Annals of Biomedical Engineering

, Volume 40, Issue 1, pp 14–22 | Cite as

The Relationship Between Subconcussive Impacts and Concussion History on Clinical Measures of Neurologic Function in Collegiate Football Players

  • Sonia M. Gysland
  • Jason P. Mihalik
  • Johna K. Register-Mihalik
  • Scott C. Trulock
  • Edgar W. Shields
  • Kevin M. Guskiewicz


Concussions sustained during college and professional football careers have been associated with both acute and chronic neurologic impairment. The contribution of subconcussive impacts to this impairment has not been adequately studied. Therefore, we investigated the relationship between subconcussive impacts and concussion history on clinical measures of neurologic function. Forty-six collegiate football players completed five clinical measures of neurologic function commonly employed in the evaluation of concussion before and after a single season. These tests included the Automated Neuropsychological Assessment Metrics, Sensory Organization Test, Standardized Assessment of Concussion, Balance Error Scoring System, and Graded Symptom Checklist. The Head Impact Telemetry (HIT) System recorded head impact data including the frequency, magnitude, and location of impacts. College football players sustain approximately 1,000 subconcussive impacts to the head over the course of a season, but for the most part, do not demonstrate any clinically meaningful changes from preseason to postseason on measures of neurologic function. Changes in performance were mostly independent of prior concussion history, and the total number, magnitude and location of sustained impacts over one season as observed R 2 values ranged between 0.30 and 0.35. Repetitive subconcussive head impacts over a single season do not appear to result in short-term neurologic impairment, but these relationships should be further investigated for a potential dose–response over a player’s career.


Concussion history Cumulative exposure Subconcussive impacts Mild traumatic brain injury 



This study was supported in part by the Centers for Disease Control and Prevention and the National Operating Committee on Standards for Athletic Equipment.


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Copyright information

© Biomedical Engineering Society 2011

Authors and Affiliations

  • Sonia M. Gysland
    • 1
  • Jason P. Mihalik
    • 1
  • Johna K. Register-Mihalik
    • 1
  • Scott C. Trulock
    • 2
  • Edgar W. Shields
    • 3
  • Kevin M. Guskiewicz
    • 1
  1. 1.Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport ScienceUniversity of North CarolinaChapel HillUSA
  2. 2.Campus Health ServicesUniversity of North CarolinaChapel HillUSA
  3. 3.Department of Exercise and Sport ScienceUniversity of North CarolinaChapel HillUSA

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