BIDDEFORD — Andrew Curro knows first-hand how concussions affect an athlete.

So the University of New England junior didn’t hesitate when asked if he would be a test subject in a pioneering study of “head hits” in men’s lacrosse conducted by two faculty members in the school’s Department of Exercise and Sport Performance.

“It offers a lot of data for head impacts, and it has the potential to make this game a lot safer,” said Curro, a starter on the men’s lacrosse team from Tolland, Connecticut.

University of New England junior Chris Harlow adjusts his sensor during a lacrosse game in April. "We need to continue to compile data on all sports," says UNE Athletic Director Jack McDonald.

University of New England junior Chris Harlow adjusts his sensor during a lacrosse game in April. “We need to continue to compile data on all sports,” says UNE Athletic Director Jack McDonald.

“I’ve had a couple (of concussions)” he said. “I had one last year, so the study definitely appealed to me. Anything to make this game safer is a big thing . . . and anything to improve player health in the long run would be great.”

UNE has joined about two dozen colleges nationwide that are using head-impact sensors to conduct research on the force and frequency of head hits in sports. Many of the studies have been done on soccer and football players. UNE’s researchers chose men’s lacrosse because no academic studies have been conducted on the sport.

“What we can’t do is just focus in on what we think are the major concussion sports,” said UNE Athletic Director Jack McDonald. “We need to continue to compile data on all sports.”

University of New England's Mitch Mullin hits the turf under pressure from Anthony Verville of Nichols College during a lacrosse game in Biddeford. UNE is studying "head hits" in the sport.

University of New England’s Mitch Mullin hits the turf under pressure from Anthony Verville of Nichols College during a lacrosse game in Biddeford. UNE is studying “head hits” in the sport.

Throughout the 2016 season, as many as 20 UNE lacrosse players volunteered to wear headbands that contained impact-motion sensors (also known as accelerometers) during practices and home games. The sensors detect the magnitude of each blow to the head. They also detect the directional vector of the hit, another factor that has been shown to have a relation to concussions.

“Over time, we can see more correlation and see what type of hit caused concussions,” said John Rosene, who along with department head Paul Visich is conducting the UNE research. They plan to extend their study to the UNE men’s and women’s ice hockey teams next winter.

SENSORS DETECT G-FORCES

Between 1.6 million and 3.8 million sports- and recreation-related concussions occur annually in the United States, and most researchers suspect many other cases go unreported, particularly in youth sports. Diagnosis of concussions has been on the rise, in part because of increased awareness of the long-term impact of concussions on brain function and health. Adding to the concern have been well-publicized cases of chronic traumatic encephalopathy, or CTE, particularly among deceased football players.

“The big question emerging is what are all the repetitive hits doing, and when we look at all the CTE issues, that’s what keeps coming up,” Rosene said. “The effect of cumulative hits is, right now, an unanswered question.”

Nick Wirth, foreground, and Dr. John Rosene monitor UNE players in their concussion research. Data from G-force sensors worn by some players are relayed to a computer in the press box.

Nick Wirth, foreground, and Dr. John Rosene monitor UNE players in their concussion research. Data from G-force sensors worn by some players are relayed to a computer in the press box.

The impact sensors cannot diagnose a concussion. Rather, they can be used to show that a player has taken a significant hit to the head, helping to alert athletic trainers or other medical personnel.

The sensor detects acceleration of the head caused by either contact or whiplash, and transfers the data to a software program. The sensors, which measure the accelerations as multiples of the acceleration of gravity, can record a G-force as low as 15. For comparison, plopping into a seat can create an acceleration equal to 10 times that of gravity. In a 30-mph car crash, a head hitting the windshield creates a G-force of about 150.

Based on previous studies conducted with football players, the danger zone for concussions appears to be hits that generate G-forces ranging from 90 to 150, Visich said.

Sophomore Andrew Markham of UNE drives into Brian Hancock of Nichols College during a lacrosse game in Biddeford in April. Gregory Rec/Staff Photographer

Sophomore Andrew Markham of UNE drives into Brian Hancock of Nichols College during a lacrosse game in Biddeford in April.
Gregory Rec/Staff Photographer

Although men’s lacrosse is not considered a contact sport in the same vein as football, lacrosse players can collide at high speed during competition. In UNE’s home game against Western New England in April, the greatest G-force reading came in a fourth-quarter collision that caused a UNE player to fall hard to the turf. It registered a 76.

“I can’t tell you what is the threshold (G-force) number and I don’t think anyone can,” Visich said. “We think it’s something up around 90, but it varies for every person.”

COUNTING THE NUMBER OF HITS

The sensors also can record how frequently an athlete is hit in the head. Counting head hits has value for academic research purposes and general player safety, said Chris Nowinski, president of the Concussion Legacy Foundation, a leading nonprofit organization focusing on concussion education.

One of the foundation’s national initiatives is called Hit Count. Based loosely on the principle of a pitch count in baseball, Nowinski contends that if head hits are tabulated and limits set based on the sport and the athletes’ ages, then a reduction in concussions will follow.

