VANDERBILT UNIVERSITY Minimizing the Risks of Head Trauma in Modern Day American Football Focus on limiting causes of subdural brain hemorrhaging BME 272 Group #3 Doug Browne, Jeff Markle, Tyler Severance Advisor: Dr. Jonathan Forbes 11/11/2010 Abstract As a result of this design process, the group hopes to: Study the effects of angular acceleration in football emulated collisions Improve existing helmet design, or create a new model to reduce the angular acceleration from collisions Develop a system to determine when a helmet has lost the functionality and can no longer safely protect athletes from angular acceleration (3.1) Introduction Since the inception of the game in 1869, American football has enjoyed ever increasing popularity until becoming the pinnacle of sporting entertainment which it achieved in the 21st century. However, as the sport continues to grow, more and more athletes are exposing themselves to the inherent risks of the game. One of these, subdural hemorrhages (SDH), poses a significant risk to athletes of any level and serves as the focus of this design and application process. It has been theorized, but only loosely proven, that subdural hemorrhages, and thus, concussions and other similar injuries, are the result of angular acceleration due to violent head collisions (Forbes). In fact, based on research performed from 1945 to 1994, subdural hemorrhages have accounted for the majority of football related deaths. To be more precise, it was determined that at least 352 of the 684 fatalities during this timeframe were the result of SDH (Cantu). This significance of head injuries has dictated the policy of equipment design for several decades. Helmet use has been mandatory for approximately 70 years and facemasks have been required for almost 60. As these new equipment models were required, it slowly began to change the manner in which the game was played. New technique, such as leading a tackle with the crown of the helmet, by athletes yielded a significant increase in helmet leading tackles (Cantu). Thus, the incidence of fatalities as a result of brain injuries peaked from 1965 to 1969. This led to the initiation of the National Operating Committee on Standards for Athletic Equipment (NOCSAE). By 1973, the NOCSAE had created a new set of rules and regulations on how to play the game safely, and by 1980, similar standards had been passed down to collegiate and high school level football as well. Additionally, the NOCSAE began implementing new standards of helmet regulation which further improved the safety of football players. Despite the initial indications that helmet related injuries were decreasing, this trend soon plateaued around 1994, and began to steadily increase once again. Additionally, the cause of a significant majority (94%) of fatalities was directly linked to the incidence of subdural hemorrhages (Boden). Modern testing and the improvement in helmet assessment now allow for a much better investigation as to the precise levels of translational and rotational accelerations and the values of these collisions, even at the high school level, overlap with the minimum threshold to induce subdural hemorrhages (SDHs). Because translational acceleration has been studied thoroughly over the past decade with minimal success, it is reasoned to believe that a much greater cause of injury due to SDH is the rotational acceleration from violent collisions. This study hopes to investigate this claim, engineer helmets that more appropriately address this concern, and finally propose a new system to the NOCSAE to properly test and measure this concept as it relates to regulating helmets in American Football. (3.2) History and Context To date, the group has done a thorough job researching the background of the NFL, NCAA, and high school football regulating bodies. Specifically, the NOCSAE is the organization responsible for enforcing all rules regarding helmet standards. As a starting point, used helmets from local teams can be used in rotational acceleration simulations to calculate actual values and determine the likelihood of them resulting in subdural hemorrhages. After a baseline has been established, it will be possible to try new types of materials and to incorporate different designs (such as shortening the lever arm) to attempt to reduce the angular acceleration. Eventually, it will be possible to create an easily replicated test that can be used by teams to determine when helmets actually need to be replaced. This project has a wide scope of applicability in that it can be applied to all three levels of competitive football. The potential market includes countless colleges, high schools, professional teams, and even Canadian and Arena football leagues. The practicality of this study cannot be underestimated as the severe nature of head injuries will always be an issue of concern. 