Citation

Swartz EE, Mihalik JP, Beltz N, Day M, Decoster LC. Spine J. 2014; 14(6): 996-1004.

Affiliation

Clinical Coordinator, Athletic Training Education Program, University of New Hampshire, 124 Main St., Durham, NH. Electronic address: eswartz@unh.edu.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.spinee.2013.10.032

PMID

24216399

Abstract

BACKGROUND CONTEXT: In cases of possible cervical spine injury, medical professionals must be prepared to achieve rapid airway access while concurrently restricting cervical spine motion. Facemask removal, rather than helmet removal, is recommended to achieve this. However, no studies have been reported that directly compared facemask removal to helmet removal. PURPOSE: To compare motion, time, and perceived difficulty in two commonly used American football helmets 1) between facemask removal and helmet removal techniques, and 2) when helmet air bladders were deflated prior to helmet removal compared to inflated scenarios. STUDY DESIGN/SETTING: Repeated measures. Controlled laboratory. PARTICIPANTS: Twenty-two certified athletic trainers (15 males, 7 females; age=33.9±10.5 yrs; experience=11.4±10.0 yrs; height=172±9.4 cm; mass=76.7±14.9 kg). All participants were free from upper extremity or central nervous system pathology for 6 months and provided informed consent. OUTCOME MEASURES: Dependent variables included head excursion in degrees (computed by subtracting minimum position from maximum position) in each of the three planes (sagittal, frontal, transverse), time to complete the required task, and ratings of perceived exertion. To address our study purposes, we employed 2x2 repeated measures ANOVA (removal technique x helmet type; helmet type x deflation status) for each dependent variable. METHODS: Independent variables consisted of removal technique (facemask removal-FMR, helmet removal-HR), helmet type (Riddell Revolution IQ-RIQ, VSR4), and helmet deflation status (deflated-D, inflated-I). After familiarization, participants conducted 2 successful trials for each of six conditions in random order (RIQ-FMR; VSR4-FMR; RIQ-HR-D; VSR4-HR-D; RIQ-HR-I; VSR4-HR-I). Facemasks, helmets, and shoulder pads were removed from a live model wearing a properly fitted helmet and shoulder pads. The participant and an investigator stabilized the model's head. A six-camera three-dimensional motion system, and a three-point one-segment marker set were used to record motion of the head. RESULTS: Facemask removal resulted in less motion in all three planes, required less completion time, and was easier to perform than helmet removal. The RIQ helmet resulted in less frontal plane motion, less time to task completion, and was easier to remove than VSR4 helmets. Inflated helmets-regardless of helmet type-required less removal time, but did not result in greater cervical spine motion or difficulty. CONCLUSIONS: It is safer to remove the facemask in the prehospital setting for the potential spine-injured American football player than to remove the helmet, based on results from both a traditional and newer football helmet designs. Deflating the air bladder inside the helmet does not provide an advantage.

Language: en