Exploring an unknown in concussion research: Youth Football

The University of Nebraska-Lincoln is teaming up with Virginia Tech, Brown University, and Wake Forest for the largest and most comprehensive biomedical study of youth football.
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October 29, 2015 - 6:44am

For several years, researchers have been studying concussions in high school, collegiate, and professional contacts sports. But much remains unknown about head impact injuries in youth football leagues- typically ranging from ages 8 to 12. But that’s soon about to change. NET News' Ben Bohall spoke with Arthur Maerlender, associate director and director of clinical research at CB3. He’ll soon head neuropsychology testing on a new, five-year study looking at the effects of mild traumatic brain injuries in 9- and 10-year-olds who play youth football.


NET NEWS: My understanding is this study is considered to be the largest and most comprehensive biomedical study of youth football. What contribution are you hoping it will make to understanding head injuries in that sport?

ARTHUR MAERLENDER: "The hope is to characterize the biomechanics forces that kids at this age sustain while playing football. We also then want to take a look at those who actually get concussions. You don't get a lot, and this is one of the issues in all of this concussion research. The IRB (Institutional Research Board) wouldn’t want to create concussions so you have to take them when you can find them. While people are concerned that there are a lot, there really aren’t that many when it comes to research. When you need a hundred subjects, for instance, for a study getting one hundred concussions from one team or one school can take a while. With the younger kids we have even fewer concussions. So we have a fairly large sample by looking over several years. We're hoping we can get enough concussions to have meaningful data. But (even) without the concussions, we'll be able to characterize just how many biomechanical forces these kids are obtaining. We don't know what that means in some ways, but it's a start. We’ve already done this with the collegiate athletic football and hockey so this is the natural extension of that kind of dropping down and seeing. So we can compare them. What do kids take- compared to what older kids take?

Arthur Maerlender is associate director and director of clinical research at UNL's Center for Brain, Biology, and Behavior. (courtesy photo)

 

NET NEWS: And how will you and your colleagues go about accomplishing that?

ARTHUR MAERLENDER: "We instrument helmets. That's not an easy task because you have to work with helmet manufacturers to embed these sensors in the helmets. But not every player has an instrumented helmet. There's a cost factor involved in terms of how many sets of instruments we have. So we look for parents who are wanting to have their kids instrumented. We instrument the helmets and then we have research assistants who go to every practice and go to every game and record the data. We also, at the start of the season and at the end of the season, get a battery of neuropsychological tests on the kids so we can look to see if there's a relationship between just playing football for a season and their cognitive performance, or not. This methodology is what we used in a previous study with three division one collegiate schools and published those results several years ago. We're modeling this study after that study. When we get a concussion, we will test them, but neuropsych tests will also look at their biomechanics. Then we'll also select another athlete who was not concussed and assess them at the same point in time. So then we have a comparison subject that we can then look to see what their metrics look like- they’re neuropsych scores and their biomechanics- and compare them."

NET NEWS: Football is a sport that’s popularity shows no signs of slowing down. When you hit the end of this five-year study, what do you think will be some of its practical implications?

ARTHUR MAERLENDER: "There is very little on kids at all. So just the fact that we're studying them is I think a contribution. I think that the size of biomechanics, looking at cognitive performance and does it change, we don't expect it to but it might be different in young kids than older kids. One of the things that shows up in a lot of the research is that there are individual differences. Some kids respond differently to various levels of biomechanical force and some kids get concussed easier than other kids. We've found that in the collegiate athletes- will we find that in the younger kids? So there's a lot of questions about how young kids differ in their brain function and in their performance. Kids are not little adults and the differences are not linear. It's not the same between an eight and ten-year-old as between a ten and a twelve year old. They magnify as you get younger... The lab that’s leading this project has a system for rating helmets based on their ability to mediate biomechanical forces and it’s in use for manufacturers- for the collegiate and professional ranks. So if this can then be translated to youth helmets, I think that would be pretty significant. There's a kind of an undercurrent or separate parallel track of folks who want to see hit counts and that if we can identify a threshold of hits- biomechanical forces- we could (have) like a pitch count where we could say, ‘Oh, you've had too many and we know you're at higher risk for concussion so you need to come out (of the game). Well, that's a wonderful idea. We're not clear that it's a practical idea and so that might be something this study Kind of helps us to decide. Can we go down that path though or is it just too much variation and there are too many differences from one individual to another where counting hits doesn't make sense. We don't know and I think this is going to help us make some of those decisions once we get that data together."

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