POSITIONAL DIFFERENCES IN HELMET IMPACT EXPOSURE RATES IN HAWAIIAN HIGH SCHOOL FOOTBALL ATHLETES

Abstract

Context: Previous research has shown the importance of analyzing head impact exposure (HIE) among high school football players, yet few studies explore the difference across position groups. Therefore, the purpose of this study was to analyze head impact frequency between position groups.Objective: Quantify the difference of impacts per exposure (Imp/E) between position groups in high school football during the 2019 and 2021 seasons. Design: Cross-sectional study. Setting: Three high school varsity football teams on O'ahu. Patients and Participants: 200 varsity football players featuring 69 offensive/defensive linemen ( 16.0 ± 0.9 yrs, 180.4 ± 7.7 cm, 87.0 ± 22.4 kg; linemen), 51 linebackers/running backs/tight ends (16 ± 0.8 yrs, 176.6 ± 7.1 cm, 83.7 ± 13.8 kg; backers) and 80 wide receivers/defensive backs (16.1 ± 1.0 yrs, 175.4 ± 6.3 cm, 71.72 ± 10.32 kg; skills). Main Outcome Measures: Games, practice, and total Imp/E analyzed across positions, teams, and years. Results: A difference was observed across position groups (P<0.001). Season was not found to be a factor (P<0.446). A significant interaction (P<0.002) exists between team B and C (P=0.021), but not between A and C. Post-hoc analysis confirms that the backers (3.37 [95% CI: 2.80, 3.949]) experience a higher HIE compared to linemen (1.55 [95%CI: 1.067, 2.049]) and skill players (1.57 [95%CI: 1.124, 2.035]). Conclusion: To our knowledge, this is the first study of this size comparing position groups in terms of Imp/E of the given population across two seasons. These data demonstrate that linebackers and running backs experience more impacts per exposure, indicating the influence of running the ball or directly defending the ball has on increased head impacts. Future research, such as player risk-compensation, impact location across position groups in the given population, or alteration of coaching techniques and style of play could contribute to overall risk reduction of head impact exposure.Key Words: Head impact frequency, Riddell Insite, traumatic brain injury Word Count: 349 Key Points: Running backs, tight ends, and linebackers experienced a greater number of impacts per exposure in high school football players. Analyzing head impacts per exposure has the potential to identify factors contributing to increased frequency of head impacts and patterns across position groups within a team.