Citation

Bartsch A, Rooks TF. Ann. Biomed. Eng. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s10439-023-03393-w

PMID

37926788

Abstract

PURPOSE: Historically, head impact monitoring sensors have suffered from single impact measurement errors, leading to their data described by clinical experts as 'clinically irrelevant.' The purpose of this study was to use an accurate impact monitoring mouthguard system and (1) define head impact distributions for military service members and civilians and (2) determine if there was a dose-response relationship between accurately measured head impact magnitudes versus observations of concussion signs.

METHODS: A laboratory-calibrated commercial impact monitoring mouthguard system, along with video and hardware to confirm the sensor was on the teeth during impacts, was used to acquire 54,602 head acceleration events (HAE) in 973 military and civilian subjects over 3,449 subject days.

RESULTS: There were 17,551 head impacts (32% of HAE) measured with peak linear acceleration (PLA) > 10 g and 37,051 low-g events (68% of HAE) in the range of activities of daily living < 10 g PLA. The median of all HAE and of all head impacts was 8 g/15 g PLA and 1 J/4 J Work, respectively. The top 1% of head impacts were above 47 g and 32 J, respectively. There were fifty-six (56) head impacts where at least one clinical indicator of a concussion sign was observed. All the clinical indicator impacts were in the top 1% by magnitude of PLA, Work, or both. The median magnitude of these 'check engine' impacts was 58 g and 48 J. This median magnitude was substantially larger than the median of all HAE as well as the median of all head impacts.

CONCLUSION: This study shows a correlation between single head impacts in the top 1% by peak linear acceleration and/or Work and clinical indicators of concussion signs in civilians and military service members.

Language: en

Keywords

Concussion; Clinical concussion signs; Head impact sensor; Impact monitoring mouthguard; TBI