With sensors tucked inside their helmets, high school football players in Illinois transmitted four years of acceleration data to help researchers determine when concussions occur. The research, which captured about two dozen concussions and a spine fracture in real time, was published last month in the New England Journal of Medicine.
On how the study was conducted and what the research found:
The sensor system fits within a standard football helmet. We don't have to modify the helmet at all. Inside the sensors are accelerometers which are the same devices that are in your car that set the airbag off. That measures how fast the head is changing speed. Driving down the highway at 60 miles per hour is fine, but [the danger is] the sudden stop when you hit the brick wall. We're measuring how fast the head is accelerating or decelerating if they get hit. That's the important thing to know.
The helmet functions like a standard helmet and we just let the students play football. We don't do an intervention. We're just measuring what's going to occur anyway. Across the four years, we've collected about 120,000 total impacts. About 25 of those were concussions. We found that if you look at the average levels at which people sustain a concussion, it's about the same at the high school level as it is at the college level as it is at the professional level.
But tolerance to high-level impact changes with the level of play. The high school kid can't tolerate a high-magnitude impact as much as a college kid as much as a professional. That's where the difference is. The high school kid and the college kid play a slower game than the professional and they don't hit as hard. But they're not as physically developed, not as mature. While they run slower and hit not as hard, they're not as able to tighten their necks down and protect themselves from the impact.
On the technology:
It was specifically designed to measure head acceleration following an impact and impact location during football. It can identify somebody who took a big hit, and then you still have to do a clinical exam to determine whether they have a concussion. We were using it for concussion research, trying to get to the point where it could be diagnostic.
On what can be done with the knowledge gleaned from this study:
Once we know where you hit somebody and how hard, you can go back to the helmet companies and say build a better helmet that can withstand these forces.
My first year of this study, we were doing a preliminary review of our data going through individual players. We were looking to see where on the helmet individuals were hitting. We had one lineman that had an inordinate number of impacts to the top of his head. This guy was hitting with the top of his head something like 60 percent of the time, which is extremely high. We mentioned it to the coaches. For a week or two, they worked with him and kept reminding him. We saw improvements to his technique and he came down to about what the team average was.
On why studying high school football is important:
There are just under four million concussions a year. That's in all sports, not just football. Certainly football gets the largest amount of attention. We knew this technology was out there. At the time, it was only for football. But what we find in football is applicable for all settings. A concussion in football is the same as one in basketball is the same as hitting your head on the ice. We're trying to understand the injury better.
We do our work in high school kids because of the number that play football. It's somewhere around one and a half million. It's a shame that so much attention is on the college level and the pro level when you have such fewer numbers playing at that level. It's not to say that you don't want to take care of them, but the much larger, more important public health question in my mind is trying to protect a high school kid who is going to play three or four years and go on to have a normal life after that.
On the next step in the research:
We're going to continue. The data in the paper was all collected in Illinois. We're up in Ann Arbor now and we will start in about two weeks with pre-season. We'll keep doing the same sort of thing. We're trying to develop the system up to a point where it could be used for diagnostics. Say a person was hit with a certain amount of force in a certain location. [With a diagnostic tool, we could know] they have a concussion and we need to pull them out right now. We're a long way off from that, but it's what we're aiming for.
Image, top: Sample head form from study
Photo, bottom: Steven Broglio