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Characterizing Verified Head Impacts in High School Girls' Lacrosse.
Am J Sports Med 2017; 45(14):3374-3381AJ

Abstract

BACKGROUND

Girls' high school lacrosse players have higher rates of head and facial injuries than boys. Research indicates that these injuries are caused by stick, player, and ball contacts. Yet, no studies have characterized head impacts in girls' high school lacrosse.

PURPOSE

To characterize girls' high school lacrosse game-related impacts by frequency, magnitude, mechanism, player position, and game situation.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

Thirty-five female participants (mean age, 16.2 ± 1.2 years; mean height, 1.66 ± 0.05 m; mean weight, 61.2 ± 6.4 kg) volunteered during 28 games in the 2014 and 2015 lacrosse seasons. Participants wore impact sensors affixed to the right mastoid process before each game. All game-related impacts recorded by the sensors were verified using game video. Data were summarized for all verified impacts in terms of frequency, peak linear acceleration (PLA), and peak rotational acceleration (PRA). Descriptive statistics and impact rates were calculated.

RESULTS

Fifty-eight verified game-related impacts ≥20 g were recorded (median PLA, 33.8 g; median PRA, 6151.1 rad/s2) during 467 player-games. The impact rate for all game-related verified impacts was 0.12 per athlete-exposure (AE) (95% CI, 0.09-0.16), equivalent to 2.1 impacts per team game, indicating that each athlete suffered fewer than 2 head impacts per season ≥20 g. Of these impacts, 28 (48.3%) were confirmed to directly strike the head, corresponding with an impact rate of 0.05 per AE (95% CI, 0.00-0.10). Overall, midfielders (n = 28, 48.3%) sustained the most impacts, followed by defenders (n = 12, 20.7%), attackers (n = 11, 19.0%), and goalies (n = 7, 12.1%). Goalies demonstrated the highest median PLA and PRA (38.8 g and 8535.0 rad/s2, respectively). The most common impact mechanisms were contact with a stick (n = 25, 43.1%) and a player (n = 17, 29.3%), followed by the ball (n = 7, 12.1%) and the ground (n = 7, 12.1%). One hundred percent of ball impacts occurred to goalies. Most impacts occurred to field players within the attack area of the field (n = 32, 55.2%) or the midfield (n = 18, 31.0%). Most (95%) impacts did not result in a penalty.

CONCLUSION

The incidence of verified head impacts in girls' high school lacrosse was quite low. Ball to head impacts were associated with the highest impact magnitudes. While stick and body contacts are illegal in girls' high school lacrosse, rarely did such impacts to the head result in a penalty. The verification of impact mechanisms using video review is critical to collect impact sensor data.

Authors+Show Affiliations

Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, Virginia, USA.MedStar Sports Medicine, Baltimore, Maryland, USA.Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, Virginia, USA.Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, Virginia, USA.Princeton University, Princeton, New Jersey, USA.MedStar Sports Medicine, Baltimore, Maryland, USA.University of Virginia, Charlottesville, Virginia, USA.Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, Virginia, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28918649

Citation

Caswell, Shane V., et al. "Characterizing Verified Head Impacts in High School Girls' Lacrosse." The American Journal of Sports Medicine, vol. 45, no. 14, 2017, pp. 3374-3381.
Caswell SV, Lincoln AE, Stone H, et al. Characterizing Verified Head Impacts in High School Girls' Lacrosse. Am J Sports Med. 2017;45(14):3374-3381.
Caswell, S. V., Lincoln, A. E., Stone, H., Kelshaw, P., Putukian, M., Hepburn, L., ... Cortes, N. (2017). Characterizing Verified Head Impacts in High School Girls' Lacrosse. The American Journal of Sports Medicine, 45(14), pp. 3374-3381. doi:10.1177/0363546517724754.
Caswell SV, et al. Characterizing Verified Head Impacts in High School Girls' Lacrosse. Am J Sports Med. 2017;45(14):3374-3381. PubMed PMID: 28918649.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterizing Verified Head Impacts in High School Girls' Lacrosse. AU - Caswell,Shane V, AU - Lincoln,Andrew E, AU - Stone,Hannah, AU - Kelshaw,Patricia, AU - Putukian,Margot, AU - Hepburn,Lisa, AU - Higgins,Michael, AU - Cortes,Nelson, Y1 - 2017/09/18/ PY - 2017/9/19/pubmed PY - 2018/5/29/medline PY - 2017/9/19/entrez KW - female KW - head impacts KW - lacrosse KW - verification KW - video analysis KW - wearable sensors SP - 3374 EP - 3381 JF - The American journal of sports medicine JO - Am J Sports Med VL - 45 IS - 14 N2 - BACKGROUND: Girls' high school lacrosse players have higher rates of head and facial injuries than boys. Research indicates that these injuries are caused by stick, player, and ball contacts. Yet, no studies have characterized head impacts in girls' high school lacrosse. PURPOSE: To characterize girls' high school lacrosse game-related impacts by frequency, magnitude, mechanism, player position, and game situation. STUDY DESIGN: Descriptive epidemiology study. METHODS: Thirty-five female participants (mean age, 16.2 ± 1.2 years; mean height, 1.66 ± 0.05 m; mean weight, 61.2 ± 6.4 kg) volunteered during 28 games in the 2014 and 2015 lacrosse seasons. Participants wore impact sensors affixed to the right mastoid process before each game. All game-related impacts recorded by the sensors were verified using game video. Data were summarized for all verified impacts in terms of frequency, peak linear acceleration (PLA), and peak rotational acceleration (PRA). Descriptive statistics and impact rates were calculated. RESULTS: Fifty-eight verified game-related impacts ≥20 g were recorded (median PLA, 33.8 g; median PRA, 6151.1 rad/s2) during 467 player-games. The impact rate for all game-related verified impacts was 0.12 per athlete-exposure (AE) (95% CI, 0.09-0.16), equivalent to 2.1 impacts per team game, indicating that each athlete suffered fewer than 2 head impacts per season ≥20 g. Of these impacts, 28 (48.3%) were confirmed to directly strike the head, corresponding with an impact rate of 0.05 per AE (95% CI, 0.00-0.10). Overall, midfielders (n = 28, 48.3%) sustained the most impacts, followed by defenders (n = 12, 20.7%), attackers (n = 11, 19.0%), and goalies (n = 7, 12.1%). Goalies demonstrated the highest median PLA and PRA (38.8 g and 8535.0 rad/s2, respectively). The most common impact mechanisms were contact with a stick (n = 25, 43.1%) and a player (n = 17, 29.3%), followed by the ball (n = 7, 12.1%) and the ground (n = 7, 12.1%). One hundred percent of ball impacts occurred to goalies. Most impacts occurred to field players within the attack area of the field (n = 32, 55.2%) or the midfield (n = 18, 31.0%). Most (95%) impacts did not result in a penalty. CONCLUSION: The incidence of verified head impacts in girls' high school lacrosse was quite low. Ball to head impacts were associated with the highest impact magnitudes. While stick and body contacts are illegal in girls' high school lacrosse, rarely did such impacts to the head result in a penalty. The verification of impact mechanisms using video review is critical to collect impact sensor data. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/28918649/Characterizing_Verified_Head_Impacts_in_High_School_Girls'_Lacrosse_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546517724754?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -