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Impact Sensors: A Missing Piece of Head Injury Programs

If there has been one area in which I have devoted more of my energy and passion as a youth sports safety expert and Executive Director of MomsTEAM/SmartTeams for the past eighteen years, it is has been in trying to reduce the risk of short- and long-term brain injury to athletes in contact and collision sports.

One of the ways I have long believed contact and collision sports can be made safer is through the use of impact sensors - most of which are small, highly sophisticated electronic devices embedded in mouth guards, chin straps, skull caps, ear buds, skin patches, or attached to the interior or exterior of helmets which transmit data via Blue Tooth connection on the number and force of head impacts athletes sustain during games or practices to a dedicated monitor, iPhone, iPad or laptop on the sports sideline.  

About six or seven years ago, I started to hear about companies which were bringing to market impact sensors for use at the youth, high school, and college level; sensors that, while not as sophisticated as the ones used for research - which cost upwards of $1,000 per player - could be used to alert sideline personnel to athletes who sustained hits hard enough to cause concussion so they could be evaluated for concussion, and to identify athletes whose poor technique caused them to sustain an unusually large number of subconcussive impacts, the cumulative effect of which research has increasingly linked with a greater risk the athlete will develop a chronic, degenerative neurological disease such as chronic traumatic encephalopathy (CTE).

In 2012, when I was asked by the high school football program in Newcastle, Oklahoma for help in implementing an evidence-based concussion risk management program, I saw a perfect opportunity to beta test two of the new impact sensors, which the manufacturers, Impact Protective and i1 Biometrics, donated for installation in some of the Newcastle players' helmets.

My experience during the filming of MomsTEAM's PBS documentary, The Smartest Team: Making High School Football Safer, convinced me that they had value as a technological end run around the chronic problem of under-reporting by athletes of concussion symptoms.  From talking candidly with the players after a duck-hunting trip (next to playing football, their favorite activity), I learned that they actually wanted to wear the sensors. Why? Because they knew that, if they took a heavy hit, it would register on the iPad the athletic trainer or his assistant was holding on the sideline.  Knowing that they would be checked out if the sensor alerted sideline personnel to a blow with the potential to cause a concussion, they felt more comfortable, if they began experiencing concussion symptoms, reporting symptoms to the AT without fear of being labeled a wimp by their teammates or the coach.

In believing that impact sensors could play a role in the early identification of concussion, I have had good company in the sports medicine and scientific communities.  Numerous studies have shown that one of the biggest hurdles to appropriate clinical management of sports concussion is identifying athletes who should be removed from play for initial screening on the sports sideline.  Many sports concussions go undetected because athletes don't recognize that they have symptoms of concussion, are reluctant and/or refuse to self-report such symptoms, or because of the less-than-perfect observational skills of sideline management in spotting signs of concussion in athletes.  Early identification is critical because, in most cases, athletes immediately removed from contact or collision sports after suffering a concussion will fully recover fairly quickly (7 to 10 days, longer for children), while athletes who continue playing after concussion, according to recent studies, are at much greater risk of a longer recovery.

One way to address the problem of chronic under-reporting and increase the chances a concussion will be identified early on the sports sideline, say some leading experts, is to rely less on athletes to remove themselves from games or practices by reporting concussion symptoms, or on game officials and sideline observers to observe signs of concussion, but to use impact sensors as essentially another set of eyes to alert sideline personnel to heavy hits that might cause a concussion.  "Although a [sensor] system may not be able to accurately predict injury," notes University of Michigan and Michigan Neurosport neurologist Jeffrey Kutcher, "it may have utility as a screening device by alerting sideline personnel of an impact that has occurred above a predetermined magnitude that triggers either observation or clinical evaluation of an athlete."  A 2017 study in the Journal of Athletic Training agreed, concluding that "impact sensors may provide critical real-time data to monitor players," and that "viewing an athlete's head-impact data may provide context for the clinician working on the sidelines."