Measurement of head impacts in collegiate football players: relationship between head impact biomechanics and acute clinical outcome after concussion.
OBJECTIVE
To determine the relationship between recorded head accelerations and impact locations and acute clinical outcome of symptomatology, neuropsychological, and postural stability tests after cerebral concussion in Division I collegiate football players.


METHODS
A prospective field study was used in which accelerometers were embedded in the football helmets of 88 collegiate football players. Linear and rotational accelerations of all head impacts sustained over the course of 2004 to 2006 National Collegiate Athletic Association football seasons were collected in real-time. Change scores were calculated on clinical measures from the players' preseason baseline to postinjury (within 48 h) and regressed against the recorded linear and rotational accelerations of the head at the time of the concussion.


RESULTS
Thirteen concussions were recorded ranging in impact magnitudes of 60.51 to 168.71 g. Linear regression showed no significant relationships between impact magnitude (linear or rotational acceleration) or impact location and change scores for symptom severity, postural stability, or neurocognitive function (P > 0.05).


CONCLUSIONS
Our findings suggest that football players are concussed by impacts to the head that occur at a wide range of magnitudes and that clinical measures of acute symptom severity, postural stability, and neuropsychological function all appear to be largely independent of impact magnitude and location. Because of the varying magnitudes and locations of impacts resulting in concussion as well as other factors such as the frequency of subconcussive impacts and number of previous concussions, it may be difficult to establish a threshold for concussive injury that can be applied to all football players.
Guskiewicz
Kevin M
KM
Department of Exercise and Sport Science, Curriculum in Human Movement Science, The University of North Carolina, Chapel Hill, North Carolina 27599, USA. gus@email.unc.edu
Mihalik
Jason P
JP
Shankar
Viswanathan
V
Marshall
Stephen W
SW
Crowell
Dean H
DH
Oliaro
Scott M
SM
Ciocca
Mario F
MF
Hooker
Daniel N
DN
D000054:Acceleration; D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000209:etiology*; D001924:Brain Concussion / Q000209:etiology*; D005500:Follow-Up Studies; D005538:Football / Q000293:injuries*; D019416:Head Movements; D006260:Head Protective Devices; D006801:Humans; D016014:Linear Models; D008297:Male; D008954:Models, Biological; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D004856:Postural Balance; D011446:Prospective Studies; D012189:Retrospective Studies; D014495:Universities