Head Kinematics Associated with Off-Field Head Injury Assessment (HIA1) Events in a Season of English Elite-Level Club Men’s and Women’s Rugby Union Matches

IF 9.3 1区医学 Q1 SPORT SCIENCES Sports Medicine Pub Date : 2024-11-16 DOI:10.1007/s40279-024-02146-6

David Allan, James Tooby, Lindsay Starling, Ross Tucker, Éanna Falvey, Danielle Salmon, James Brown, Sam Hudson, Keith Stokes, Ben Jones, Simon Kemp, Patrick O’Halloran, Matt Cross, Melanie Bussey, Gregory Tierney

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Abstract

Objectives

The purpose of this study was to investigate head kinematic variables in elite men’s and women’s rugby union and their ability to predict player removal for an off-field (HIA1) head injury assessment.

Methods

Instrumented mouthguard (iMG) data were collected for 250 men and 132 women from 1865 and 807 player-matches, respectively, and synchronised to video-coded match footage. Head peak resultant linear acceleration (PLA), peak resultant angular acceleration (PAA) and peak change in angular velocity (dPAV) were extracted from each head acceleration event (HAE). HAEs were linked to documented HIA1 events, with ten logistical regression models for men and women, using a random subset of non-case HAEs, calculated to identify kinematic variables associated with HIA1 events. Receiver operating characteristic curves (ROC) were used to describe thresholds for HIA1 removal.

Results

Increases in PLA and dPAV were significantly associated with an increasing likelihood of HIA1 removal in the men’s game, with an OR ranging from 1.05–1.12 and 1.13–1.18, respectively. The optimal values to maximise for both sensitivity and specificity for detecting an HIA1 were 1.96 krad⋅s⁻², 24.29 g and 14.75 rad⋅s⁻¹ for PAA, PLA and dPAV, respectively. Only one model had any significant variable associated with increasing the likelihood of a HIA1 removal in the women’s game—PAA with an OR of 8.51 (1.23–58.66). The optimal values for sensitivity and specificity for women were 2.01 krad⋅s⁻², 25.98 g and 15.38 rad⋅s⁻¹ for PAA, PLA and dPAV, respectively.

Conclusion

PLA and dPAV were predictive of men’s HIA1 events. Further HIA1 data are needed to understand the role of head kinematic variables in the women’s game. The calculated spectrum of sensitivity and specificity of iMG alerts for HIA1 removals in men and women present a starting point for further discussion about using iMGs as an additional trigger in the existing HIA process.

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在一个赛季的英格兰精英级俱乐部男子和女子橄榄球联盟比赛中，与场外头部伤害评估 (HIA1) 事件相关的头部运动学特征

方法分别从 1865 场和 807 场球员比赛中收集了 250 名男子和 132 名女子的护齿器 (iMG) 数据，并与视频编码的比赛录像同步。从每个头部加速度事件（HAE）中提取头部峰值结果线性加速度（PLA）、峰值结果角加速度（PAA）和峰值角速度变化（dPAV）。将 HAE 与记录在案的 HIA1 事件联系起来，利用非病例 HAE 的随机子集计算出男性和女性的 10 个逻辑回归模型，以确定与 HIA1 事件相关的运动学变量。结果在男子比赛中，PLA 和 dPAV 的增加与 HIA1 移除可能性的增加显著相关，OR 分别为 1.05-1.12 和 1.13-1.18。PAA、PLA 和 dPAV 检测 HIA1 的灵敏度和特异性的最佳值分别为 1.96 krad⋅s-2、24.29 g 和 14.75 rad⋅s-1。只有一个模型中的一个重要变量与女性比赛中 HIA1 被移除的可能性增加有关--PAA，OR 为 8.51（1.23-58.66）。PAA、PLA 和 dPAV 对女性的灵敏度和特异性的最佳值分别为 2.01 krad⋅s-2、25.98 g 和 15.38 rad⋅s-1。需要更多的 HIA1 数据来了解头部运动学变量在女子比赛中的作用。计算得出的 iMG 警报对男性和女性 HIA1 移除的敏感性和特异性范围为进一步讨论将 iMG 作为现有 HIA 流程中的额外触发因素提供了一个起点。

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来源期刊

Sports Medicine 医学-运动科学

CiteScore

18.40

自引率

5.10%

发文量

165

审稿时长

6-12 weeks

期刊介绍： Sports Medicine focuses on providing definitive and comprehensive review articles that interpret and evaluate current literature, aiming to offer insights into research findings in the sports medicine and exercise field. The journal covers major topics such as sports medicine and sports science, medical syndromes associated with sport and exercise, clinical medicine's role in injury prevention and treatment, exercise for rehabilitation and health, and the application of physiological and biomechanical principles to specific sports. Types of Articles: Review Articles: Definitive and comprehensive reviews that interpret and evaluate current literature to provide rationale for and application of research findings. Leading/Current Opinion Articles: Overviews of contentious or emerging issues in the field. Original Research Articles: High-quality research articles. Enhanced Features: Additional features like slide sets, videos, and animations aimed at increasing the visibility, readership, and educational value of the journal's content. Plain Language Summaries: Summaries accompanying articles to assist readers in understanding important medical advances. Peer Review Process: All manuscripts undergo peer review by international experts to ensure quality and rigor. The journal also welcomes Letters to the Editor, which will be considered for publication.