Skip to main content

Advertisement

SpringerLink
Log in

Development, Validation and Pilot Field Deployment of a Custom Mouthpiece for Head Impact Measurement

  • Special Issue on the NCAA-DoD CARE Consortium Research
  • Published:
Annals of Biomedical Engineering Aims and scope Submit manuscript

Abstract

The objective of this study was to develop a mouthpiece sensor with improved head kinematic measurement for use in non-helmeted and helmeted sports through laboratory validation and pilot field deployment in female youth soccer. For laboratory validation, data from the mouthpiece sensor was compared to standard sensors mounted in a headform at the center of gravity as the headform was struck with a swinging pendulum. Linear regression between peak kinematics measured from the mouthpiece and headform showed strong correlation, with r2 values of 0.95 (slope = 1.02) for linear acceleration, 1.00 (slope = 1.00) for angular velocity, and 0.97 (slope = 0.96) for angular acceleration. In field deployment, mouthpiece data were collected from four female youth soccer players and time-synchronized with film. Film-verified events (n = 915) were observed over 9 practices and 5 games, and 632 were matched to a corresponding mouthpiece event. This resulted in an overall sensitivity of 69.2% and a positive predictive value of 80.3%. This validation and pilot field deployment data demonstrates that the mouthpiece provides highly accurate measurement of on-field head impact data that can be used to further study the effects of impact exposure in both helmeted and non-helmeted sports.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

FIGURE. 1
FIGURE. 2
FIGURE. 3
FIGURE. 4
FIGURE. 5
FIGURE. 6
FIGURE. 7

Similar content being viewed by others

References

  1. Allison, M. A., Y. S. Kang, J. H. T. Bolte, M. R. Maltese, and K. B. Arbogast. Validation of a helmet-based system to measure head impact biomechanics in ice hockey. Med. Sci. Sports Exerc. 46:115–123, 2014.

    Article  Google Scholar 

  2. Bartsch, A., S. Samorezov, E. Benzel, V. Miele, and D. Brett. Validation of an “Intelligent Mouthguard” single event head impact dosimeter. Stapp Car Crash J. 58:1–27, 2014.

    PubMed  Google Scholar 

  3. Beckwith, J. G., J. J. Chu, and R. M. Greenwald. Validation of a noninvasive system for measuring head acceleration for use during boxing competition. J. Appl. Biomech. 23:238–244, 2007.

    Article  Google Scholar 

  4. Beckwith, J. G., R. M. Greenwald, and J. J. Chu. Measuring head kinematics in football: correlation between the head impact telemetry system and Hybrid III headform. Ann. Biomed. Eng. 40:237–248, 2012.

    Article  Google Scholar 

  5. Camarillo, D. B., P. B. Shull, J. Mattson, R. Shultz, and D. Garza. An instrumented mouthguard for measuring linear and angular head impact kinematics in American football. Ann. Biomed. Eng. 41:1939–1949, 2013.

    Article  Google Scholar 

  6. Campbell, K. R., M. J. Warnica, I. C. Levine, J. S. Brooks, A. C. Laing, T. A. Burkhart, and J. P. Dickey. Laboratory evaluation of the gForce tracker, a head impact kinematic measuring device for use in football helmets. Ann. Biomed. Eng. 44:1246–1256, 2016.

    Article  Google Scholar 

  7. Chrisman, S. P. D., B. E. Ebel, E. Stein, S. J. Lowry, and F. P. Rivara. Head impact exposure in youth soccer and variation by age and sex. Clin. J. Sport Med. 29:3–10, 2019.

    Article  Google Scholar 

  8. Chrisman, S. P., C. L. Mac Donald, S. Friedman, J. Andre, A. Rowhani-Rahbar, S. Drescher, E. Stein, M. Holm, N. Evans, A. V. Poliakov, R. P. Ching, C. C. Schwien, M. S. Vavilala, and F. P. Rivara. Head impact exposure during a weekend youth soccer tournament. J. Child Neurol. 31:971–978, 2016.

    Article  Google Scholar 

  9. Cobb, B. R., A. M. Tyson, and S. Rowson. Head acceleration measurement techniques: Reliability of angular rate sensor data in helmeted impact testing. Proc. Inst. Mech. Eng. Part P 2017. https://doi.org/10.1177/1754337117708092.

    Article  Google Scholar 

  10. Covassin, T., C. B. Swanik, and M. L. Sachs. Sex differences and the incidence of concussions among collegiate athletes. J. Athl. Train. 38:238–244, 2003.

    PubMed  PubMed Central  Google Scholar 

  11. Engineers, S. O. A. Instrumentation for Impact Test, Part 1: Electronic Instrumentation. Warrendale, PA: Society of Automotive Engineers, 1995.

    Google Scholar 

  12. FIFA. FIFA Big Count 2006: 270 Million People Active in Football. Cairo: FIFA Communications Division, 2007.

    Google Scholar 

  13. Funk, J. R., J. M. Cormier, C. E. Bain, H. Guzman, E. Bonugli, and S. J. Manoogian. Head and neck loading in everyday and vigorous activities. Ann. Biomed. Eng. 39:766–776, 2011.

