implementationofconcussiondetectinghelmets! · implementationofconcussiondetectinghelmets!!!!! by!!...

Implementation of Concussion Detecting Helmets

by

Elizabeth Dengler The Ohio State University 20 E. 14th Avenue, Apt H Columbus, Ohio 43210

(614) 579.2695 [email protected]

Prepared for Athletics Administration The Ohio State University

October 10, 2013

Abstract: The purpose of this proposal is to implement concussion-‐detecting helmets for football at The Ohio State University. Concussion-‐detecting helmets can help protect players of high-‐contact sports from future brain damage. When given appropriate time, a concussion can heal properly; however, when left untreated, they can have long-‐term effects. Players, coaches, and doctors can easily use the helmets without losing the protection and integrity of a helmet. The benefits of the helmets can be seen in the well being of student athletes and the image of the university.

Concussion-‐Detecting Helmets Dengler 2

Introduction Objective The proposal first describes a brief background of concussions and the NCAA. Next, it discusses the current NCAA system for concussion management and states the problem to be solved. A solution is then presented to decrease the amount of concussions that are left untreated, as well as provide better protection for players. The workings of the helmets are discussed along with two options for implementation. Benefits, qualifications, and a budget are included. Background Concussions have been a common injury in contact sports for many years. The Intercollegiate Athletic Association was founded in 1906 to “protect young people from the dangerous and exploitive athletics practices of the time” and the NCAA has acknowledged the dangers of concussions since 1933 [1]. However, not until 1994 did the NCAA implement guidelines for returning to play when exposed to concussions [1]. Concussions have long been overlooked as a serious medical problem by Athletic organizations, exposing athletes to harmful consequences. A research study conducted by the Journal of the American Medical Association in 2007 concluded that athletes require a full week before athletes return to normal levels after a concussion, but most players were withheld from competition for only five days or less [1]. Today, the NCAA is facing concussion related litigation brought by former athletes [1]. The guidelines in concussion management are not clearly defined, leaving significant room for various interpretations of policy. Figure 1 below shows the specific needs of the concussion management plan, as laid out by the NCAA. Current System The NCAA currently has a concussion management program for its participating institutions, as outlined in the Sports Medicine Handbook. In April 2010, the NCAA Executive Committee enacted a “policy that requires NCAA institutions to have a concussion management plan on file” [3]. The policy requires a student-‐athlete who may have a concussion to be removed from participation and evaluated by a healthcare provider with experience [3]. It also requires that student-‐athletes sign a waiver, recognizing it is his or her responsibility to report injuries [3]. Figure 1 below displays detailed guidelines demanded by the NCAA.


Figure 1: NCAA requirements for the concussion management plan at an institution [3].

The NCAA acknowledges that the magnitude of a concussion can be hard to determine. Suggestions are given regarding how to monitor student-‐athletes with concussions and it is stressed that such student-‐athletes are tested thoroughly before returning to action. The NCAA also implemented an Injury Surveillance System (ISS) to monitor injuries in collegiate athletics. The ISS is used to “provide current and reliable data on injury trends in intercollegiate athletics” [3]. This system is able to monitor the amount of reported concussions to ensure there is no significant change on a year-‐to-‐year basis. The current system contains specific guidelines for institutions; however, each individual institution determines interpretation of the guidelines. Concussion Problem Description There is a plethora of research on sports related concussions. A study published in the Journal of Athletic Training found “an estimated 300,000 sport-‐related traumatic brain injuries, predominantly concussions, occur annually in the United States” [2]. Furthermore, the likelihood of serious reoccurrence increases with each concussion [4]. Cumulative effects may result from repeated concussions, leaving student-‐athletes at risk of life-‐long problems [2]. A report published in JAMA investigated whether concussion history left a football player more vulnerable to repeat concussions. Table 1 below shoes the association between a history of concussion and the risk of the event of another concussion.


Table 1: Association between History of Concussion and the Risk of the Event of a Concussion [4].

From the Table 1, the rate of concussion rises from 3.7 percent to 12.7 percent based on the number of concussions sustained [4]. Players with a previous concussion were 3-‐times more likely to sustain another. Among players with in-‐season repeat concussions, 91.7 percent sustained the concussion within one day of the previous injury [4]. Table 2 shows the course of recovery based on history of concussion.

Table 2: "Length of Symptom Recovery in Players with Concussion by history of concussion" [4].

