Sport- and Gender-Based Differences in Head Impact Exposure and Mechanism in High School Sports

• Authors: Colin M Huber, University of Pennsylvania; Declan A Patton, Childrens Hospital of Philadelphia; Catherine C McDonald, Childrens Hospital of Philadelphia; Divya Jain, University of Pennsylvania; Katherine Simms, University of Pennsylvania; Valerie A Lallo, Childrens Hospital of Philadelphia; Susan Margulies, Emory University; Christina L Master, Childrens Hospital of Philadelphia; Kristy B Arbogast, Childrens Hospital of Philadelphia
• Journal Title: ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE
• Volume: Volume 9, Number 3
• Publisher: SAGE PUBLICATIONS INC | 2021-03-01, Pages 2325967120984423-2325967120984423
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1177/2325967120984423
• Subjects: Engineering, Biomedical; Health Sciences, Public Health
• Keywords: Science & Technology; Life Sciences & Biomedicine; Orthopedics; Sport Sciences; head injuries; concussion; pediatric sports medicine; injury prevention; football (soccer); basketball; lacrosse

Abstract

Background: Repeated head impacts sustained by athletes have been linked to short-term neurophysiologic deficits; thus, there is growing concern about the number of head impacts sustained in sports. Accurate head impact exposure data obtained via head impact sensors may help identify appropriate strategies across sports and between genders to mitigate repetitive head impacts. Purpose: To quantify sport- and gender-based differences in head impact rate and mechanism for adolescents. Study Design: Cohort study; Level of evidence, 2. Methods: High school female and male varsity soccer, basketball, lacrosse, and field hockey (female only) teams were instrumented with headband-mounted impact sensors during games over 2 seasons of soccer and 1 season of basketball, lacrosse, and field hockey. Video review was used to remove false-positive sensor-recorded events, and the head impact rate per athlete-exposure (AE) was calculated. Impact mechanism was categorized as equipment to head, fall, player to head, or head to ball (soccer only). Results: Male players had significantly higher head impact rates as compared with female players in soccer (3.08 vs 1.41 impacts/AE; rate ratio, 2.2 [95% CI, 1.8-2.6]), basketball (0.90 vs 0.25; 3.6 [2.6-4.6]), and lacrosse (0.83 vs 0.06; 12.9 [10.1-15.8]). Impact mechanism distributions were similar within sports between boys and girls. In soccer, head to ball represented 78% of impacts, whereas at least 88% in basketball were player-to-player contact. Conclusion: Across sports for boys and girls, soccer had the highest impact rate. Male high school soccer, basketball, and lacrosse teams had significantly higher head impact rates than did female teams of the same sport. For girls, basketball had a higher head impact rate than did lacrosse and field hockey, and for boys, basketball had a similar impact rate to lacrosse, a collision sport. Sport differences in the distribution of impact mechanisms create sport-specific targets for reducing head impact exposure.