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Evaluation of impact attenuation of facial protectors in ice hockey helmets

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The purpose of this study was to investigate the extent to which ice hockey facial protectors can decrease overall head acceleration during blunt impacts, as well as to identify whether attenuation differences exist between visors and cages. Commercial models of three cages and three visors were assessed. Blunt impacts were simulated, permitting the measurement of peak accelerations (PA) within the surrogate headform. Results indicated that face protectors, in combination with helmets, substantially reduced PA during blunt impacts within threshold safety limits (below 300g). In general, cages showed lower PA than visors. Differences between models were also observed during repeated impacts and impact site. In conclusion, this study demonstrates that facial protectors function beyond their role in solely preventing facial injuries, complementing the role of the helmet in attenuating head deceleration during impact. Consequently, the utilisation of facial protectors may reduce the severity and incidence of head injuries.
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© 2007
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Sports Engineering (2007) 10, 65–74 65
Introduction
In addition to skating and stick skills, ice hockey
involves numerous collisions between players and the
environment; hence, the game involves an inherent
risk of injury. In leagues permitting body checking,
previous epidemiological studies have shown that the
head and neck have consistently ranked as two of the
most commonly injured body sites, followed by the
knee, shoulder, hip/thigh/groin, and hands/fingers
(Azuelos et al., 2004). More specific studies on head
injuries in ice hockey reported that concussions (or
mild traumatic brain injuries, mTBI) account for
between 2% and 14% of all hockey-related injuries,
and between 15% and 30% of all hockey-related head
injuries (Goodman et al., 2001). More recently, Flik
and colleagues (2005) reported that head injuries in ice
hockey represent up to 20% of all trauma. In short,
concussions form a substantial and persistent problem
in ice hockey that has acute and long-term conse-
quences for the health of the players (Biasca et al.,
2002; Flik et al., 2005; Goodman et al., 2001).
Correspondence address:
David Pearsall
Department of Kinesiology & Physical Education
McGill University, 475 Pine Avenue West
Montréal, Québec, Canada H2W 1S4
Tel: 001 514 398 4184, extension 09976
Fax: 001 514 398 4186
E-mail: david.pearsall@mcgill.ca
Evaluation of impact attenuation of facial protectors
in ice hockey helmets
M. Lemair and D.J. Pearsall
Department of Kinesiology & Physical Education, McGill University, Montréal, Québec, Canada
Abstract
The purpose of this study was to investigate the extent to which ice hockey facial protectors can
decrease overall head acceleration during blunt impacts, as well as to identify whether attenua-
tion differences exist between visors and cages. Commercial models of three cages and three
visors were assessed. Blunt impacts were simulated, permitting the measurement of peak acceler-
ations (PA) within the surrogate headform. Results indicated that face protectors, in combination
with helmets, substantially reduced PA during blunt impacts within threshold safety limits
(below 300g). In general, cages showed lower PA than visors. Differences between models were
also observed during repeated impacts and impact site. In conclusion, this study demonstrates
that facial protectors function beyond their role in solely preventing facial injuries, complement-
ing the role of the helmet in attenuating head deceleration during impact. Consequently, the
utilisation of facial protectors may reduce the severity and incidence of head injuries.
Keywords: helmets, impact, facial protection, ice hockey
10.2.1 Sports F73 30/8/07 16:48 Page 65
To address this specific concern, the wearing of
helmets (covering the cranial skull of a player’s head) is
obligatory in competitive contact ice hockey leagues.
Helmets are designed to diminish the magnitude of
impact forces during collisions by distributing the
contact load over a wider area of the cranium and by
means of an energy-absorbing liner system.
Manufactured helmets must pass safety standard
guidelines such as ASTM International F1045-04 or
NOCSAE DOC 001-04m05 standards for certifica-
tion. Typically, these standardised tests involve
controlled-impact simulations of surrogate headforms
with helmets to assess impact attenuation gains (as
quantified by reduced peak headform acceleration). In
most contact sports, the intervention of helmets has
reduced the severity of head injuries.
The potential to reduce concussion incidence by
wearing facial protectors in conjunction with helmets
has been proposed (Biasca et al., 2002). Some prospec-
tive cohort studies have been conducted to investigate
this possibility. For instance, Benson et al. (1999)
monitored the number of head or neck injuries
sustained among intercollegiate players wearing full-
face shields compared to those wearing half-face
shields. They found no evidence to support specula-
tion that the full-face shield increases a player’s risk of
sustaining a neck injury or concussion. In a later study,
Benson et al. (2002) reported on concussion incidence
rates in ice hockey. Independent of prior injury
history, position played and experience, the half-face
shield players lost a greater amount of times than full-
face shield players (average of 3.29 sessions per
concussion versus 1.70, respectively). In a similar
prospective study by Stuart and colleagues (2002),
athletes were monitored within competitive junior A
league where none, partial and full facial protection
was allowed. Stuart et al. observed that players wearing
no facial protection were injured at a rate more than
twice that of players wearing partial protection and
almost seven times more than players wearing full
facial protection. Therefore, full-face guards were
found to provide almost a 5-fold reduction of eye
injury incidences and a rate of concussion reduced
from 12.2 to 2.9 concussions per 1000 players’ hours,
compared to no facial protection. Similarly, in a review
of concussion frequency in the NHL during the
2001–2002 season (Stevens et al., 2006), the use of
visors was not shown to significantly affect the preva-
lence of concussion, though other head and face
injuries were minimised. Hence, these studies suggest
that the use of facial protectors decreases, at least, the
severity and, at most, the rate of head injuries.
The dynamics of impact at an incident vector
towards the face in terms of net head acceleration is
not well understood with respect to concussion events,
let alone the intervening effects of facial protectors in
combination with helmets. Thus, the purpose of this
project was to determine:
1 if facial protectors can attenuate head acceleration
within acceptable limits (i.e. below 300g) during
blunt facial collisions
2 if acceleration attenuation differs between cages
and visor facial protectors conjoined with ice
hockey helmets
3 if helmet liner materials (vinyl nitryl, VN, or
expanded polypropylene, EPP) significantly modify
the above responses.
Materials and methods
Materials
Six models of commercial ice hockey facial protectors
were evaluated: three full-face shields (cages) and
three half-face shields (visors) (Fig. 1). The cage
models included the Bauer Nike FM8500, Itech FM
480 and the CCM RBE VIII. The visor models
included the Bauer Nike FM1000, Itech HLC and the
Oakley Aviator. Four samples of each model were
tested for each condition as described below (see
‘Procedure’). During testing, all facial protectors were
mounted on a common reference ice hockey helmet
model (medium NBH8500). In addition to the above,
two separate liners covering the inside of the ice
hockey helmet were evaluated: VN and EPP foams.
