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Capturing Head Impacts in Boxing: A Video-Based Comparison of Three Wearable Sensors

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Abstract

Wearable sensors are used to quantify head impacts in athletes, but recent work has shown that the number of events recorded may not be accurate. This study aimed to compare the number of head acceleration events recorded by three wearable sensors during boxing and assess how impact type and location affect the triggering of acceleration events. Seven boxers were equipped with an instrumented mouthguard, a skin patch, and a headgear patch. Contacts to participants’ heads were identified via three video cameras over 115 sparring rounds. The resulting 5168 video-identified events were used as reference to quantify the sensitivity, specificity, and positive predictive value (PPV) of the sensors. The mouthguard, skin patch, and headgear patch recorded 695, 1579, and 1690 events, respectively, yielding sensitivities of 35%, 86%, and 78%, respectively, and specificities of 90%, 76%, and 75%, respectively. The mouthguard, skin patch, and headgear patch yielded 693, 1571, and 1681 true-positive events, respectively, leading to PPVs for head impacts over 96%. All three sensors were more likely to be triggered by punches landing near the sensor and cleanly on the head, although the mouthguard’s sensitivity to impact location varied less than the patches. While the use of head impact sensors for assessing injury risks remains uncertain, this study provides valuable insights into the capabilities and limitations of these sensors in capturing video-verified head impact events.

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Abbreviations

CSx:

CSx instrumented mouthguards, equipped with accelerometers and angular rate sensors designed to monitor in vivo head impacts

TP:

True positive

FP:

False positive

PPV:

Positive predictive value

References

  1. Alois, J., S. Bellamkonda, E. T. Campolettano, R. A. Gellner, A. Genemaras, J. G. Beckwith, R. M. Greenwald, E. Smith, S. Rowson, S. M. Duma, and J. J. Crisco. Do American youth football players intentionally use their heads for high-magnitude impacts? Am. J. Sports Med. 47:3498–3504, 2019.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Asken, B. M., Z. S. Brooke, T. C. Stevens, P. G. Silvestri, M. J. Graham, M. S. Jaffee, and J. R. Clugston. Drill-specific head impacts in collegiate football practice: implications for reducing “friendly fire” exposure. Ann. Biomed. Eng. 47:2094–2108, 2018.

    Article  PubMed  Google Scholar 

  3. Bartsch, A., E. Benzel, V. Miele, D. Morr, and V. Prakash. Boxing and mixed martial arts: preliminary traumatic neuromechanical injury risk analyses from laboratory impact dosage data. J. Neurosurg. 116:1070, 2012.

    Article  PubMed  Google Scholar 

  4. Broglio, S. P., R. M. Williams, K. L. O’Connor, and J. Goldstick. Football players’ head-impact exposure after limiting of full-contact practices. J. Athl. Train. 51:511–518, 2016.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Caputo, K. What I have learned from scoring 528 fights as a boxing judge. In: The Guardian 2019. https://www.theguardian.com/sport/queensberry-rules-boxing-blog/2019/jan/02/boxing-judge-scoring-528-fights.

  6. Carey, L., P. Stanwell, D. P. Terry, A. S. McIntosh, S. V. Caswell, G. L. Iverson, and A. J. Gardner. Verifying head impacts recorded by a wearable sensor using video footage in rugby league: a preliminary study. Sports Med.—Open. 5:1–11, 2019.

    Article  Google Scholar 

  7. Cooper, S.-M., M. Hughes, P. O’Donoghue, and M. A. Nevill. A simple statistical method for assessing the reliability of data entered into sport performance analysis systems. Int. J. Perform. Anal. Sport. 7:87–109, 2007.

    Article  Google Scholar 

  8. Cortes, N., A. E. Lincoln, G. D. Myer, L. Hepburn, M. Higgins, M. Putukian, and S. V. Caswell. Video analysis verification of head impact events measured by wearable sensors. Am. J. Sports Med. 45:2379–2387, 2017.

    Article  PubMed  Google Scholar 

  9. Cummiskey, B. R. Characterization and Evaluation of Head Impact Sensors and Varsity Football Helmets. West Lafayette: Purdue University, 2015.

    Google Scholar 

  10. Di Felice, U., and S. Marcora. Errors in judging Olympic boxing performance: false negative or false positive? In: Performance Analysis of Sport IX. London: Routledge, 2013, pp. 216–221.

    Google Scholar 

  11. Fanton, M., L. Wu, and D. Camarillo. Comment on “Frequency and magnitude of game-related head impacts in male contact sports athletes: a systematic review and meta-analysis.” Sports Med. 50:841–842, 2020.

