title: Prevention of commotio cordis in baseball: an evaluation of chest protectors.
abstract: BACKGROUND
  In a recent study of fatal chest impacts by baseballs, 28% of the children were wearing a chest protector. This study evaluates the effectiveness of chest protectors in reducing the risk of commotio cordis.
  
  
  METHODS
  Five commercially available chest protectors were placed on a three-rib structure simulating the chest and impacted at 40, 50, 60, and 70 miles per hour by a standard baseball. Ten repeated tests were conducted on each vest in random order, and on the control (unprotected chest). The viscous response (or viscous criterion [VC]) was used to assess differences in fatality risk.
  
  
  RESULTS
  One vest had a statistically lower VC (average, 50.6%, p < 0.05) for all impact speeds. Three averaged 18.7% to 27.7% lower VC, but were significantly different only at higher speeds. One vest had an average 34.2% higher VC, and was significantly higher at 40 to 50 miles per hour (p < 0.05). A method was proposed linking laboratory test results to real-world incidents of ventricular fibrillation.
  
  
  CONCLUSIONS
  The majority of commercially available chest protectors fail to provide consistent reductions in commotio cordis risk. Nonetheless, there are benefits from their use in baseball until improved safety equipment is developed and standard tests are established to assess sport equipment effectiveness.
authors.affiliation: Institute for Preventative Sport Medicine, Ann Arbor, Michigan, USA. david.viano@GM.com
authors.forename: D C
authors.initials: DC
authors.lastname: Viano
authors.forename: C A
authors.initials: CA
authors.lastname: Bir
authors.forename: A K
authors.initials: AK
authors.lastname: Cheney
authors.forename: D H
authors.initials: DH
authors.lastname: Janda
mesh_terms: D001265:Athletic Injuries / Q000517:prevention & control; D001484:Baseball / Q000293:injuries*; D001696:Biomechanical Phenomena; D004869:Equipment Safety; D006335:Heart Injuries / Q000517:prevention & control*; D006801:Humans; D011482:Protective Devices / Q000592:standards*