    Article  Google Scholar 

  14. Gessel, L. M., S. K. Fields, C. L. Collins, R. W. Dick, and R. D. Comstock. Concussions among United States high school and collegiate athletes. J. Athl. Train. 42:495–503, 2007.

    PubMed  PubMed Central  Google Scholar 

  15. Hanlon, E. M., and C. A. Bir. Real-time head acceleration measurement in girls’ youth soccer. Med. Sci. Sports Exerc. 44:1102–1108, 2012.

    Article  Google Scholar 

  16. Harriss, A., A. M. Johnson, D. M. Walton, and J. P. Dickey. Head impact magnitudes that occur from purposeful soccer heading depend on the game scenario and head impact location. Musculoskelet. Sci. Pract. 40:53–57, 2019.

    Article  Google Scholar 

  17. Higgins, M., P. D. Halstead, L. Snyder-Mackler, and D. Barlow. Measurement of impact acceleration: mouthpiece accelerometer versus helmet accelerometer. J. Athl. Train. 42:5–10, 2007.

    PubMed  PubMed Central  Google Scholar 

  18. Jadischke, R., D. C. Viano, N. Dau, A. I. King, and J. McCarthy. On the accuracy of the head impact telemetry (HIT) system used in football helmets. J. Biomech. 46:2310–2315, 2013.

    Article  Google Scholar 

  19. Kuo, C., L. C. Wu, B. T. Hammoor, J. F. Luck, H. C. Cutcliffe, R. C. Lynall, J. R. Kait, K. R. Campbell, J. P. Mihalik, C. R. Bass, and D. B. Camarillo. Effect of the mandible on mouthguard measurements of head kinematics. J. Biomech. 49:1845–1853, 2016.

    Article  Google Scholar 

  20. Lamond, L. C., J. B. Caccese, T. A. Buckley, J. Glutting, and T. W. Kaminski. Linear acceleration in direct head contact across impact type, player position, and playing scenario in collegiate women’s soccer players. J. Athl. Train. 53:115–121, 2018.

    Article  Google Scholar 

  21. Lightman, K. Silicon gets sporty. IEEE Spectr. 53:48–53, 2016.

    Article  Google Scholar 

  22. Mainwaring, L., K. M. Ferdinand Pennock, S. Mylabathula, and B. Z. Alavie. Subconcussive head impacts in sport: a systematic review of the evidence. Int. J. Psychophysiol. 132:39–54, 2018.

    Article  Google Scholar 

  23. Manoogian, S., D. McNeely, S. Duma, G. Brolinson, and R. Greenwald. Head acceleration is less than 10 percent of helmet acceleration in football impacts. Biomed. Sci. Instrum. 42:383–388, 2006.

    PubMed  Google Scholar 

  24. Miller, L. E., C. Kuo, L. C. Wu, J. E. Urban, D. B. Camarillo, and J. D. Stitzel. Validation of a custom instrumented retainer form factor for measuring linear and angular head impact kinematics. J. Biomech. Eng. 140:054501, 2018.

    Article  Google Scholar 

  25. Miller, L., E. Pinkerton, K. Fabian, L. Wu, M. Espeland, L. Lamond, C. Miles, D. Camarillo, J. Stitzel, and J. Urban. Characterizing head impact exposure in youth female soccer with a custom-instrumented mouthpiece. Res. Sports Med. 2019. https://doi.org/10.1080/15438627.2019.1590833.

    Article  PubMed  Google Scholar 

  26. Naunheim, R. S., P. V. Bayly, J. Standeven, J. S. Neubauer, L. M. Lewis, and G. M. Genin. Linear and angular head accelerations during heading of a soccer ball. Med. Sci. Sports Exerc. 35:1406–1412, 2003.

    Article  Google Scholar 

  27. Nevins, D., L. Smith, and J. Kensrud. Laboratory evaluation of wireless head impact sensor. Procedia Eng. 112:175–179, 2015.

    Article  Google Scholar 

  28. O’Kane, J. W. Is heading in youth soccer dangerous play? Phys. Sportsmed. 44:190–194, 2016.

    Article  Google Scholar 

  29. Press, J. N., and S. Rowson. Quantifying head impact exposure in collegiate women’s soccer. Clin. J. Sport Med. 27:104–110, 2017.

    Article  Google Scholar 

  30. Rice, S. G. Medical conditions affecting sports participation. Pediatrics 121:841–848, 2008.

    Article  Google Scholar 

  31. Rowson, S., J. G. Beckwith, J. J. Chu, D. S. Leonard, R. M. Greenwald, and S. M. Duma. A six degree of freedom head acceleration measurement device for use in football. J. Appl. Biomech. 27:8–14, 2011.

    Article  Google Scholar 

  32. Rowson, S., S. M. Duma, R. M. Greenwald, J. G. Beckwith, J. J. Chu, K. M. Guskiewicz, J. P. Mihalik, J. J. Crisco, B. J. Wilcox, T. W. McAllister, A. C. Maerlender, S. P. Broglio, B. Schnebel, S. Anderson, and P. G. Brolinson. Can helmet design reduce the risk of concussion in football? J. Neurosurg. 120:919–922, 2014.