3.3. Team Our design team is composed of three Vanderbilt University undergraduate engineering students. Tyler Severance is a Biomedical Engineering student who will serves as group leader, communicator, and biomechanics and physics specialist. Doug Browne is a Mechanical Engineering student who will act as the team’s design engineer and materials and mechanics specialist. Jeff Markle is a Biomedical Engineering Student with a background in Computer Science. He will serve the group as task focuser, technology specialist, and statistical analyst. This team features a strong mix of skills that are all extremely relevant to the biological and physical study of subdural hemorrhaging as well as the design and construction of a helmet. The team members are also all accountable for their own work and dedicated to this specific task. The team reports to three outside sources, Dr. Paul King a Biomedical Engineering professor, Dr. Joel Barnett a professor of Mechanical Engineering, and Dr. Jonathan Forbes who is a neurologist at Vanderbilt Hospital. Dr. Forbes is the project adviser and will oversee the group over the course of the grant. (3.4.) Work Plan and Outcome We hope to learn about the risks of subdural brain hemorrhaging and concussions in American football. Also, we wish to understand the causes of these injuries and why they occur more frequently in high school than in the National Football League. Ultimately, this project has a twofold goal, firstly, to design a new football helmet to drastically reduce the events that cause subdural brain hemorrhaging and concussions, and secondly to develop a system to assess the degradation of quality of helmets used in lower level football programs. The major processes we will follow include a research period to determine the causes of these injuries and how they can be reduced, a research-based brainstorming session to generate design ideas, a design proposal, a design period to implement our proposed design, a testing period, and finally a marketing and an application period. Throughout this design project we hope to firstly understand the causes and effects of subdural brain hemorrhaging and concussions occurring in football. Then, at the conclusion of the grant period we hope to have successfully created an easily accessible and affordable helmet to reduce these risks that can be marketed to football programs of all levels. (3.5) Evaluation and sustainability plan In this project, we are attacking two different problems with subdural hemorrhaging in American football. The two problems are the helmet itself and the process for which used helmets are tested to make sure they meet standards before they are redistributed and reused. As a design team we will feel like the project is a success if that by the end of April we have designed a football helmet that decreases rotational acceleration of a player’s head when hit to below the threshold where subdural hemorrhages can take place. We will be looking for innovative ways to decrease the rotational acceleration that a player’s head will undergo such that subdural hemorrhages will decrease in likelihood at all levels of American football. The next part of this project will be considered a success if we formulate a plan to make the testing of used helmets more efficient and more accurate. We will look into the current processes used by different helmet manufacturers and see if these processes can be improve and standardized such that an industry-wide standard can be set. We will consider this part of the project a success if we find a way to significantly improve on the current testing process or if we come up with an all new process that is more efficient, cost effective and accurate. Budget Proposal Expense Justification Cost Travel to Denver If we make sufficient progress, me may be able to attend a conference in April Testing Equipment To measure acceleration to see if new helmet designs decrease rotational acceleration 400 Used Helmets 4-5 helmets to modify and experiment with design 200 Total Timeline: Date October 28 Proposed Activities Submit NCIIA Grant Proposal November 3 4 10 11 16 18 Week of 22 Research Begins Update Website Submit Progress Report #1 Submit Progress Report #2 Updated NCIIA Grant Proposal Submit Progress Report #3 Electronic References due Oral Report #1 December 7 9 18 Research Continues IWB Conflict Map Due on Web Submit Progress Report #4 Submit Progress Report #5 CHRISTMAS BREAK January 14 Research Continues Update Website 2000 2600 20 28 Submit Progress Report #6 Oral Report #2 February 1 4 6 10 16 25 Begin Design Process Brainstorm Sessions Relate ideas to possible designs Submit Progress Report #7 Update Website Oral Report #3 Submit Progress Report #8 March 1 5 14 18 Design Continues Update Web SPRING BREAK Oral Report #4 Submit Progress Report #9 April 1 12 18 21 28 Testing and Modifications Submit Progress Report #10 Submit Progress Report #11 Oral Report #5 Submit Progress Report #12 Prepare final presentation/poster May ~1 Poster Presentation Future Marketing and Application References 1. Forbes, Jonathan. Biomechanics of Subdural Hemorrhage in American Football. Department of Neurological Surgery, Vanderbilt University Medical Center. Nashville, TN. 2010 2. Cantu RC, Mueller FO: Brain injury-related fatalities in American football, 1945-1999. Neurosurgery 52(4): 846-852; discussion 852-853, 2003. 3. Boden BP, Tacchetti RL, Cantu RC, Knowles SB, Mueller FO: Catastrophic head injuries in high school and college football players. Am J Sports Med 35(7):1075-81, 2007.