A drop rig monorail guide assembly (specifications
according ASTM F1045-04 standards; Fig. 2) was
used to control the free drop height and direction of
the headform mounted with the helmet and facial
protector. A full-facial NOCSAE headform (DOC
001-04m05 standard) was attached to the armature of
the drop rig monorail guide. The headform’s orienta-
tion was adjustable, allowing impacts to be delivered
to any point on the helmet or the facial protector.
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Impact attenuation of facial protectors in ice hockey helmets M. Lemair and D.J. Pearsall
10.2.1 Sports F73 30/8/07 16:48 Page 66
© 2007
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Sports Engineering (2007) 10, 65–74 67
M. Lemair and D.J. Pearsall Impact attenuation of facial protectors in ice hockey helmets
Figure 1 Models of facial protectors evaluated
(a) NBH FM8055 (d) Oakley Aviator
(b) CCM RBE VIII (e) NBH FM1000
(c) Itech FM480 (f) Itech HCL
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Impact attenuation of facial protectors in ice hockey helmets M. Lemair and D.J. Pearsall
Headforms with approximate facial geometry were
essential to assess the cages and visors, since the latter
are designed to function around the former. The
medium-size headform (head circumference of
578 mm) was used during impact testing. The
combined mass of the assembly (headform and
armature) was 6.98 kg. Within the headform, a tri-
axial accelerometer (±500g) was mounted at its centre
of mass. An analogue/digital data acquisition card
(Cadex Inc. version 4.6) was used to record and
condition the output acceleration signals (frequency
range 0–1000 Hz with a ±1.5% variance; sampling
rate 10 kHz; filtering acquisition use 1000 Hz). From
this data, peak acceleration (PA) and Gadd Severity
Index (GSI) scores could be obtained from each
impact. All tests were conducted at ambient room
temperature (20 ± 2°C) and relative humidity of 55%.
The impact surface was a flat steel anvil that was
supported on a rigid, concrete foundation.
Figure 2 Monorial drop rig tester; headform and steel anvil.
Procedure
The testing protocol followed the ASTM F1045-04
standard using the NOCSAE headform. Facial pro-
tectors and helmets were positioned on the headform
(attached to the armature and guide rail) then dropped
77 ± 1 cm in order to achieve a pre-impact kinetic
energy of 45 ± 3 J. During impact, acceleration
measures were recorded over a 20 ms window.
Helmet positioning and tightness were checked
before each impact test. The helmet’s ear aperture was
aligned concentrically with the headform’s index ear
holes and the helmet’s front rim was positioned along
a pre-measured line on the headform forehead (5 cm
above the basic plane). By re-orienting the headform
on the drop rig’s armature, each helmet and facial
protector were impacted at four different sites (Fig. 3)
including:
1 the crown (C) of helmet (the intersection of the
mid-sagittal and the coronal planes); the crown was
used as a reference impact site to compare direct
helmet to direct facial protector impacts;
2 the front (F) of the facial protector (located at the
intersection of the basic plane and the coronal plane);
3 at 45º to the front boss (FB45) of the facial protector
(located on the basic plane at a 45° angle from the
coronal plane); impact was on the left cheek; and,
4 the J clip (JCL) of the helmet (located on the basic
plane at the approximate intersection of the basic
plane and the mid-sagittal plane). The J clip
(shaped in the form of a ‘J’) secures the facial
protector to the side of the helmet. Impacts were
done on the left ear side of the headform.
Before impact, the headform was oriented to impact
the designated site. Then, the helmet and the facial
protector were mounted on the headform. Therefore,
impacts were conducted with respect to the reference
lines on the headform. Prior to each drop test, the
helmet was adjusted on the headform. Each site was
impacted three times with 1-minute intervals between
tests. Both new samples of helmet and facial protec-
tors were used for each site-specific test, so as to avoid
potential cumulative damage effect.
In addition to the above, prior to each test the face
of the headform was covered with a 1 mm-thick
coating of white contact paste. After impacts, if face
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© 2007
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Sports Engineering (2007) 10, 65–74 69
contact occurred, the extent and location of contact
could be identified by paste marks transferred either
to the facial protector and/or the steel anvil. Finally, as
a visual log of collisions, F impacts were filmed using a
high-speed video camera (TroubleShooter, Fastec
Imaging Inc.) at 1000 frames s–1. The camera was
positioned lateral and perpendicular to the monorail’s
drop plane. Subsequent analysis permitted the linear
kinematics of headform and facial protector to be cal-
culated. Specifically, the amount of deformation
(linear compression) of the headform’s facial structure
(nose) was measured. This was accomplished by
tracking the change in relative displacements between
the facial cheek and nose tip using motion measure-
ment software of the scaled digital images.
Data analysis
With a standard reference helmet (NBH8500) lined
with VN foam, peak acceleration (PA) was evaluated
with respect to the independent variables (model, site,
repeated impacts) by means of a 3-way ANOVA:
PA = model6×site3×repeat impact3
Three samples of models were tested. For two helmet
models, the effects of two different liner materials
(EPP, VN) were assessed using a 4-way ANOVA:
PA = model2×site3×repeat impact3×foam2
Five samples of models and liner foam were tested.
Statistical analyses were performed with Statistica
(6.0, GLM & Post Hoc tests). Significant differences
were evaluated at αlevel of 0.05. Given that the intent
is not to endorse nor denigrate particular products, in
the following results specific name brands will not be
cited. Instead, they will be referred to as cage A, B, C
and visor A, B, C (in no particular order).
Results
For direct helmet impacts (C site), PA was lower for
VN-lined ice hockey helmets than for EPP (Fig. 4,
p< 0.001). PA for VN liners ranged from 75gto 110g,
whereas PA for EPP liners ranged from 90gto 130g.
The wide range of PA was dependent on the repeated
impact sequence (p= 0.028). The general trend
observed was that the PA increased progressively from
the first to third impacts. Significant differences
between the first and the third impacts were calculated
(p= 0.036). However, for impacts direct at the facial
protectors (F, FB45, JCL), the type of helmet liner had
no significant effect (p= 0.39, Fig. 5).
Nonetheless, as will be shown in the following
results (irrespective of helmet liner), use of cages and
visors demonstrated substantial and significant reduc-
tions in PA. To put in perspective the magnitude of the
effects introduced, note that from several pre-testing F
impacts of the uncovered headform, PA values ranged
from 380gto 420g, whereas with the use of an ice
hockey helmet alone, PA were reduced to between
100gand 130g. Furthermore, with the attachment of a
face protector, PA were further reduced from 10gto
100g. The following results will provide specific details
on influence models, site and repeated impacts on PA.
M. Lemair and D.J. Pearsall Impact attenuation of facial protectors in ice hockey helmets
Figure 3 Impact location sites.
