Characterization of Concussive Events in Professional American Football Using Videogrammetry.

Sports concussions offer a unique opportunity to study head kinematics associated with mild traumatic brain injury. In this study, a model-based image matching (MBIM) approach was employed to analyze video footage of 57 concussions which occurred in National Football League (NFL) games. By utilizing at least two camera views, higher frame rate footage (> 60 images s-1), and laser scans of the field and helmets involved in each case, it was possible to calculate the change in velocity of the helmet during impact in six degrees of freedom. The average impact velocity for these concussive events was 8.9 ± 2.0 m s-1. The average changes in translational and rotational velocity for the concussed players' helmets were 6.6 ± 2.1 m s-1 and 29 ± 13 rad s-1, respectively. The average change in translational velocity was higher for helmet-to-ground (n = 16) impacts compared to helmet-to-helmet (n = 30) or helmet-to-shoulder (n = 11) events (p < 0.001), while helmet-to-shoulder impacts had a smaller change in rotational velocity compared to the other impact sources (p < 0.001). By quantifying the impact velocities and locations associated with concussive impacts in professional American football, this study provides information that may be used to improve upon current helmet testing methodologies.

Position-Specific Circumstances of Concussions in the NFL: Toward the Development of Position-Specific Helmets.

Consideration of position-specific features of the NFL concussion environment could enable improved risk mitigation through the design of position-specific helmets to improve self-protection as well as protection for the other player with whom the contact occurs. The purpose of this paper is to quantify position-specific features of scenarios resulting in concussions to NFL players, and the players they contact, by reviewing all game footage (broadcast and non-broadcast) over 4 seasons. Position-specific features were documented for 647 concussions in which a primary exposure could be visualized, including impact source, helmet impact location, activity, and the other player with whom the contact occurred. Findings include the over-representation of helmet-to-ground impacts to the rear of the quarterback's helmet, the high frequency of impacts to the side (upper) location of both concussed players and the players they contacted regardless of position, and distinct differences in the circumstances of concussions to cornerbacks and safeties. The study shows that some features of concussion scenarios are common to all positions, but several position-specific features exist and can inform the design of position-specific helmets for NFL players.

Video Analysis of Reported Concussion Events in the National Football League During the 2015-2016 and 2016-2017 Seasons.

BACKGROUND: Concussions in American football remain a high priority of sports injury prevention programs. Detailed video review provides important information on causation, the outcomes of rule changes, and guidance on future injury prevention strategies. PURPOSE: Documentation of concussions sustained in National Football League games played during the 2015-2016 and 2016-2017 seasons, including consideration of video views unavailable to the public. STUDY DESIGN: Descriptive epidemiology study. METHODS: All reported concussions were reviewed with all available video footage. Standardized terminology and associated definitions were developed to describe and categorize the details of each concussion. RESULTS: Cornerbacks sustained the most concussions, followed by wide receivers, then linebackers and offensive linemen. Half (50%) of concussions occurred during a passing play, 28% during a rushing play, and 21% on a punt or kickoff. Tackling was found to be the most common activity of concussed players, with the side of the helmet the most common helmet impact location. The distribution of helmet impact source-the object that contacted the concussed player's helmet-differed from studies of earlier seasons, with a higher proportion of helmet-to-body impacts (particularly shoulder) and helmet-to-ground impacts and with a lower proportion of helmet-to-helmet impacts. Helmet-to-ground concussive impacts were notable for the high prevalence of impacts to the back of the helmet and their frequency during passing plays. CONCLUSION: Concussion causation scenarios in the National Football League have changed over time. CLINICAL RELEVANCE: The results of this study suggest the need for expanded evaluation of concussion countermeasures beyond solely helmet-to-helmet test systems, including consideration of impacts with the ground and with the body of the opposing player. It also suggests the possibility of position-specific countermeasures as part of an ongoing effort to improve safety.

