Can research make sports safer? Researchers at the Wake Forest University School of Medicine’s Biomedical Engineering department have been studying head impacts in youth sports for more than 12 years to discover what is possible. In 2016, they started working with NC Fusion to collect head impact exposure data in youth soccer and have followed over 70 athletes from 11 teams over seven playing seasons from soccer clubs in the greater Winston-Salem, North Carolina, area.
“Atrium Health Wake Forest Baptist has been an incredible partner for NC Fusion in helping us fulfill our mission,” says Scott Wollaston, CEO of NC Fusion. “From the innovation and pioneering side of concussion research that we’ve been able to participate in, to the top notch athletic trainer services that have been provided to our athletes, and to the overall health based educational opportunities that improve the quality of our players’ and families’ lives, we are so thankful for the support of Atrium Health Wake Forest Baptist at NC Fusion.”
While following a team during a season, a member of the research team attends each practice and game. At the beginning of each session, the member of the research team activates and distributes mouthpiece-based sensors to each athlete in the study. The sensors will automatically detect and record head impacts experienced on field. During the season, the researcher at the field will record any relevant additional information about events occurring on the field. At the end of each season, players will return their mouthpieces to the researcher, and they download all the recorded data and review and process it in the lab.
Put Your Money Where Your Mouth Is
For every athlete that enrolls in one of the studies, researchers use an intraoral scanner to obtain a 3D scan of the athlete’s mouth. From the scan, they create custom-fit mouthpieces that contain an accelerometer and gyroscope. A member of the research team attends all practices and games and distributes the mouthpieces to the athletes.
The mouthpieces are configured to automatically record head impacts. For each head impact, the sensors inside the mouthpiece record information about how the head is moving, such as the linear acceleration or “g force” and the speed of head rotation. This information is an estimate of how “hard” a particular impact is. All of the data collected on-field is downloaded, processed and reviewed in the lab.
The study team reviews film of each practice and game to confirm that each event recorded by the mouthpiece is associated with a real head impact. They also categorize the type of impact, like header or player-to-player collision and add any other contextual information, such as if the impact happened during a corner kick or as the player was jumping, or if the impact was to the side of the head. At the end of a season, they have an estimate of the frequency and magnitude of head impacts experienced by each player in the study.
Measuring Impacts
As the study team has done in their previous youth sports research, they use the information they collect to answer specific research questions they might have about how techniques and practice skills might be modified to reduce head impact exposure. They also analyze variations of impacts, such as how header magnitudes during corner kick drills compare to other types of drills.
They then combine the data recorded by the mouthpieces with other computational tools to learn more about what is happening to the brain during these impacts. For example, they can use the head motion data recorded by the mouthpieces to simulate the impact using a computer model of the head and brain to estimate how much the brain is moving or stretching during the impact.
“Our collaborative work with NC Fusion will include further engagement with parents, coaches and organizational leaders to translate our research findings into practical strategies that improve the safety and health benefits of soccer,” says Jillian Urban, assistant professor of biomedical engineering.
The research team has remained connected with NC Fusion leadership to communicate research findings and discuss opportunities for future collaboration. In addition to season-long data collection efforts, NC Fusion assisted in recruiting players for a laboratory study in collaboration with Dr. Kristen Nicholson to utilize motion capture technology to assess relationships between heading technique and header impact magnitude.