(a) Top view
(b) Side view
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70 Sports Engineering (2007) 10, 65–74 © 2007
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Impact attenuation of facial protectors in ice hockey helmets M. Lemair and D.J. Pearsall
Liner
VNEPP
*EPP, VN (p < 0.001)
*1st impact, 3rd impact (p = 0.036)
One
Two
Three
0
20
40
60
80
Peak acceleration (g)
100
120
140
*Cage A, Visor A (p = 0.009)
*Front, FB45 (p = 0.029)
*Front, JCL (p = 0.006)
Front
EPP VN
Visor A
Liner, facial protector
EPP VN
Cage A
FB45
JCL
0
20
40
60
80
Peak acceleration (g)
100
120
140
160
180
200
Cage A Cage B Cage C Visor A
Facial protector
Visor B Visor C
*Cage A, Cage C at 3rd impact (p<0.012)
One
Two
Three
0
20
–20
40
60
80
Peak acceleration (g)
100
120
140
Figure 4 Peak acceleration (g) for crown impacts at third impact.
Figure 5 Peak acceleration
(g) as a function of helmet
liner and impact site for
third impact.
Figure 6 Peak acceleration (g)
as a function of impact
number and front impact site.
10.2.1 Sports F73 30/8/07 16:48 Page 70
The type of facial protector model tested affected
PA (p= 0.004). In general, PA was lower for cages than
for visors (Figs. 5–6). There were no significant differ-
ences between the three cage models, but visor C
showed significantly lower PA than visors A and B
(p= 0.00072 and 0.00081, respectively).
By impact sites, PA was lowest at F and highest at
the JCL sites (Fig. 7). Significant differences were
noted between impact sites (F > FB45, p= 0.016;
F > JCL, p= 0.0001; JCL > FB45, p= 0.0001).
Repeated impacts significantly increased PA with each
consecutive test (i.e. 1st < 2nd, 1st < 3rd, p= 0.0001;
2nd < 3rd, p= 0.021).
Interactions were identified for specific models and
sites (Table 1); for instance, cages A and C were signif-
icantly different (p= 0.0128) at the third impact. In
addition, visor C was significantly different from
visors A and B (p= 0.0001 and p= 0.019) at FB45.
Cages A and C were significantly different (p= 0.013)
at F.
From the high-speed imaging, the nature and
extent of facial contact was considerably different
between the six facial protectors (Fig. 8). The amount
of resulting facial (nose) compression closely paral-
leled PA. In general, facial compression was greater
in visors than in cages (p< 0.001) and was dependent
© 2007
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Sports Engineering (2007) 10, 65–74 71
M. Lemair and D.J. Pearsall Impact attenuation of facial protectors in ice hockey helmets
Cage A Cage B Cage C Visor A
Facial protector
Visor B Visor C
*Cage A, Cage C at Front (p = 0.013)
Front
FB45
JCL
0
Peak acceleration (g)
300
250
200
150
100
50
*Visor C, Visor A at FB45 (p < 0.001)
*Visor C, Visor B at FB45 (p = 0.019)
Cage A Cage B Cage C Visor A
Facial protector
Visor B Visor C
*Cage B, Cage C (p < 0.001)
*Cage B, Cage A (p = 0.041)
0
Distance of nose compression (cm)
1.2
1
0.8
0.6
0.4
0.2
*Visor C, Visor A (p = 0.027)
**
Figure 8 Distance (cm) of nose
compression for facial protectors
for third impacts at front site.
Figure 7 Peak acceleration (g)
as a function of impact site for
third impact.
10.2.1 Sports F73 30/8/07 16:48 Page 71
on the model. The effect of repeated impacts was
more substantial for certain facial protector models.
For cages, the impact repetition significantly affected
the extent of nose compression (p< 0.001), whereas
for visors, there were no significant differences in nose
compression for each impact repetition (p= 0.307).
There were significant differences across each model.
Cage B was significantly less than cages A and C
(p= 0.041 and p< 0.001, respectively) and visor C was
significantly lower than visor A (p= 0.027).
During F impacts, the cages progressively deformed
with repeated impacts. Typically, the cages would not
return to their original spherical shape. Structural
deformation was restricted to the area of impact with
the wires bent inward, such that the impact point was
flattened. The extent and form of deformation varied
between cages but typically involved deformation over
2–3 wire rows (~5 cm). Conversely, with the visors, no
permanent deformation comparable to the flattening in
cages was observed. Instead, visors flexed with impact
and returned to their original form after impact (as
observed from visual digital recording at front impacts).
From post impact visual inspection, some fractures or
breakage were observed; for instance, the fracture of the
upper plastic support designed for aeration.
In addition to the above, the use of superficial paste
applied over the headform’s face indicated that during
F and FB45 impacts, contact occurred between the
face and the facial protector or anvil. For cages, paste
marks from the nose of the headform were left on the
steel anvil, increasing in size with repeated impact.
The chin support from the cage prevents any slippage
motion of the helmet and facial protector. Also, the
chin support prevents any contact of the mouth on the
steel anvil. For visors, paste marks were found both on
the inside of the visor, and from the mouth of the
headform onto the steel anvil. These also increased in
size with repeated impacts. Moreover, slippage of the
nose–visor contact point at impact was observed.
Consequently, the cage facial protector provides more
extensive contact shielding.
For FB45 impacts, cages show similar deformation
patterns as observed in front impacts, with perma-
nently bent wires and focal flattening of the cage. In
contrast to F impacts, the damage is not restricted to
the area of impact. The flattening on the right side
(impact side) of the cage causes a bulging or outward
buckling of the wires of the cage on the left side
(opposite impact site). Lack of paste marks on the
cheek indicated non-contact with the side of the cage
during impact. Presumably, the chin support prevents
the cheek from headform slippage.
Unlike the cages, the visors retake their original
shape but some damage remote to the impact point
was noted. Fissures within the plastic were observed
on the sides of the visor both at the lateral and medial
portions of the visor. Paste mark observations indicate
that the contact of the cheek with the visor progres-
sively increased with impact repetition. On the inside
of the visor, the surface area of the paste mark
gradually increased. Moreover, by third impact, there
was paste from the mandible side jaw on the steel
anvil. Thus, unlike the cages, the visor did not prevent
the chin from contacting the steel anvil.
For the most lateral site (JCL), minimal deforma-
tion to the cages and visors was shown probably to
72 Sports Engineering (2007) 10, 65–74 © 2007
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Impact attenuation of facial protectors in ice hockey helmets M. Lemair and D.J. Pearsall
Table 1 Average peak accelerations (a) (g± SD) and Gadd Severity Index (b) (g*s ± SD) measures for third impacts.
a)
g
(
g
±SD) Cage A Cage B Cage C Visor A Visor B Visor C
Site
FB45 53.6 ± 0.8 63.4 ± 18.2 69.5 ± 18.7 214.1 ± 115.2 165.0 ± 14.2 64.5 ± 9.2
Front 107.1 ± 5.4 87.1 ± 23.7 9.4 ± 2.6 107.8 ± 3.7 86.4 ± 3.1 88.9 ± 5.4
JCL 146.6 ± 22.3 86.4 ± 2.9 88.0 ± 4.3 157.6 ± 24.0 210.6 ± 54.9 212.9 ± 79.8
b) GSI (
g
*s ±SD) Cage A Cage B Cage C Visor A Visor B Visor C
Site
FB45 80.0 ± 35.4 135.0 ± 67.4 159.3 ± 72.7 558.5 ± 178.9 690.3 ± 153.7 180.0 ± 16.9
Front 357.5 ± 15.9 262.3 ± 105.0 0.5 ± 0.1 398.0 ± 7.3 242.0 ± 11.3 301.3 ± 40.1
JCL 508.0 ± 71.0 236.8 ± 13.1 264.8 ± 19.2 545.0 ± 97.6 784.3 ± 198.0 832.0 ± 364.0
10.2.1 Sports F73 30/8/07 16:48 Page 72
concurrent impact with the side of the helmet shell.