Rear-facing versus forward-facing child restraints: an updated assessment.

OBJECTIVES: The National Highway Traffic Safety Administration and the American Academy of Pediatrics recommend children be placed in rear-facing child restraint systems (RFCRS) until at least age 2. These recommendations are based on laboratory biomechanical tests and field data analyses. Due to concerns raised by an independent researcher, we re-evaluated the field evidence in favour of RFCRS using the National Automotive Sampling System Crashworthiness Data System (NASS-CDS) database. METHODS: Children aged 0 or 1 year old (0-23 months) riding in either rear-facing or forward-facing child restraint systems (FFCRS) were selected from the NASS-CDS database, and injury rates were compared by seat orientation using survey-weighted χ2 tests. In order to compare with previous work, we analysed NASS-CDS years 1988-2003, and then updated the analyses to include all available data using NASS-CDS years 1988-2015. RESULTS: Years 1988-2015 of NASS-CDS contained 1107 children aged 0 or 1 year old meeting inclusion criteria, with 47 of these children sustaining injuries with Injury Severity Score of at least 9. Both 0-year-old and 1-year-old children in RFCRS had lower rates of injury than children in FFCRS, but the available sample size was too small for reasonable statistical power or to allow meaningful regression controlling for covariates. CONCLUSIONS: Non-US field data and laboratory tests support the recommendation that children be kept in RFCRS for as long as possible, but the US NASS-CDS field data are too limited to serve as a strong statistical basis for these recommendations.

Development of a frontal small overlap crashworthiness evaluation test.

OBJECTIVES: Small overlap frontal crashes are those in which crash forces are applied outboard of the vehicle's longitudinal frame rails. In-depth analyses of crashes indicate that such crashes account for a significant proportion of frontal crashes with seriously injured occupants. The objective of this research was to evaluate possible barrier crash tests that could be used to evaluate the crashworthiness of vehicles across a spectrum of small overlap crash types. METHODS: Sixteen full-scale vehicle tests were conducted using 3 midsize passenger vehicles in up to 6 different test configurations, including vehicle-to-vehicle and barrier tests. All vehicles were tested at 64 km/h with an instrumented Hybrid III midsize male driver dummy. RESULTS: All test configurations resulted in primary loading of the wheel, suspension system, and hinge pillar. Vehicles underwent substantial lateral movement during the crash, which varied by crash configuration. The occupant compartments had significant intrusion, particularly to the most outboard structures. Inboard movement of the steering wheel in combination with outboard movement of the dummies (due to the lateral vehicle motion) caused limited interaction with the frontal air bag in most cases. CONCLUSIONS: When assessing overall crashworthiness (based on injury measures, structural deformation, and occupant kinematics), one vehicle had superior performance in each crash configuration. This was confirmation that the countermeasures benefiting performance in a single small overlap test also will provide a benefit in other crash configurations. Based on these test results, the Insurance Institute for Highway Safety has developed a small overlap crashworthiness evaluation with the following characteristics: a rigid flat barrier with a 150-mm corner radius, 25 percent overlap, 64 km/h test speed, and a Hybrid III midsize male driver dummy.

Comparison of Hybrid III and THOR dummies in paired small overlap tests.

The Insurance Institute for Highway Safety (IIHS) is investigating small overlap crash test procedures for a possible consumer information program. Analysis of real-world small overlap crashes found a strong relationship between serious head and chest injuries and occupant compartment intrusion. The main sources of serious head injuries were from the A-pillar, dash panel, or door structure, suggesting head trajectories forward and outboard possibly bypassing the airbag. Chest injuries mainly were from steering wheel intrusion and seat belt loading. In developing this program, two test dummies were evaluated for predicting occupant injury risk: midsize male Hybrid III and THOR. In the collinear small overlap crash tests conducted here, results from the two dummies were similar. Both predicted a low risk of injury to the head and chest and sometimes a high risk of injury to the lower extremities. Head and torso kinematics also were similar between dummies. Other test scenarios might show larger differences between the dummies.

