Head Impact Exposure in Hawaiian High School Football: Influence of Adherence Rates on a Helmetless Tackling and Blocking Training Intervention

Erik E. Swartz, Vice Dean & Ruth S. Ammon Professor School of Health Sciences, Ruth S. Ammon College of Education and Health Sciences Adelphi University Harvey Hall 116, 1 South Avenue Garden City, NY 11530 Phone: 516.877.4094 Email: eswartz@adelphi.edu.
Jay L. Myers, Assistant Professor, Department of Biology Southern New Hampshire University j.myers2@snhu.edu.
Jong Soo Lee, Associate Professor, Department of Mathematics and Statistics University of Massachusetts Lowell jongsoo_lee@uml.edu.
Steven P. Broglio, Associate Dean, Professor, School of Kinesiology Director, U-M Concussion Center University of Michigan broglio@umich.edu.
Troy Furutani, Program Manager, Hawaii Concussion Awareness and Management Program, Department of Kinesiology and Rehabilitation Science University of Hawai'i at Manoa tfurutan@hawaii.edu.
Ross Oshiro, Program Coordinator, Hawaii Concussion Awareness & Management Program, Department of Kinesiology & Rehabilitation Science University of Hawai'i at Manoa oshiror@hawaii.edu.
Gerard A. Gioia, SCORE Program, Children's National Hospital, Professor, Depts of Pediatrics and Psychiatry George Washington University School of Medicine GGioia@childrensnational.org.
Darian Brothers, Graduate Assistant, Department of Kinesiology and Rehabilitation Science University of Hawai'i at Manoa darianb@hawaii.edu.
Kiera Glodowski, Graduate Assistant, Department of Kinesiology and Rehabilitation Science University of Hawai'i at Manoa kierag27@hawaii.edu.
Ivet Lloansi, Graduate Assistant, Department of Kinesiology and Rehabilitation Science University of Hawai'i at Manoa illoansi@hawaii.edu.
Lauren Meyer, Graduate Assistant, Department of Kinesiology and Rehabilitation Science University of Hawai'i at Manoa meyerlk@hawaii.edu.
Nathan Murata, Dean, College of Education University of Hawai'i at Manoa nmurata@hawaii.edu.

Document Type

Journal Article

Publication Date

4-18-2024

Journal

Journal of athletic training

DOI

10.4085/1062-6050-0014.24

Keywords

athletes; brain; neck injuries; outcome assessment; prospective studies

Abstract

CONTEXT: High school football remains a popular, physically demanding sport despite the known risks for acute brain and neck injury. Impacts to the head also raise concerns about their cumulative effects and long-term health consequences. OBJECTIVE: To examine the effectiveness of a helmetless tackling training program to reduce head impact exposure in football participants. DESIGN: A three-year, quasi-experimental, prospective cohort (clinicaltrials.gov #NCTXXX) study. SETTING: Honolulu (XXX, XXX) area public and private secondary schools with varsity and junior varsity football. PATIENTS OR OTHER PARTICIPANTS: Football participants (n=496) ages 14 to 18 years old. Intervention(s) Participants wore new football helmets furnished with head impact sensor technology. Teams employed a season-long helmetless tackling and blocking intervention in Years 2 and 3 consisting of a 3-phase, systematic progression of 10 instructional drills. MAIN OUTCOME MEASURE(S): Head impact frequency per athlete exposure (ImpAE), location, and impact magnitude per participant intervention adherence levels (60% and 80%). RESULTS: An overall regression analysis revealed a significant negative association between ImpAE and adherence (p=0.003, beta=-1.21, SE=0.41). In year 3, a longitudinal data analysis of weekly ImpAE data resulted in an overall difference between the adherent and non-adherent groups (p=0.040 at 80%; p=0.004 at 60%), mainly due to decreases in top and side impacts. Mean cumulative impact burden for the adherent group (n=131: 2,105.84g ± 219.76,) was significantly (p=0.020) less than the non-adherent group (n=90: 3,158.25g ± 434.80) at the 60% adherence level. CONCLUSIONS: Participants adhering to the intervention on at least a 60% level experienced a 34% to 37% significant reduction in the number of head impacts (per exposure) through the season. These results provide additional evidence that a helmetless tackling and blocking training intervention (utilizing the HuTT® program) reduces head impact exposure in high school football players. Adherence to an intervention is crucial for achieving intended outcomes.

Department

Psychiatry and Behavioral Sciences

Link to Full Text

Share

COinS