cohorts of athletes to quantify head impact exposure and concussive biomechanics.16,18,22,31,34,36,38 While we now know more than ever about subconcussive and concussive impacts, we still have much to learn bef
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