Players with a history of concussions experienced a longer recovery period than those without history, revealing the importance of monitoring the amount of concussions experienced by a player. According to the study published in JAMA, there may be a seven-‐to-‐ten day window of increased vulnerability to concussion [4]. Such repeated concussions lead to motor sequence learning impairments, which may be “an early and long-‐lasting manifestation of concussive injury” [8]. Furthermore, repeated concussions generate reduction of glutamate concentration levels, which are linked to motor function and cognitive behavior and affect the function of the brain [8]. Another negative outcome is chronic traumatic encephalopathy (CTE, see glossary for definition). This disease causes a build-‐up of the protein tau, which when experienced in excess causes harm to neurons in the brain, leading to dementias [11]. The implications of concussions result in declining quality of life for former athletes. Additionally, a clinical review conducted at Boston University reported data collected by the NCAA ISS of the frequency and rates of concussions. Table 3 below shows the rate by sport. Men’s football accounted for 11.6 percent of all injuries (when combining fall and spring). This figure is higher than all other sports, not including Women’s Ice Hockey, which has a smaller sample size [5].


Table 3: "Frequency and rates of concussion in NCAA from 1988 to 1989 through 2003 to 2004" [5].

The study also found that many concussions are unrecognized and thus unreported. Along with unreported concussions, many “coaches, athletic trainers, and other sports medicine professionals do not properly use current guidelines for concussion assessment and management” [5]. This poses a dangerous problem consequence, a problem that needs to be solved in order to protect student-‐athletes. Significance The significance of resolving the concussion guideline problem lies in the wellbeing of student-‐athletes and the image of the university. The institution has a right to protect its players, just as players have a right to act with honesty and integrity. However, in the heat of a game, it can be easy to overlook concussions. A player wants to help the team and coaches need the player to win. The university wants to win, as football is crucial revenue for the school. According to Forbes, The Ohio State University totaled the second most in football revenue in 2011-‐2012 with 58.1 million dollars [6]. With the concussion dilemma in the public eye, now is the best time to improve concussion-‐detecting policies. A review published in the British Journal of Sports Medicine demonstrated that “helmets do an excellent job at preventing traumatic head injuries” [7]. Improving helmets is a key area to start with reducing the


long-‐term harms of concussions. Therefore, a concussion management system must be implemented to clearly define concussions.

Proposed Program

Description The proposed solution for the concussion problem is introducing a concussion-‐detecting helmet for football players. The helmet will have an impact sensor and chip strap with a color-‐coded LED light system. The color of the light will correspond with the impact experienced. Figure 1 below shows an image of the product. The impact sensor will detect the force and duration of impact and feed the information to the chinstrap. If the impact was forceful enough to cause a concussion, the light on the chinstrap will turn from green to red. The impact sensor is programmed to determine an impact that could possibly cause a concussion. Figure 1 below shows a prototype of the product, revealing the location of the sensor and lighting system on the chinstrap.

Figure 2: Prototype of the concussion-‐detecting helmet. Source: www.sportsunlimitedinc.com.

Additionally, through a mobile application, medical staff can monitor the color of the chinstrap. The mobile application receives signals wirelessly from the helmets and can be run on any platform (Android, iPhone, iPad, and tablets). The application will show the color of each player’s chinstrap. If the chinstrap is red, this indicates the player is to be removed from the game for further medical evaluation. It is important to note that a red light does not mean a player has a concussion; it signals the impact force was strong enough to likely cause a concussion. Each helmet will include the impact sensor and lighting chinstrap already in place, and the downloadable mobile application. Battle Sports Science has developed a similar product with the IMPACT INDICATOR chinstrap for football players. The company found that about 50 percent of football-‐related concussions go undiagnosed; however, when a concussion is diagnosed and the player is rested properly, players’ return quicker [9]. Battle Sports Science IMPACT INDICATOR was tested at the Biomedical Engineering Laboratory at Wayne State University [9]. The concussion-‐detection helmet uses similar technology to the IMPACT INDICATOR and similar results are expected of the product. The key difference between the concussion-‐detection helmet and the IMPACT INDICATOR is the location of the impact sensor. In the helmets, the sensor is located in the helmet, detecting forces close to the brain, while the IMPACT INDICATOR uses a chinstrap. Therefore, the helmets are expected to be more accurate in predicting injury to the brain.


Benefits There are several benefits to the concussion-‐detecting helmets. Protection of Players

• The helmets will provide increased protection for players. Players will be relieved of their responsibility to report concussions. As stated earlier, players often attempt to hide concussions in order to continue to contribute to the team. With the new helmet, concussion reporting will be the responsibility of the helmet and medical staff monitoring the chinstrap light. A research article published by BioMed Central found that retired players experience increased risk of severe neurodegenerative conditions and “cognitive motor declines” [8]. Furthermore, research regarding the relationship between concussions and chronic traumatic encephalopathy (CTE) suggests that players exposed to multiple concussions without proper rest are more likely to develop CTE. Research suggests that CTE leads to depression, dementia, and even suicide [11]. In order to avoid long-‐term problems, implementing the helmets will provide players with better life experiences in the future.