The JCL was not damaged, though scratching on the
interior and exterior portions of the facial protector was
seen. On the exterior, abrasion occurred due to slippage
on the steel anvil. On the interior, abrasion due to
contact with the J clip anchoring screws occurred.
Structural damage was only observed in cages where in
wires were deformed focally over 1 to 2 wire gaps.
Discussion
This study demonstrated that facial protectors can
serve to attenuate impact accelerations below accept-
able tolerance criteria (i.e. below 300g) as applied to
helmet shells and liners. Hence, it is appropriate to
conclude that the use of facial protectors in combina-
tion with helmets can further reduce the risk of head
injuries. This point is self-evident if one compares
peak acceleration measures with, and without, helmets
and protectors. From calibration testing, facial
impacts of the headform alone were as high as 400g
well above the safety threshold tolerance. With the use
of an ice hockey helmet alone, PA decreased by up to
4-fold during front impacts. Though initially unex-
pected, the helmet shell covering the forehead was
observed to hit the outer portions of the steel anvil
concurrently with facial contact, thereby reducing the
PA for impacts directed along the basic plane. The use
of a facial protector combined with the ice hockey
helmet showed greater reductions in PA. Indeed, facial
protectors exhibited comparable PA attenuation to ice
hockey helmet shells and liners. Consequently, facial
protectors fulfill their primary function in providing
eye protection, while simultaneously reducing the PA
of direct impact of forces from facial vector incidence.
The types of helmet liner were shown to affect
impact response to the helmet (Fig. 4) but not to the
facial protector. It was speculated that the different
rigidity of the two foams tested may change the
stability of the facial protectors anchoring to the shell;
in turn altering the latter’s impact response. However,
for impacts on the facial protectors at all sites, no sig-
nificant differences were observed. Thus, facial
protectors may be considered to function independ-
ently of the liner.
Overall, cages perform better than visors in terms
of reducing PA (Figs. 4–6). There are several factors
that may be conjectured to explain such a result.
Primarily, the cages include a firm chin support,
whereas a visor’s lower margin is not supported and
easily collapses during impact by buckling inward and
downward. The chin support may have permitted
force distribution of the facial protector both above
and below the basic plane; whereas with the visor, the
forces can be distributed only above the basic plane.
Secondly, based on qualitative observations the cages
and visors exhibited two different behaviours upon
impact. Typically, cages were permanently deformed
focally at the area of impact including the bulging of
the wires and flattening of the cage, whereas visors
offered insufficient resistance to the forces of impact,
collapsing but then elastically rebounding to their
original geometric configuration. Lastly, the
geometric design and anchoring of the cage and the
visor differ substantially. The cage typically forms a
hemisphere covering the entire face, whereas the visor
forms a hemi-cylinder covering only the upper
portion of the face. Consequently, at impact, the
forces are distributed differently for the cage and the
visor. The cage shape may permit the radial distribu-
tion of the forces, whereas the visor shape may only
allow forces to be distributed medially-laterally
parallel to the basic plane.
A major factor in this research project was the effect
of repeated impact. A progressive increase in the PA
corresponding to a decrease in impact attenuation
capacity of the facial protector was observed. The
repeated impact effect was present for all facial
protector models and impact sites, indicating cumula-
tive structural damage and/or material degradation.
It was expected that impact sites would affect PA.
Given that the protector-to-face distance progres-
sively decreases laterally, a corresponding increase in
PA was expected. However, this general assumption
was not evident, such that each facial protector model
had different site-specific PA responses. Hence, other
design model specific parameters interact to alter PA
site behaviour.
The fact that facial contact occurred during
impact with the face protector in place should raise
some concern. Most safety standards require a non-
contact criterion for certification. For instance, to
obtain NOCSAE certification (i.e. NOCSAE DOC
(ND) 021-98m05a), facial protectors are submitted
© 2007
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Sports Engineering (2007) 10, 65–74 73
M. Lemair and D.J. Pearsall Impact attenuation of facial protectors in ice hockey helmets
10.2.1 Sports F73 30/8/07 16:48 Page 73
to standardised projectile tests wherein no impactor
contact to the face is accepted. In such tests, pucks are
propelled at the facial protector at 28 ms–1.
Considering the weight of the puck (120 g), this repre-
sents an impact of 65 J. From this study, high-speed
filming and paste marks clearly demonstrated that
facial contacts occurred from the drop test of 45 J.
However, given fundamental differences between the
projectile and drop tests, caution in exact comparison
is necessary. The projectile testing consists of a high
velocity, low mass impact to a small surface area,
whereas the drop test consists of a low velocity, high
mass impact on a large surface area. Furthermore,
facial contact injuries in the latter scenario are rare,
given epidemiological evidence (Stuart et al., 2002;
Benson et al., 2002).
During F impacts, the facial protectors as a whole
were both driven backwards and locally deformed,
permitting transient facial contact. Concurrent
forward slippage of the headform occurred. The
distance of facial (nose) compression varied with facial
protector models. As with PA, less compression
happened with cages than with visors. This is probably
due to the better support of the entire face in cages,
than in visors. For cages, compression progressively
increased with impact repetition up to an average of
8 mm maximum. For visors, compression was not
dependent on the impact repetition but was, in
general, larger (up to 1 cm on average). Further review
of the implications of contact permitted despite the
facial protector presented is recommended.
Conclusion
The prevalence of head injuries in ice hockey has been
reported in many epidemiological studies (Azuelos et
al., 2004; Goodman et al., 2001; Flik et al., 2005). This
study addressed the effect of facial protection on
impact attenuation. Facial protectors were found to
reduce PA transmitted to the headform, with cages
yielding significantly lower PA than visors. The
benefit of decreased PA from facially directed impacts
may in turn decrease the severity and/or incidence of
head injuries. This benefit may, in part, explain the
reduced head injuries reported in the respective
studies of Benson et al. (2002) and Stuart et al. (2002).
Acknowledgements
Assistance from Nike Bauer Hockey Inc. and financial
support from the Natural Science & Engineering
Research Council of Canada were greatly appreciated.
