Identifying a severity measure for head acceleration events associated with suspected concussions

TL;DR

This study evaluates various head acceleration event (HAE) severity measures to predict suspected concussions in elite rugby, finding peak power as a promising indicator due to its strong association with HIA1 removals.

Contribution

The paper identifies peak power as a new, effective severity measure for head acceleration events linked to suspected concussions in rugby players.

Findings

Peak power is most strongly associated with HIA1 removals.

All three measures (power, MPS, HARM) are linked to HIA1 events.

Peak power outperforms other measures in predictive accuracy.

Abstract

Objectives: To identify a head acceleration event (HAE) severity measure associated with HIA1 removals in elite level rugby union. Methods: HAEs were recorded from 215 men and 325 women with 30 and 28 HIA1 removals from men and women, respectively. Logistical regression were calculated to identify if peak power, maximum principal strain (MPS) and or Head Acceleration Response Metric (HARM) were associated with HIA1 events compared to non-cases. Optimal threshold values were determined using the Youden Index. Area under the curve (AUC) were compared using a paired sample approach. Significant differences were set at p<0.05. Results: All three severity measures were associated with HIA1 removals in both the mens and womens game. Power performed greatest for HIA1 removals in both the mens and womens games, based on overall AUC, sensitivity, and specificity values. HARM and MPS were found to perform lower than PLA in the womens game based on AUC comparisons (p=0.006 and 0.001, respectively), with MPS performing lower than PAA (p=0.001). Conclusion: The findings progress our understanding of HAE measures associated with HIA1 removals. Peak power, a measure based on fundamental mechanics and commonly used in sports performance, may be a suitable HAE severity measure.