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Published on: February 19, 2017
Head Impact Exposure in Hawaiian High School Football: Influence of Adherence Rates on a Helmetless Tackling and
Erik E Swartz1, Jay L Myers2, Jong Soo Lee3
1Vice 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
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.