References
ASTM International (2004) Standard Performance
Specification for Ice Hockey Helmets, F1045-04.
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D.L. (2004) A review of ice hockey injuries: Location,
diagnosis, mechanism, in D.J. Pearsall & A.B. Ashare
(eds) Safety in Ice Hockey, American Society for Testing
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Benson, B.W., Mohtadi, N.C.H., Rose, M.S. & Meeuwisse,
W.H. (1999) Head and neck injuries among ice hockey
players wearing full face shields vs half face shields.
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multivariate analysis. British Journal of Sports Medicine,
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Biasca, N., Wirth, S. & Tegner, Y. (2002) The avoidability
of head and neck injuries in ice hockey: an historical
review. British Journal of Sports Medicine, 36, 410–427.
Flik, K., Lyman, S. & Marx, R.G. (2005) American
collegiate men’s ice hockey an analysis of injuries.
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Goodman, D., Gaetz, M. & Meichenbaum, D. (2001)
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NOCSAE (2005) Standard Projectile Impact Test Method
and Equipment Used in Evaluating the Performance
Characteristics Protective Headgear, Faceguard or
Projectiles. NOCSAE DOC (ND) 021-98m05a.
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J.P. (2006) The effect of visors on head and facial injury
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74 Sports Engineering (2007) 10, 65–74 © 2007
isea
Impact attenuation of facial protectors in ice hockey helmets M. Lemair and D.J. Pearsall
10.2.1 Sports F73 30/8/07 16:48 Page 74
... The results revealed that the helmet outfitted with the MFS had the greatest stiffness when compared to the NFS and PFS conditions across the helmet impact locations as shown in Figure 3. This outcome corresponds with the research work of Lemair et al, 30 which found that the MFS had stiffer material properties than the PFS. ...
... The static results provided a better understanding of the capabilities of the helmet material to withstand and mitigate impact forces before being exposed to dynamic collision at different helmet locations. The dynamic results build on Lemair et al. 30 by providing new insights into how facial shielding affects GSI measures when the shield is not directly impacted but is present on the helmet. The findings offer a more comprehensive understanding of how helmet and facial shielding combinations affect a player's vulnerability to injury. ...
... Further investigation into helmet material properties across locations, however, is needed to better understand the risk of head injury and concussions when wearing protective devices. 14,18,30 Future research should continue to explore the relationship between facial shielding and helmet performance in reducing impact severity. Such research could assist manufacturers in improving the design of facial shields and their attachment mechanisms as shown in Figures 1 and 2 to better protect players from the impacts encountered in hockey. ...
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Originally designed to mitigate skull fractures and traumatic brain injuries in hockey players, hockey helmets have now become a critical focus for further research due to the rise in mild traumatic brain injuries. With the sport's evolution introducing stronger and faster players, new approaches that incorporate facial shielding in helmet technology and enhance athletes’ neck strength are needed to reduce concussion risks. This study pursued two primary objectives. Firstly, it sought to determine if a hockey helmet's stiffness fluctuated at different contact locations during static compression with the inclusion of facial shielding. Secondly, it examined the influence of impact location, facial protection type, and neck stiffness on head injury risk during simulated dynamic impacts, gauged by the Gadd Severity Index (GSI). The findings revealed that helmet stiffness varied across locations, and a significant three-way interaction was observed between facial shielding, impact location, and neckform stiffness level concerning GSI measures at p < 0.05. Further analysis unveiled significant two-way interactions between impact location and facial shielding across neck strength levels at p < 0.05. These outcomes underscore the critical role of facial shielding, neck strength and impact location, in averting brain injuries in hockey. The results carry practical implications for helmet manufacturers, standards bodies, coaches, and players, urging a comprehensive approach to helmet design and player safety.
... The Fédération Internationale de Football Association and World Rugby have developed guidelines for the use of protective equipment; however, in contrast with the guidelines for sports with a higher risk of facial injuries, the use of face guards is not mandatory [49]. A key problem in regulating the use of face guards is the lack of standardized regulations globally [50]. Although strict standards have been adopted for some contact sports, such as American soccer and field hockey, similar measures have not been implemented for other high-risk sports [51]. ...
... Although these appliances are crucial for injury prevention, many athletes, especially those participating in contact sports like soccer and hockey, report discomfort, particularly with breathing and vision [64]. This discomfort often leads to reluctance in using face guards [50]. In contrast, in high-speed sports like cycling, the development of lightweight materials such as carbon fiber has made face guards more appealing because they offer protection without significantly affecting comfort [65]. ...
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Face guards effectively reduce the risk of facial injuries in athletes. This study aimed to present a case report and discuss the scientific literature on facial trauma in sports and innovations in the fabrication of face guards. Global regulatory disparities and the importance of education in promoting the use of protective equipment are key factors for injury prevention. Conventionally, alginate impressions have been widely used in manufacturing processes. However, the implementation of digital workflows involving photogrammetry and three‐dimensional printing offers a promising alternative for fabricating customized face guards. Various materials have been used for fabricating the outer layer of face guards, with carbon fibers standing out for their ability to enhance both protection and comfort. These findings suggest that digital innovations and custom designs can improve athlete safety and increase comfort and confidence, thereby contributing to a safer sports environment.
... Over the past few decades a wide range of personnel protective equipment (PPE) has been developed to protect wearers from various types of risks or hazards to their health and safety. [1][2][3][4][5][6][7] Impact protectors, which are the most commonly used PPE, are normally manufactured to include energy-absorbing material in the form of pads. 8,9 They are integrated or inserted into protective clothing or equipment specially designed for protecting the human body from impact, blows or falls. ...
... A number of different types of impact protectors are on the market for protecting different areas of the body in a variety of circumstances. [1][2][3][4] To ensure adequate protection is provided for the intended use a series of standard tests have been developed for evaluating the protective performance of commercial impact protectors for a variety of sporting applications. For instance, European Standards BS EN 13546, 13277-1, 13158, 13567, 14120, 13061, 1621-1, 1621-2 and British Standard BS 6183-3 specify the requirements and test methods for hand, arm, leg, foot, instep, shin, chest, abdomen, genitals, trunk, head, breast and shoulder protectors for field hockey, martial arts, equestrianism, fencing, roller sports, football, motorcycling and cricket. ...
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Full-text available
This paper presents an experimental study of the protective properties of warp-knitted spacer fabrics developed for protecting the human body on impact. A drop-weight impact tester was used to test the fabrics in a hemispherical form to simulate the use of impact protectors in real life. The study consists of two parts. The first part, presented in the current paper, focuses on the impact behavior of a typical spacer fabric impacted at different levels of energy. The analysis includes the impact process and the energy absorption and force attenuation properties of the spacer fabric. Frequency domain analysis is also used, to identify the different deformation and damage modes of the fabric under various levels of impact energy. The results show that the impact behavior of the fabric under impact in the hemispherical form is different from that in the planar form. The results also indicate that the curvature of the fabric can reduce energy absorption during the impact process and therefore reduce the force attenuation properties of the spacer fabric. This study provides a better understanding of the protective properties of spacer fabrics. The effect of fabric structural parameters and lamination on the protective properties of spacer fabrics under impact will be presented in Part II.
... This outcome is likely attributed to the ability of the cage to distribute some of the forces radially, away from the head's center of mass. The chin support in full facial shields is also speculated to reduce forces experienced by the head (25). The full cage used in the current study, therefore, likely played an important role in reducing the peak linear acceleration in the frontal impacts. ...
Article
nternational Journal of Exercise Science 14(1): 446-461, 2021. This study examined the effect of isometric cervical strength and impact location of the hockey helmet in mitigating the risk of concussions for two different mechanisms of injury from a fall during head impact simulation testing. Isometric cervical strength was measured on 25 female hockey players to compute and model neck strength on a mechanical neckform. A dual-rail vertical drop system with a helmet mounted on a surrogate headform simulated the mechanisms of injury causing concussions on female ice hockey players. Measures of peak linear acceleration and risk of injury due to a head collision (GSI) were used to assess the magnitude of the head impact due to a fall across three neck strength measures (weak, average, strong), three helmet locations (front, rear, side), and two mechanisms of injury (direct, whiplash+impact). A three-way ANOVA revealed a significant main effect for impact mechanism on the magnitude of peak linear acceleration and GSI, with the whiplash+impact mechanism generating significantly greater peak linear acceleration and GSI than the direct impact mechanism. A significant two-way interaction effect was found between impact location and mechanism of injury on peak linear acceleration measures, with the direct impact on the side location generating significantly greater peak linear acceleration than the frontal location. On the contrary, the whiplash+impact mechanism revealed that the frontal impact location produced significantly greater peak linear acceleration than the side location. This outcome suggests the geometry of the helmet material and the type of mechanism of injury both play a role in concussion risk.
... To protect people from injuries in sports activities, protective equipment has been developed by including cushioning materials to absorb the impact kinetic energy under compression actions at a relatively constant stress over a large range of strain, to keep the maximum load below some limit that tissue or bones can bear. [19][20][21] The above analysis shows that the spacer fabric possesses the typical cushioning effect of an ideal energy absorber. The energy absorbed by the fabric is low in the densification stage, but the stress steeply increases. ...
Article
Three-dimensional spacer fabrics which have a sandwich structure are formed in a single knitting process without any additional joining treatment. They consist of two separate multifilament outer layers connected by arrays of spacer monofilaments. This paper presents an experimental study on the relationships between the cushioning properties and structural parameters of weft-knitted spacer fabrics in order to lay a foundation for the development of seamless shaped impact protectors for human body impact protection. Sixteen spacer fabrics of different structural parameters were knitted on a computerized flat knitting machine and tested on a universal mechanical testing machine. The cushioning properties of the spacer fabrics were analyzed in terms of their structural features, compression stress–strain curves, energy absorption, and compression resilience. It was found that multifilament fineness, spacer yarn diameter, and spacer yarn pattern should be matching in order to form effective binding structures between the outer layers and spacer monofilaments. The results also showed that spacer fabrics knitted with a shorter spacer yarn span distance, coarser monofilaments, and higher spacer yarn density have better compression resistance and absorption energy but inferior compression resilience if their binding structures are effective. This study has practical significance in promoting the application of this type of fabric as a cushion material for human body protection.
Thesis
Dans le cadre de cette recherche, nous avons étudié l'effet de divers paramètres d'influençant le comportement d’un non-tissé Vertilap®3D à faible impact. Ce matériau a été développé pour la protection du corps humain. Ce nouveau produit textile offre les meilleures solutions de résistance aux chocs à basse vitesse, pour combler le vide des produits concurrents sur le marché, dans le domaine de la protection individuelle. À cet égard, une nouvelle structure fibreuse tridimensionnelle (3D) en matériau polyester (PET) a été développée pour enrichir ou remplacer la gamme de produits de protection. Ces nouvelles structures fibreuses 3D fabriquées sont stratifiées avec des non-tissés aiguilletées et thermoliés. Les feuilles sont en 100% PET, pour obtenir un produit monocomposant. Pour la caractérisation des propriétés physiques et mécaniques de ces nouvelles structures fibreuses 3D, des méthodes d'essais doivent être développées. Sur la base des spécifications de protection du corps humain, une méthodologie a été mise en place pour tester le comportement à l’impact de ces nouveaux produits. Afin de répondre à la question des produits existants et de leur remplacement, certains produits en tricot chaine ont également été caractérisés, et des comparaisons avec d'autres produits ont été faites.Les résultats de cette étude montrent que les non-tissés Vertilap® peuvent être utilisés comme un matériau efficace pour la protection du corps humain contre les chocs en raison de leur grande capacité d'absorption d'énergie à différents stades d'impact. Les non-tissés 3D Vertilap® étudiés permettent de réduire d'environ 44% la profondeur de déformation et de 70% le volume de déformation en fonction du diamètre de l'impacteur et de l'énergie à l’impact.Les propriétés de la nouvelle structure fibreuse 3D sont intéressantes en termes de comportement d'impact par rapport aux tricots chaine. Ces résultats sont des informations importantes pour la conception de Vertilap® pour des applications d'amortissement et de protection dans les vêtements de protection et les semelles de chaussures, etc.Il y a deux volets de ce travail dans cette thèse. Le premier volet de ce travail présente la partie de recherche bibliographique et le deuxième volet à ce travail est basé sur la caractérisation du comportement et les performances à l’impact de la nouvelle structure Vertilap®.Ces performances seront étudiées, par deux méthodes spécialement développées dans le cadre de ces travaux en premier lieu, et puis une étude comparative, entre cette nouvelle structure fibreuse et un autre produit connu sur le marché par sa capacité de protection, sera menée en deuxième lieux, afin de positionner les performances de ce nouveau produit en termes d eprotection humaine.
Chapter
Sports and recreation-related injury burden is extended because they frequently occur among children and young adults. Athletes are at risk for multiple injuries and those that result in long-term disability can impede educational, occupational, and personal fulfillment. Fortunately, the significant burden of these preventable injuries can be minimized through prevention. In particular, successful programs address the multidimensional nature of risk and generate change within the associated sport’s safety culture. This chapter will review ten case studies that demonstrate exemplary practice in programs aimed at intervening in sports and recreation unintentional injuries.