    Article  Google Scholar 

  33. Self, B. P., J. Beck, D. Schill, C. Eames, T. Knox, and J. Plaga. Head accelerations during soccer heading. Eng. Sport 6:81–86, 2006.

    Google Scholar 

  34. Siegmund, G. P., K. M. Guskiewicz, S. W. Marshall, A. L. DeMarco, and S. J. Bonin. Laboratory validation of two wearable sensor systems for measuring head impact severity in football players. Ann. Biomed. Eng. 44:1257–1274, 2016.

    Article  Google Scholar 

  35. Stewart, W. F., N. Kim, C. S. Ifrah, R. B. Lipton, T. A. Bachrach, M. E. Zimmerman, M. Kim, and M. L. Lipton. Symptoms from repeated intentional and unintentional head impact in soccer players. Neurology 88:901–908, 2017.

    Article  Google Scholar 

  36. Triax Technologies. Laboratory Validation of the SIM-G Head Impact Sensor. Norwalk, CN: Triax Technologies Inc, 2014.

    Google Scholar 

  37. Tyson, A. M., S. M. Duma, and S. Rowson. Laboratory evaluation of low-cost wearable sensors for measuring head impacts in sports. J. Appl. Biomech. 34:320–326, 2018.

    Article  Google Scholar 

  38. Wu, L. C., K. Laksari, C. Kuo, J. F. Luck, S. Kleiven, C. R. Dale’ Bass, and D. B. Camarillo. Bandwidth and sample rate requirements for wearable head impact sensors. J. Biomech. 49:2918–2924, 2016.

    Article  Google Scholar 

  39. Wu, L. C., V. Nangia, K. Bui, B. Hammoor, M. Kurt, F. Hernandez, C. Kuo, and D. B. Camarillo. In vivo evaluation of wearable head impact sensors. Ann. Biomed. Eng. 44:1234–1245, 2016.

    Article  Google Scholar 

  40. Wu, L. C., L. Zarnescu, V. Nangia, B. Cam, and D. B. Camarillo. A head impact detection system using SVM classification and proximity sensing in an instrumented mouthguard. IEEE Trans. Biomed. Eng. 61:2659–2668, 2014.

    Article  Google Scholar 

  41. Yang, Y. T., and C. M. Baugh. US youth soccer concussion policy: heading in the right direction. JAMA Pediatr. 170:413–414, 2016.

    Article  Google Scholar 

  42. Yoganandan, N., F. A. Pintar, J. Zhang, and J. L. Baisden. Physical properties of the human head: mass, center of gravity and moment of inertia. J. Biomech. 42:1177–1192, 2009.

    Article  Google Scholar 

Download references

Acknowledgments

The authors thank the Virginia Tech Helmet Lab for their assistance in conducting the laboratory validation tests. They would also like to thank Konstantia Strates for her efforts in study coordination. Special thanks to the Childress Institute for Pediatric Trauma at Wake Forest Baptist Medical Center for providing support for this study. The National Institute of Neurological Disorders and Stroke of the National Institutes of Health, through Award Numbers R01NS091602-01A1, R01NS082453 and R01NS094410, supported members of the research team who contributed to this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The mouthpiece technology presented herein is patent pending.

Author information

Authors and Affiliations

  1. Department of Biomedical Engineering, Wake Forest School of Medicine, 575 N. Patterson Avenue, Suite 120, Winston-Salem, NC, 27101, USA

    Andrea M. Rich, Tanner M. Filben, Logan E. Miller, Brian T. Tomblin, Aaron R. Van Gorkom, Ryan T. Barnard, Dena S. Kohn, Jillian E. Urban & Joel D. Stitzel

  2. School of Biomedical Engineering and Sciences, Virginia Tech – Wake Forest University, 575 N. Patterson Avenue, Suite 120, Winston-Salem, NC, 27101, USA

    Andrea M. Rich, Tanner M. Filben, Logan E. Miller, Brian T. Tomblin, Aaron R. Van Gorkom, Jillian E. Urban & Joel D. Stitzel

  3. Department of Biostatistics and Data Science, Wake Forest School of Medicine, 525 Vine St, Winston-Salem, NC, 27101, USA

    Ryan T. Barnard

  4. Hurst Dental Laboratory, 946 Brookstown Avenue, Winston-Salem, NC, 27101, USA

    Michael A. Hurst

Authors
  1. Andrea M. Rich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tanner M. Filben
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Logan E. Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brian T. Tomblin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Aaron R. Van Gorkom
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael A. Hurst
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ryan T. Barnard
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dena S. Kohn
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jillian E. Urban
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Joel D. Stitzel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joel D. Stitzel.

Additional information

Associate Editor Stefan M. Duma oversaw the review of this article.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix

Appendix

See Figs. 5, 6 and 7.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rich, A.M., Filben, T.M., Miller, L.E. et al. Development, Validation and Pilot Field Deployment of a Custom Mouthpiece for Head Impact Measurement. Ann Biomed Eng 47, 2109–2121 (2019). https://doi.org/10.1007/s10439-019-02313-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10439-019-02313-1

Keywords

Search

Navigation