Reducing Head Impact Exposure in Hawaii High School Football
Condition: Head Trauma; Cognitive Change; Confidence, Self; Sports Injuries in Children
MeSH terms: Craniocerebral Trauma; Athletic Injuries
Study type: Interventional

Summary: 
      This three-year study will determine the effectiveness of a helmetless tackling training
      intervention to decrease head impact exposure in Hawaiian high school football players.
    

Detailed description: 
      High school football participants are reported to sustain an average of 600, and as many as
      2000, head impacts in a single season. Impacts to the top and front of the helmet generate
      the greatest forces, and thus pose the highest risk for acute brain and spinal cord injury.
      Equally disconcerting is the potential relationship between the accumulation of concussive
      and sub-concussive impacts (head impact exposure, HIE) and the risk for developing long-term
      conditions such as cognitive impairment, early-onset Alzheimer's, and chronic traumatic
      encephalopathy (CTE). Tackling and blocking behaviors using the head as the point of first
      contact can be attributed, in part, to the fact that players wear a helmet, which influences
      behavior by increasing the perception of safety.

      The central hypothesis is such that a football player who regularly practices tackling and
      blocking drills without a helmet in a controlled environment will naturally leave the head
      out of contact and is likely to continue to do so while wearing the helmet during games and
      full-contact practices. This learned motor behavior will reduce the number of head impacts a
      football player experiences throughout their playing career and thus reduces the risk of
      acute and chronic head and neck injury.

      The investigation will be a pre-test, post-test quasi experimental design using an
      evidence-based helmetless tackling and blocking program (HuTT®) with football players (~200)
      recruited from high school football teams in Oahu, Hawaii.

      Year 1 will serve as a baseline and entail collecting only head impact data during regular
      football participation for two teams. After adding a third team for years 2 and 3, all
      subjects will then undergo the HuTT® Program intervention emphasizing proper tackling and
      blocking techniques under closely supervised drills where players participate without their
      helmets and shoulder pads in place.

      From the outset, subjects will use a new Speedflex helmet outfitted with the InSite™ head
      impact sensor (Riddell, Co). The helmet and sensor will be worn in all practices and games
      and used to record head impact exposure (frequency, location, and magnitude). ImPACT tests
      will be conducted at pre- and post-season intervals to measure verbal and visual memory
      composite, visual motor speed composite, reaction time composite and symptoms scores. In
      addition, player self-efficacy for head-safe behavior will be scored each year using a
      self-reported survey.

      A between-subjects ANOVAs will be used to compare outcome measures among teams. Significant
      interactions and main effects will be identified by appropriate t-tests with Bonferonni
      corrections at an alpha-level of 0.05.
    

Intervention name(s): HuTT-2x; HuTT-4x
Intervention type(s): Behavioral; Behavioral
Intervention description(s): tackling and blocking training twice/week; tackling and blocking training four times/week
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: pre-test, post-test, quasi-experimental
Masking: Single (Investigator)
Primary purpose: Prevention
Keywords: concussion; tackle; youth sports