Chapter
Protective equipment use in contact/collision sports has evolved during the modern era from rudimentary design and function to sophisticated, state-of-the-art gear. Comprised of lightweight durable materials, current equipment can withstand impact forces that previously would have resulted in significant morbidity to the participant. Despite this evolution, sports-related injuries continue to increase as participation rates rise and young athletes perform sport-specific training and conditioning that often result in their ability to generate more force during collision activities, as the adage “bigger, stronger, faster” continues to play out in youth competitive sports. Recent studies have demonstrated that youth American football players can generate high-magnitude impacts during practice and competition—forces previously thought to be achieved only by college and professional American football players. Tremendous focus and attention by youth sports organizations, medical, safety, and scientific communities have been directed in recent years toward a common goal of reducing injury risk in young athletes, specifically injuries to the head and neck. This chapter provides a review of the role of protective equipment in injury reduction; the history of protective equipment; the evidence supporting the utilization of head, face, and neck protective gear in contact/collision sports; attitudes among players, medical staff, and coaches toward the use of protective equipment; issues pertaining to enforcement and mandated use of protective gear; advertising and marketing claims regarding protective equipment; and future directions and research regarding head and neck protective equipment.
Article
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Speculation exists that use of a full face shield by ice hockey players may increase their risk of concussions and neck injuries, offsetting the benefits of protection from dental, facial, and ocular injuries, but, to our knowledge, no data exist regarding this possibility. To determine the risk of sustaining a head or neck injury among intercollegiate ice hockey players wearing full face shields compared with those wearing half shields. Prospective cohort study conducted during the 1997-1998 Canadian Inter-University Athletics Union hockey season of 642 male hockey players (mean age, 22 years) from 22 teams. Athletes from 11 teams wore full face shields and athletes from 11 teams wore half face shields during play. Reportable injury, defined as any event requiring assessment or treatment by a team therapist or physician or any mild traumatic brain injury or brachial plexus stretch, categorized by time lost from subsequent participation and compared by type of face shield. Of 319 athletes who wore full face shields, 195 (61.6%) had at least 1 injury during the study season, whereas of 323 who wore half face shields, 204 (63.2 %) were injured. The risk of sustaining a facial laceration and dental injury was 2.31 (95% confidence interval [CI], 1.53-3.48; P<.001) and 9.90 (95% CI, 1.88-52.1; P = .007) times greater, respectively, for players wearing half vs full face shields. No statistically significant risk differences were found for neck injuries, concussion, or other injuries, although time lost from participation because of concussion was significantly greater in the half shield group (P<.001), than in the group wearing full shields. These data provide evidence that the use of full face shields is associated with significantly reduced risk of sustaining facial and dental injuries without an increase in the risk of neck injuries, concussions, or other injuries.
Article
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To identify specific risk factors for concussion severity among ice hockey players wearing full face shields compared with half face shields (visors). A prospective cohort study was conducted during one varsity hockey season (1997-1998) with 642 male ice hockey players (median age 22 years) from 22 teams participating in the Canadian Inter-University Athletics Union. Half of the teams wore full face shields, and half wore half shields (visors) for every practice and game throughout the season. Team therapists and doctors recorded on structured forms daily injury, participation, and information on face shield use for each athlete. The main outcome measure was any traumatic brain injury requiring assessment or treatment by a team therapist or doctor, categorised by time lost from subsequent participation and compared by type of face shield worn. Players who wore half face shields missed significantly more practices and games per concussion (2.4 times) than players who wore full face shields (4.07 sessions (95% confidence interval (CI) 3.48 to 4.74) v 1.71 sessions (95% CI 1.32 to 2.18) respectively). Significantly more playing time was lost by players wearing half shields during practices and games, and did not depend on whether the athletes were forwards or defence, rookies or veterans, or whether the concussions were new or recurrent. In addition, players who wore half face shields and no mouthguards at the time of concussion missed significantly more playing time (5.57 sessions per concussion; 95% CI 4.40 to 6.95) than players who wore half shields and mouthguards (2.76 sessions per concussion; 95% CI 2.14 to 3.55). Players who wore full face shields and mouthguards at the time of concussion lost no playing time compared with 1.80 sessions lost per concussion (95% CI 1.38 to 2.34) for players wearing full face shields and no mouthguards. The use of a full face shield compared with half face shield by intercollegiate ice hockey players significantly reduced the playing time lost because of concussion, suggesting that concussion severity may be reduced by the use of a full face shield.
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The number of minor traumatic brain injury (mTBI), cerebral concussions, is increasing and cannot be eliminated by any kind of equipment. Prevention strategies, such as the introduction of "checking from behind" rules have become effective in decreasing the number of severe spinal injuries. A new "head checking" rule should reduce mTBI in the same way in the following years. Mouthguards should be mandatory as an effective device for the prevention of dental and orofacial injuries, as well as reducing the incidence and severity of mTBI. A new internet database system, the International Sports Injury System (ISIS) should improve epidemiological analysis of head, face, and spinal injuries worldwide. ISIS should provide an internationally compatible system for continuous monitoring of risk factors, protective effects of equipment, and protective effects of equipment and effects of changes in rules through the years.
Article
Full-text available
National Football League game video was analyzed for the typical locations of severe helmet impacts in professional football. By use of selected cases that were reconstructed in laboratory tests and reported previously, the magnitude and direction of force causing concussion was determined for these locations. Multiple video views were obtained for 182 severe helmet impacts that occurred between 1996 and 2001. From a top view, the helmet was divided into 45-degree quadrants with 0 degrees eyes forward. From a side view, it was divided into seven equal levels, four (+Q1 to +Q4) above the head center of gravity and three below (-Q1 to -Q3). The initial helmet contact was located in these regions. Thirty-one impacts were reconstructed with helmeted Hybrid III dummies involving 25 concussions. Measurement of head translational and rotational acceleration was used to determine the average and +/-1 standard deviation in responses, with impacts reflected to the right side. From video, the majority (71%) of impact is to the helmet shell primarily from a striking player's helmet, arm, or shoulder pad to the side (45-135 degrees) or from ground contact to the back (135-180 degrees). Most impacts were high on the helmet at +Q2 to +Q4. The remainder (29%) were primarily from helmet contact on the facemask at an oblique frontal angle (0-45 degrees) and -Q3 to +Q1 height. From reconstructions, concussion occurred with the lowest peak head acceleration in facemask impacts at 78 +/- 18 g versus an average 107 to 117 g for impacts on other quadrants (t = 2.90, P < 0.005). There was a significantly higher head acceleration for concussed versus nonconcussed players (t = 2.85, P < 0.05). The vector of peak force was essentially horizontal for facemask impacts and downward at 12 to 27 degrees for impacts to the helmet side and back. Concussion in professional football involves four typical conditions, as follows: A, 0- to 45-degree quadrant, -Q3 to +Q3 level, peak force 49 +/- 18 degrees from front and horizontal; B, 45- to 90-degree quadrant, -Q2 to +Q3 level, peak force 73 +/- 12 degrees and horizontal; C, 90- to 135-degree quadrant, +Q1 to +Q4 level, peak force 97 +/- 9 degrees and 12 degrees downward; and D, 135- to 180-degree quadrant, +Q1 to +Q4 level, peak force 157 +/- 1 degrees and 27 degrees downward. Concussed players averaged 3.6 +/- 2.7 initial signs and symptoms. The most common were headaches, dizziness, immediate recall problems, and difficulty with information processing. The location, direction, and severity of helmet impacts causing concussion in the National Football League have been defined from analysis of game video and laboratory reconstruction. These conditions define the circumstances in which helmets need to reduce head injury risks in professional football.