Front air bag nondeployments in frontal crashes fatal to drivers or right-front passengers.

OBJECTIVE: Public concern has arisen about the reliability of front air bags because Fatality Analysis Reporting System (FARS) data indicate many nondeployed air bags in fatal frontal crashes. However, the accuracy of air bag deployment, the variable in question, is uncertain. This study aimed to provide more certain estimates of nondeployment incidence in fatal frontal crashes. METHODS: Fatally injured passenger vehicle drivers and right-front passengers in frontal crashes were identified in two U.S. databases for calendar years 1998-2006 and model years 1994-2006: FARS, a census of police-reported fatal crashes on public roads, and National Automotive Sampling System/Crashworthiness Data System (NASS/CDS), a probability sample of tow-away crashes. NASS/CDS contains subsets of fatal crashes in FARS and collects detailed data using crash investigators. Front air bag deployment coding for front-seat occupant fatalities was compared in FARS and NASS/CDS, and case reviews were conducted. RESULTS: Among FARS frontal deaths with available deployment status (N = 43,169), front air bags were coded as not deployed for 18 percent of front occupants. In comparison, NASS/CDS (N = 628) reported 9 percent (weighted estimate) nondeployment among front occupants killed. Among crashes common to both databases, NASS/CDS reported deployments for 45 percent of front occupant deaths for which FARS had coded nondeployments. Detailed case reviews of NASS/CDS crashes indicated highly accurate coding for deployment status. Based on this case review, 8 percent (weighted estimate) of front occupant deaths in frontal crashes appeared to involve air bag nondeployments; 1-2 percent of front occupant deaths represented potential system failures where deployments would have been expected. Air bag deployments appeared unwarranted in most nondeployments based on crash characteristics. DISCUSSION: FARS data overstate the magnitude of the problem of air bag deployment failures; steps should be taken to improve coding. There are inherent uncertainties in judgments about whether or not air bags would be expected to deploy in some crashes. Continued monitoring of air bag performance is warranted.

Evaluation of the static belt fit provided by belt-positioning booster seats.

Belt-positioning booster seats are recommended for children who use vehicle seat belts as primary restraints but who are too small to obtain good belt fit. Previous research has shown that belt-positioning boosters reduce injury risk, but the belt fit produced by the wide range of boosters in the US market has not previously been assessed. The present study describes the development of a method for quantifying static belt fit with a Hybrid-III 6-year-old test dummy. The measurement method was applied in a laboratory seat mockup to 31 boosters (10 in both backless and highback modes) across a range of belt geometries obtained from in-vehicle measurements. Belt fit varied widely across boosters. Backless boosters generally produced better lap belt fit than highback boosters, largely because adding the back component moved the dummy forward with respect to the lap belt routing guides. However, highback boosters produced more consistent shoulder belt fit because of the presence of belt routing guides near the shoulder. Some boosters performed well on both lap belt and shoulder belt fit. Lap belt fit in dedicated boosters was generally better than in combination restraints that also can be used with an integrated harness. Results demonstrate that certain booster design features produce better belt fit across a wide range of belt geometries. Lap belt guides that hold the belt down, rather than up, and shoulder belt guides integrated into the booster backrest provided better belt fit.

Factors leading to crash fatalities to children in child restraints.

Efforts to improve child restraint designs would benefit from more detailed information on how child occupants are dying in crashes. Detailed reports involving 92 children (ages 5 and younger) in child restraints who died in crashes in 2000 were obtained from police departments. Cases were reviewed to obtain basic crash information and determine the factor most responsible for the fatality. Half of the crashes were considered unsurvivable for the child, and 12 percent of fatalities were judged to result from gross misuse of the child restraint. Forty percent of all of the crashes were side impacts, and in all fatal side impact crashes there was intrusion at the child's seating position.