    Article  PubMed  Google Scholar 

  12. Gabler, L. F., S. H. Huddleston, N. Z. Dau, D. J. Lessley, K. B. Arbogast, X. Thompson, J. E. Resch, and J. R. Crandall. On-field performance of an instrumented mouthguard for detecting head impacts in American football. Ann. Biomed. Eng. 48:2599–2612, 2020.

    Article  PubMed  Google Scholar 

  13. Greenwald, R. M., J. T. Gwin, J. J. Chu, and J. J. Crisco. Head impact severity measures for evaluating mild traumatic brain injury risk exposure. Neurosurgery. 62:789–798, 2008.

    Article  PubMed  Google Scholar 

  14. Hernandez, F., L. C. Wu, M. C. Yip, K. Laksari, A. R. Hoffman, J. R. Lopez, G. A. Grant, S. Kleiven, and D. B. Camarillo. Six degree-of-freedom measurements of human mild traumatic brain injury. Ann. Biomed. Eng. 43:1918–1934, 2015.

    Article  PubMed  Google Scholar 

  15. International Boxing Association. AIBA Referee and Judge Regulations. Lausanne: Internation Boxing Association, 2018.

    Google Scholar 

  16. 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  PubMed  Google Scholar 

  17. Joodaki, H., A. Bailey, D. Lessley, J. Funk, C. Sherwood, and J. Crandall. Relative motion between the helmet and the head in football impact test. J. Biomech. Eng. 2019. https://doi.org/10.1115/1.4043038.

    Article  PubMed  Google Scholar 

  18. Kieffer, E. E., M. T. Begonia, A. M. Tyson, and S. Rowson. A two-phased approach to quantifying head impact sensor accuracy: in-laboratory and on-field assessments. Ann. Biomed. Eng. 48:2613–2625, 2020.

    Article  PubMed  Google Scholar 

  19. Kieffer, E. E., C. Vaillancourt, P. G. Brolinson, and S. Rowson. Using in-mouth sensors to measure head kinematics in rugby. In: International IRCOBI Conference on the Biomechanics of Injury, 2020.

  20. Kuo, C., J. Sganga, M. Fanton, and D. B. Camarillo. Head impact kinematics estimation with network of inertial measurement units. J. Biomech. Eng. 2018. https://doi.org/10.1115/1.4039987.

    Article  PubMed  Google Scholar 

  21. Kuo, C., L. Wu, J. Loza, D. Senif, S. C. Anderson, and D. B. Camarillo. Comparison of video-based and sensor-based head impact exposure. PLoS ONE. 13:e0199238, 2018.

    Article  PubMed  PubMed Central  Google Scholar 

  22. 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  PubMed  PubMed Central  Google Scholar 

  23. Lennon, A. Measurement of Head Impact Biomechanics: A Comparison of the Head Impact Telemetry System and X2 Biosystems xPatch. Chapel Hill: University of North Carolina, 2015.

    Google Scholar 

  24. Liu, Y., A. G. Domel, S. A. Yousefsani, J. Kondic, G. Grant, M. Zeineh, and D. B. Camarillo. Validation and comparison of instrumented mouthguards for measuring head kinematics and assessing brain deformation in football impacts. Ann. Biomed. Eng. 48:2580–2598, 2020.

    Article  PubMed  PubMed Central  Google Scholar 

  25. McIntosh, A. S., and D. A. Patton. Boxing headguard performance in punch machine tests. Br. J. Sports Med. 49:1108–1112, 2015.

    Article  PubMed  Google Scholar 

  26. McIntosh, A. S., C. Willmott, D. A. Patton, B. Mitra, J. H. Brennan, B. Dimech-Betancourt, T. S. Howard, and J. V. Rosenfeld. An assessment of the utility and functionality of wearable head impact sensors in Australian Football. J. Sci. Med. Sport. 22:784–789, 2019.

    Article  PubMed  Google Scholar 

  27. Mihalik, J. P., J. T. Blackburn, R. M. Greenwald, R. C. Cantu, S. W. Marshall, and K. M. Guskiewicz. Collision type and player anticipation affect head impact severity among youth ice hockey players. Pediatrics. 125:e1394–e1401, 2010.

    Article  PubMed  Google Scholar 

  28. Montenigro, P. H., M. L. Alosco, B. M. Martin, D. H. Daneshvar, J. Mez, C. E. Chaisson, C. J. Nowinski, R. Au, A. C. McKee, R. C. Cantu, M. D. McClean, R. A. Stern, and Y. Tripodis. Cumulative head impact exposure predicts later-life depression, apathy, executive dysfunction, and cognitive impairment in former high school and college football players. J. Neurotrauma. 34:328–340, 2017.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ocwieja, K. E., J. P. Mihalik, S. W. Marshall, J. D. Schmidt, S. C. Trulock, and K. M. Guskiewicz. The effect of play type and collision closing distance on head impact biomechanics. Ann. Biomed. Eng. 40:90–96, 2012.