Protection from future liability for the university

• The NCAA is currently facing lawsuits regarding brain damage due to concussions in former student-‐athletes and the National Football League recently settled a lawsuit for 765 million dollars regarding the same issue [10]. The helmet will protect the university from such liability, as it will allow medical staff to diagnose all concussions, not just obvious or reported traumas. Players will be aware of their concussions as well as educated (the NCAA has programs to educate players on concussions [3]); therefore, will have no basis for a lawsuit. The helmet can save the university millions in future concussion related expenses.

Improved image for the university

• In a time when the concussion issue is at the center of college sports, the helmet will give a great image for the university. The helmets will show initiative on the part of the university in protecting players. In turn, the public will view the university in a positive light resulting in the possibility of more fans, donations, and a positive atmosphere.

Qualifications & Experience

I am a current engineering student at The Ohio State University. I have experience working in the sports industry and have completed extensive research on the harms and frequency of concussions in football. The research stems from top sources such as the Journal of Athletic Training, JAMA, The NCAA Medical Handbook, and BioMed Central. These sources provided PhD level information into concussions. Furthermore, I have conducted research on similar products in order understand the workings of impact sensing technology.


Budget

Below is a planned budget for implementation of the helmets. The total cost to purchase 115 helmets is $51,750. One helmet will be supplied for each member of the team plus several extras for security purposes. There will be no shipping cost.

Helmet Impact Sensor Chinstrap Mobile App TOTAL Cost $300.00 $100.00 $50.00 $0.00 $450.00

Amount 115 115 115 1 115 TOTAL $34,500 $11,500 $5,750 $0.00 $51,750.00

Conclusion

In conclusion, the concussion-‐detecting helmet will provide much needed advancement regarding the crucial concussion problem in college sports. The helmet will benefit the Ohio State players, the university’s image, and the university’s finances. It will show forward progress and an excellent step toward increased quality of life in former football players. If the university finds success with the helmets, the product could be expanded across all high-‐contact sports. I thank you for your time and attention and would ask you to seriously consider implementing the helmets in your football program.


References [1] Markel, M. (2012). Technical communication. Boston, MA: Bedford/St. Martin’s, 2012, pp. 439-‐

465, 687-‐695.


APPENDIX 1: ANNOTATED BIBLIOGRAPHY [1] Travis Waldron. 2013. The NCAA’s History with Concussions: A Timeline [Online]. Available:

http://thinkprogress.org/sports/2013/07/23/2339571/ncaa-‐concussion-‐timeline/

This source contains a timeline of the NCAA’s action regarding concussions. It provides background

information on how concussions have been dealt with and what changes have been made. The

article is a good introduction into showing that, while progress has been made, there is still a large

concussion problem in the NCAA.

[2] Luke M. Gessel, BS, Sarah K. Fields, JD, PhD, Christy L. Collins, MA, Randall W. Dick, MS, FACSM, and

R. Dawn Cornstock, PhD. (2007, Oct.-‐Dec.). “Concussions Among United States High School and

Collegiate Athletes.” Journal of Athletic Training. [Online]. Vol. 42, pp. 495-‐503. Available:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2140075/ [Oct. 8, 2013].

[3] Sports Medicine Handbook, 23rd ed., The National Collegiate Athletic Association, Indianapolis, IN,

2012, pp. 53-‐59, 121-‐124.

The official NCAA Sports Medicine Handbook, this resource contains the regulations and

specifications required by the NCAA regarding medical topics in collegiate athletics. This includes

information on injury management, prevention, equipment requirements, and more. The

handbook provides the specific information regarding concussions that the NCAA acknowledges

and reveals areas that need improvement.

[4] Kevin M. Guskiewicz, Michael McCrea, Stephen W. Marshall, et al. (2010, Feb.). “Cumulative Effects

Associated With Recurrent Concussion in Collegiate Football Players: The NCAA Concussion

Study.” JAMA. [Online]. Vol. 290 (19). Available:

http://www.x2biosystems.com/files/JAMA_NCAA_Concussion_Study.pdf [Oct. 8, 2013].

The research review provides an in-‐depth look into effects of repeated concussions in college

football players. This information is crucial in showing that concussions are clearly a problem in


college sports. It supports the notion that there need to be more measures to protect players from

the harmful injury and it is not to be taken lightly.