Article
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A 6-year study was performed to determine the circumstances, causes, and outcomes of concussions in the National Football League. Between 1996 and 2001, the epidemiological features of concussions were recorded by National Football League teams with a standardized reporting form. Symptoms were reported and grouped as general symptoms, cranial nerve symptoms, memory or cognitive problems, somatic complaints, and loss of consciousness. The medical actions taken were recorded. In total, 787 game-related cases were reported, with information on the players involved, type of helmet impact, symptoms, medical actions, and days lost. Concussion risks were calculated according to player game positions. There were 0.41 concussions per National Football League game. The relative risk was highest for quarterbacks (1.62 concussions/100 game-positions), followed by wide receivers (1.23 concussions/100 game-positions), tight ends (0.94 concussion/100 game-positions), and defensive secondaries (0.93 concussion/100 game-positions). The majority of concussions (67.7%) involved impact by another player's helmet. The remainder involved impact by other body regions of the striking player (20.9%) or ground contact (11.4%). The three most common symptoms of mild traumatic brain injury were headaches (55.0%), dizziness (41.8%), and blurred vision (16.3%). The most common signs noted in physical examinations were problems with immediate recall (25.5%), retrograde amnesia (18.0%), and information-processing problems (17.5%). In 58 of the reported cases (9.3%), the players lost consciousness; 19 players (2.4%) were hospitalized. A total of 92% of concussed players returned to practice in less than 7 days, but that value decreased to 69% with unconsciousness. The professional football players most vulnerable to concussions are quarterbacks, wide receivers, and defensive secondaries. Concussions involved 2.74 symptoms/injury, and players were generally removed from the game. More than one-half of the players returned to play within 1 day, and symptoms resolved in a short time in the vast majority of cases.
Article
Full-text available
Our aim was to quantify with functional magnetic resonance imaging (fMRI) changes in brain activity in concussed athletes and compare the results with those of normal control subjects. Regional brain activations associated with a working memory task were obtained from a group of concussed athletes (15 symptomatic, 1 asymptomatic) and eight matched control subjects, using blood oxygen level dependent (BOLD) fMRI. The average percent signal change from baseline to working memory condition in each region of interest was computed. Symptomatic concussed athletes demonstrated task-related activations in some but not all the regions of interest, even when they performed as well as the control subjects. Furthermore, several concussed athletes had additional increases in activity outside the regions of interest, not seen in the control group. Quantitative analysis of BOLD signals within regions of interest revealed that, in general, concussed athletes had different BOLD responses compared to the control subjects. The task-related activation pattern of the one symptom-free athlete was comparable to that of the control group. We also repeated the study in one athlete whose symptoms had resolved. On the first study, when he was still symptomatic, less task-related activations were observed. On follow-up, once his symptoms had disappeared, the task-related activations became comparable to those of the control group. These results demonstrate the potential of fMRI, in conjunction with the working memory task, to identify an underlying pathology in symptomatic concussed individuals with normal structural imaging results.
Article
This review summarizes the published reports of ice hockey injuries sustained by junior level or higher players dating between 1952 and 2000. North American and European results were compared wherever possible. Considerable changes in the general injury profile distribution (i.e., injury location, diagnosis or type, and mechanism) have taken place particularly since the introduction of helmets, facemasks, and the high sticking rule. In brief, the percentages of head and face injuries, lacerations, and injuries caused by the stick have decreased substantially. Conversely, shoulder and knee injuries, contusions, as well as injuries caused through player-player contacts (i.e., checking, being checked, accidental, or intentional) have substantially increased.
Article
Background Reported rates and types of ice hockey injuries have been variable. Ice hockey combines tremendous speeds with aggressive physical play and therefore has great inherent potential for injury. Purpose To identify rates and determinants of injury in American men's collegiate ice hockey. Study Design Prospective cohort study. Methods Data were collected from 8 teams in a Division I athletic conference for 1 season using an injury reporting form specific for ice hockey. Results There were a total of 113 injuries in 23 096 athlete exposures. Sixty-five percent of injuries occurred during games, although games accounted for only 23% of all exposures. The overall injury rate was 4.9 per 1000 athlete exposures (13.8 per 1000 game athlete exposures and 2.2 per 1000 practice athlete exposures). Collision with an opponent (32.8%) or the boards (18.6%) caused more than half of all injuries. Concussion (18.6%) was the most common injury, followed by knee medial collateral ligament sprains, acromioclavicular joint injuries, and ankle sprains. Conclusions The risk of injury in men's collegiate ice hockey is much greater during games than during practices. Concussions are a main cause for time lost and remain an area of major concern.
Article
The purpose of the study was to document various aspects of concussion in Canadian Amateur hockey including demographics, causes, treatment, and prevention in order to guide future recommendations on how to reduce injury. A detailed prospective and retrospective concussion history was obtained from British Columbia Junior Hockey League players over the course of two seasons (1998-2000). Higher rates of concussions occur in games versus practice, and there was an overrepresentation of forwards injured versus defensemen or goaltenders. There was between 4.63 and 5.95 concussions per 1000 player/game hours with the average age of the first hockey-related concussion in the 15th year. The greatest cause of concussion was contact with the ice and/or the boards. Fighting was not a major cause of concussion, although other illegal actions such as elbowing were. The primary recommendation to reduce the number and severity of concussions is to eliminate plays where there is a demonstrable intent to injure another player. Concussions in hockey are of considerable concern; however, there is now encouraging information with respect to the treatment of these injuries.
Article
A cohort of 282 elite amateur ice hockey players were analyzed to 1) record the number, type, location, and severity of head, neck, and facial injuries sustained during games; 2) examine the relationship between injuries and the type of facial protection (none, partial, or full) according to individual playing time; and 3) determine whether full or partial facial protection is associated with an increased incidence of concussions, eye injuries, and neck injuries. Fifty-two injuries (158.9 per 1000 player-game hours) occurred in players wearing no facial protection, 45 (73.5 per 1000 player-game hours) in players wearing partial facial protection (half shield), and 16 (23.2 per 1000 player-game hours) in players wearing full facial protection (full cage or shield). Players wearing no protection were injured at a rate more than twice that of players wearing partial protection and almost seven times higher than those wearing full protection. Concussions occurred in four players wearing no protection, five players wearing partial protection, and two players wearing full protection; these differences were not significant. The risk of eye injury was 4.7 times greater for players wearing no protection compared with those wearing partial protection. No eye or neck injuries occurred in players wearing full protection. This study demonstrates that both full and partial facial protection significantly reduce injuries to the eye and face without increasing neck injuries and concussions.