    Article  PubMed  Google Scholar 

  30. Patton, D. A., C. M. Huber, D. Jain, R. K. Myers, C. C. McDonald, S. S. Margulies, C. L. Master, and K. B. Arbogast. Head impact sensor studies in sports: a systematic review of exposure confirmation methods. Ann. Biomed. Eng. 2020. https://doi.org/10.1007/s10439-020-02642-6.

    Article  PubMed  PubMed Central  Google Scholar 

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

    Article  PubMed  Google Scholar 

  32. Rich, A. M., T. M. Filben, L. E. Miller, B. T. Tomblin, A. R. Van Gorkom, M. A. Hurst, R. T. Barnard, D. S. Kohn, J. E. Urban, and J. D. Stitzel. Development, validation and pilot field deployment of a custom mouthpiece for head impact measurement. Ann. Biomed. Eng. 47:2109–2121, 2019.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Rowson, S., E. T. Campolettano, S. M. Duma, B. Stemper, A. Shah, J. Harezlak, L. Riggen, J. P. Mihalik, A. Brooks, K. L. Cameron, S. J. Svoboda, M. N. Houston, T. McAllister, S. Broglio, and M. McCrea. Concussion risk between individual football players: survival analysis of recurrent events and non-events. Ann. Biomed. Eng. 48:2626–2638, 2020.

    Article  PubMed  Google Scholar 

  34. Schneider, D. K., R. Galloway, J. Bazarian, J. A. Diekfuss, J. Dudley, J. Leach, R. Mannix, T. M. Talavage, W. Yuan, and G. D. Myer. Diffusion tensor imaging in athletes sustaining repetitive head impacts: a systematic review of prospective studies. J. Neurotrauma. 36:2831–2849, 2019.

    Article  PubMed  Google Scholar 

  35. Siegmund, G. P., S. J. Bonin, J. F. Luck, and C. R. D. Bass. Validation of a skin-mounted sensor for measuring in-vivo head impacts. In: International IRCOBI Conference on the Biomechanics of Injury. Lyon, France, 2015, pp. 182–183.

  36. Swartz, E. E., J. L. Myers, S. B. Cook, K. M. Guskiewicz, M. S. Ferrara, R. C. Cantu, H. Chang, and S. P. Broglio. A helmetless-tackling intervention in American football for decreasing head impact exposure: a randomized controlled trial. J. Sci. Med. Sport. 22:1102–1107, 2019.

    Article  PubMed  Google Scholar 

  37. Thomson, E., K. Lamb, and C. Nicholas. The development of a reliable amateur boxing performance analysis template. J. Sports Sci. 31:516–528, 2013.

    Article  PubMed  Google Scholar 

  38. Wilcox, B. J., J. T. Machan, J. G. Beckwith, R. M. Greenwald, E. Burmeister, and J. J. Crisco. Head-impact mechanisms in men’s and women’s collegiate ice hockey. J. Athl. Train. 49:514–520, 2014.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Wu, L. C., C. Kuo, J. Loza, M. Kurt, K. Laksari, L. Z. Yanez, D. Senif, S. C. Anderson, L. E. Miller, and J. E. Urban. Detection of American football head impacts using biomechanical features and support vector machine classification. Sci. Rep. 8:855, 2017.

    Article  PubMed  PubMed Central  Google Scholar 

  40. 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  PubMed  Google Scholar 

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Authors and Affiliations

  1. Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand

    Enora Le Flao, Seth Lenetsky & Robert Borotkanics

  2. Department of Bioengineering, Stanford University, Stanford, CA, 94305, USA

    Enora Le Flao

  3. Canadian Sport Institute Pacific, Victoria, BC, Canada

    Seth Lenetsky

  4. MEA Forensic Engineers & Scientists, Laguna Hills, CA, USA

    Gunter P. Siegmund

  5. School of Kinesiology, University of British Columbia, Vancouver, Canada

    Gunter P. Siegmund

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  1. Enora Le Flao
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Correspondence to Enora Le Flao.

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GPS is a shareholder and director of MEA Forensic Engineers & Scientists, a forensic consulting company that may derive benefit from being involved in this study.

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Le Flao, E., Lenetsky, S., Siegmund, G.P. et al. Capturing Head Impacts in Boxing: A Video-Based Comparison of Three Wearable Sensors. Ann Biomed Eng 52, 270–281 (2024). https://doi.org/10.1007/s10439-023-03369-w

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