[5] Daniel H. Daneshvar, Christopher J. Nowinski, Ann C. McKee, Robert C. Cantu. (2011). “The

Epidemiology of Sport-‐Related Concussion.” Clinic Sports Med. [Online]. Vol. 30. Available:

http://www.bu.edu/cste/files/2011/07/Daneshvar-‐et-‐al.-‐Epi-‐Sport-‐Concussion.-‐2011.pdf [Oct. 8,

2013].

The article contains information about the frequency of concussions in various sports. Football is

one of the featured sports in the article. The information gives readers a picture of the concussion

problem by revealing the amount of concussions that occur. It also contains information on the

amount of concussions that go unreported or undiagnosed, which is the main issue that the

product strive to correct.

[6] Alicia Jessop. (2013). The Economics of College Football: A Look At The Top-‐25 Teams’ Revenues And

Expenses [Online]. Available: http://www.forbes.com/sites/aliciajessop/2013/08/31/the-‐

economics-‐of-‐college-‐football-‐a-‐look-‐at-‐the-‐top-‐25-‐teams-‐revenues-‐and-‐expenses/ [Oct. 5, 2013].

[7] Andrew Stuart McIntosh, Thor Einar Andersen, Roald Bahr, Richard Greenwald, Svein Kleiven.

Michael Turner, Massimo Varese, Paul McCroy. (2011, Oct.). “Sports helmets now and in the

future.” British Journal of Sports Medicine. [Online]. Vol. 45. Pp. 1258-‐1265. Available:

http://bjsm.bmj.com/content/45/16/1258.full [Oct. 8, 2013].

[8] Louis De Beaumont, Sebastien Tremblay, Luke C. Henry, Judes Poirier, Maryse Lassonde, and Hugo

Theoret. (2013). “Motor system alterations in retired former athletes: the role of aging and

concussion history.” BioMed Central. [Online]. Vol. 13. Available:

http://www.biomedcentral.com/1471-‐2377/13/109 [Oct. 5, 2013].

This medical research review illustrates the effect concussions have on retired former athletes.

While it includes multiple sports, one of the main sports research was football and former football


players. This crucial in showing that concussions have long-‐term effects that reduce the quality of

life of the players.

[9] Battle Sports Science. (2011). Battle Sports Science, LLC [Online]. Available:

http://www.battlesportsscience.com/index.php [Oct. 5, 2013].

The website give information on a similar product, the IMPACT INDICATOR. The information

provides support to the new product, as it has already had success. It serves as a good comparison

as to how the helmet will work.

[10] Jeremy Fowler (2013). Plainiff list in NCAA concussion lawsuit growing, schools bracing. CBS Sports

[Online]. Available: http://www.cbssports.com/collegefootball/writer/jeremy-‐

fowler/23630356/ncaa-‐concussion-‐lawsuit-‐growing-‐plaintiff-‐list-‐schools-‐brace-‐for-‐scope-‐of-‐issue

[Oct. 6, 2013].

[11] Mark Fainaru-‐Wada and Steve Fainaru. “Head-‐on Collision.” ESPN The Magazine, vol. 16, no. 18,

pp. 33-‐42. Oct. 14, 2013.


APPENDIX 2: GLOSSARY OF TERMS

Term Definition Chronic traumatic encephalopathy (CTE)

A progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma. This trauma, which includes multiple concussions, triggers progressive degeneration of the brain tissue, including a build-‐up of an abnormal protein called tau. Source: http://www.sportslegacy.org/research/cte/

Concussion A concussion is type of traumatic brain injury that is caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull. Source: http://www.webmd,com/

Glutamate Acknowledged to be the most important transmitter for normal brain function. It is estimated that over half of all brain synapses release this agent. Elevated concentrations of extracellular glutamate, released as a result of neural injury, are toxic to neurons. Source: http://www.ncbi.nlm.nih.gov/books/NBK10807/

Injury Surveillance System (ISS)

The NCAA Injury Surveillance System Program was developed in 1982 to provide current and reliable data on injury trends in intercollegiate athletics. It collects injury and activity information in order to identify and highlight potential areas of concern and interest related to student-‐athlete health and safety. Source: NCAA Medical Handbook

Tau protein Protein that stabilizes microtubules. It is abundant in the central nervous system and less common elsewhere. When tau proteins are defective, and no longer stabilize microtubules properly, they can result in dementias, such as Alzheimer’s disease. Source: http://www.news-‐medical.net/health/Tau-‐Proteins-‐What-‐are-‐Tau-‐Proteins.aspx

implementationofconcussiondetectinghelmets! · implementationofconcussiondetectinghelmets!!!!! by!!...

Documents