 

BIDDEFORD, ME - APRIL 23: Junior Philip Young holds on to his concussion strap and helmet during the halftime break in a lacrosse game against Nichols College on Saturday, April 23, 2016. (Photo by Gregory Rec/Staff Photographer)

Junior Philip Young holds on to his concussion strap and helmet during the halftime break in a lacrosse game against Nichols College on April 23, 2016. Gregory Rec/Staff Photographer

“All other things being equal, if athletes are hit half as many times, it seems logical to think we’ll have half as many concussions,” Nowinski said. “And the only way to give (athletes) direct feedback is to have a way to count hits.

“Collecting data in every sport is critical. We’ve been trying to get people to count hits for nearly five years and we’re excited to have researchers adding more data to our understandings,” Nowinski said. “Data on exposure in college lacrosse I don’t believe has been published, so it will be a significant contribution to the literature.”

According to statistics published in 2013 from a five-year meta-analysis conducted by the Institute of Medicine, college men’s lacrosse players suffer sports-related concussions, or SRCs, at a rate of 3.1 per 10,000 athlete exposures, with an exposure consisting of one athlete participating in one game or practice. Lacrosse’s incidence rate is significantly lower than those for college sports such as wrestling (12.4 per 10,000 exposures), men’s ice hockey (8.2), women’s soccer (6.5) and football (6.3). According to the same report, high school athletes are most likely to be concussed in football (11.2), boys’ lacrosse (6.9), girls’ soccer (6.7) and wrestling (6.2).

No UNE men’s lacrosse player suffered a concussion this season while wearing a sensor.

“I don’t really know a good way to put it, but to learn more about what causes a person to be concussed, people have to get concussed while we’re measuring the G-force,” Rosene said. “It’s kind of a double-edged sword when you do this kind of work.”

RESEARCH, PLAY SEPARATE FOR NOW

Over the summer, student research assistants Christian Merritt and Nick Wirth will review game and practice film to match each head hit with the on-field action. The UNE research team will analyze the data, with plans to publish a paper based on their findings.

Merritt and Wirth were responsible for monitoring the system during games and practices. Among the things they already have learned is that rather routine events can cause measurable readings. What appear to be gentle helmet-to-helmet touches during a goal celebration registered in the 30 G-force range during the April 16 game against Western New England. Merritt and Wirth said they quickly learned one UNE player is prone to banging himself in the head with his stick if he makes a bad play. Those self-administered blows routinely top a G-force of 40.

Although the data is recorded in “real time,” there has been no interaction during the game between the researchers and UNE’s coaches, players or athletic trainers.

Data from G-Force sensors worn by some of the UNE men's lacrosse players is transmitted wirelessly from the headbands, which are worn under their helmets, to the device at left, which then sends it to the computer at right, which keeps track of the frequency and magnitude of blows to the head a player takes in a game and season. Gregory Rec/Staff Photographer

Data from G-Force sensors worn by some of the UNE men’s lacrosse players is transmitted wirelessly from the headbands, which are worn under their helmets, to the device at left, which then sends it to the computer at right, which keeps track of the frequency and magnitude of blows to the head a player takes in a game and season.
Gregory Rec/Staff Photographer

“We aren’t doing it that way right now,” said UNE Coach Charlie Burch. “I suppose if the technology gets better and the way to communicate that down to us from the press box gets better, it would be helpful probably to the trainer, but our trainers are pretty good. If they’re even suspicious that a guy got dinged, they’re going to check him out very carefully.”

UNE goalie John Dusel, a senior, wore a sensor headband for most of the season. He is studying to become an athletic trainer. Someday soon he’ll be checking other athletes for concussion symptoms.

“You could maybe monitor how much force was put on a guy and then maybe take that into account in his diagnosis,” Dusel said. “And then monitoring the amount of force he’s taken over the season.”

Rosene and Visich believe the real value of their data collection will come when it is paired with other measures.

“If we looked at cognitive function during the season then we could ask, ‘Is there a relationship between the number of hits, or the magnitude of hits, and cognitive function?’ ” Rosene said. “That’s not something we did this year.”

TECHNOLOGY LINKED TO AIR BAGS

Rosene said he also would like to incorporate offseason training focused on areas such as reaction time and neck strength. Then counting the hits over multiple seasons could demonstrate that specific training can reduce the number of hits, and potentially their force.

Triax Technologies, a company based in Norwalk, Connecticut, manufactures the sensors, monitors and software being used by UNE.

Individual headbands with the “Smart Impact Monitors” sell for $189, and Triax is marketing its product for use by parents. The technology for small accelerometers was first developed for the auto industry to trigger air-bag deployment.

“We wanted to make a product that could collect data in all sports,” said Chad Hollingsworth, president and co-founder of Triax.

That process will keep researchers like Rosene and Visich busy.

“It’s such a new area of work, there’s years and years of research ahead of us,” Rosene said.


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