Cited by 210Traumatic Brain Injury ResearchAutomotive and Human Injury BiomechanicsSports injuries and prevention

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Head-Impact–Measurement Devices: A Systematic Review

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O'Connor, Kathryn L., Rowson, Steven, Duma, Stefan M., Broglio, Steven P.·2017·Journal of Athletic Training

DOI 10.4085/1062-6050.52.2.05PMC PMC5384819

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Abstract

Context: With an estimated 3.8 million sport- and recreation-related concussions occurring annually, targeted prevention and diagnostic methods are needed. Biomechanical analysis of head impacts may provide quantitative information that can inform both prevention and diagnostic strategies. Objective: To assess available head-impact devices and their clinical utility. Data Sources: We performed a systematic search of the electronic database PubMed for peer-reviewed publications, using the following phrases: accelerometer and concussion, head impact telemetry, head impacts and concussion and sensor, head impacts and sensor, impact sensor and concussion, linear acceleration and concussion, rotational acceleration and concussion, and xpatch concussion. In addition to the literature review, a Google search for head impact monitor and concussion monitor yielded 15 more devices. Study Selection: Included studies were performed in vivo, used commercially available devices, and focused on sport-related concussion. Data Extraction: One author reviewed the title and abstract of each study for inclusion and exclusion criteria and then reviewed each full-text article to confirm inclusion criteria. Controversial articles were reviewed by all authors to reach consensus. Data Synthesis: In total, 61 peer-reviewed articles involving 4 head-impact devices were included. Participants in boxing, football, ice hockey, soccer, or snow sports ranged in age from 6 to 24 years; 18% (n = 11) of the studies included female athletes. The Head Impact Telemetry System was the most widely used device (n = 53). Fourteen additional commercially available devices were presented. Conclusions: Measurements collected by impact monitors provided real-time data to estimate player exposure but did not have the requisite sensitivity to concussion. Proper interpretation of previously reported head-impact kinematics across age, sport, and position may inform future research and enable staff clinicians working on the sidelines to monitor athletes. However, head-impact–monitoring systems have limited clinical utility due to error rates, designs, and low specificity in predicting concussive injury.

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Investigation of Head Kinematics and Brain Strain Response During Soccer Heading Using a Custom-Fit Instrumented Mouthguard
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Background
Sub-concussive trauma, acute concussion, and history of multiple concussions: Effects on quiet stance postural control stability
Dierijck, J. K., Wright, A. D., Smirl, J. D., Bryk, K. N., & van Donkelaar, P. (2018) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2018.03.005 · Cited by 20
An Investigation of Factors Associated With Head Impact Exposure in Professional Male and Female Australian Football Players
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“001 0-5 y 12 (13) 48 (41) 6-10 y 18 (20) 42 (36) 11-15 y 23 (25) 23 (19) .”
Duration of Ice Hockey Play and Chronic Traumatic Encephalopathy
Abdolmohammadi, B., Tuz‐Zahra, F., Uretsky, M., Nicks, R., Mosaheb, S., Labonte, J., Yhang, E., Durape, S., Martin, B. M., Palmisano, J. N., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.49106 · Cited by 22
Impact behaviour of 3D printed cellular structures for mouthguard applications
Saunders, J., Lißner, M., Townsend, D., Petrinić, N., & Bergmann, J. (2022) · Scientific Reports · doi:10.1038/s41598-022-08018-1 · Cited by 19
IoT Integrated Accelerometer Design and Simulation for Smart Helmets
Priyanka, J., Ramya, M., & Alagappan, M. (2023) · Indian Journal of Information Sources and Services · doi:10.51983/ijiss-2023.13.2.3862 · Cited by 19
“Measuring the tissue-level response of the brain to impact in vivo poses significant challenges, making it exceedingly difficult to obtain direct measurements [17].”
Background
Comparing fMRI activation during smooth pursuit eye movements among contact sport athletes, non-contact sport athletes, and non-athletes
Kellar, D., Newman, S., Pestilli, F., Cheng, H., & Port, N. (2018) · NeuroImage: Clinical · doi:10.1016/j.nicl.2018.01.025 · Cited by 21
“When tested against biomechanical sensors in a laboratory setting, the accuracy of helmet-based accelerometers must be interpreted cautiously (O'Connor et al., 2017; Siegmund et al., 2016).”
Physics-Informed Machine Learning Improves Detection of Head Impacts
Raymond, S., Cecchi, N. J., Alizadeh, H. V., Callan, A. A., Rice, E. N., Liu, Y., Zhou, Z., Zeineh, M., & Camarillo, D. B. (2022) · Annals of Biomedical Engineering · doi:10.1007/s10439-022-02911-6 · Cited by 18
SCAT3 changes from baseline and associations with X2 Patch measured head acceleration in amateur Australian football players
Willmott, C., McIntosh, A. S., Howard, T., Mitra, B., Dimech-Betancourt, B., Donovan, J., & Rosenfeld, J. V. (2017) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2017.09.591 · Cited by 18
A Dose Relationship Between Brain Functional Connectivity and Cumulative Head Impact Exposure in Collegiate Water Polo Players
Monroe, D. C., Cecchi, N. J., Gerges, P. E., Phreaner, J. J., Hicks, J. W., & Small, S. L. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00218 · Cited by 18
Altered Functional and Structural Connectomes in Female High School Soccer Athletes After a Season of Head Impact Exposure and the Effect of a Novel Collar
Dudley, J. A., Yuan, W., Diekfuss, J. A., Foss, K. D. B., DiCesare, C. A., Altaye, M., Logan, K., Leach, J. L., & Myer, G. D. (2020) · Brain Connectivity · doi:10.1089/brain.2019.0729 · Cited by 18
“Because the accuracy of head impact detection via accelerometer tracking is quite poor (O’Connor et al., 2017; Press and Rowson, 2017), we also present results from a model without the continuous predictor variable for number of head impacts.”
Sex and Sport Differences in College Lacrosse and Soccer Head Impact Biomechanics
Mihalik, J. P., Amalfe, S. A., Roby, P. R., Ford, C. B., Lynall, R. C., Riegler, K. E., Teel, E. F., Wasserman, E. B., & Putukian, M. (2020) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002382 · Cited by 18
“To achieve this outcome, scientists have several head impact measurement devices in the market to choose from (12).”
Background
No Seasonal Changes in Cognitive Functioning Among High School Football Athletes: Implementation of a Novel Electrophysiological Measure and Standard Clinical Measures
Broglio, S. P., Williams, R. M., Rettmann, A., Moore, B., Eckner, J. T., & Meehan, S. K. (2017) · Clinical Journal of Sport Medicine · doi:10.1097/jsm.0000000000000420 · Cited by 18
Self-citation
Sensors and digital medicine in orthopaedic surgery
Merle, G. E., Parent-Harvey, A., & Harvey, E. J. (2022) · OTA International The Open Access Journal of Orthopaedic Trauma · doi:10.1097/oi9.0000000000000189 · Cited by 18
“2 rate and blood pressure.([31]) Patients are more than willing to accept new technology and the gamification of rehabilitation.”
Background
Subconcussion, Concussion, and Cognitive Decline: The Impact of Sports Related Collisions
Dioso, E., Cerillo, J., Azab, M. A., Foster, D. T., Smith, I. B., Leary, O. P., Goutnik, M., & Lucke-Wold, B. P. (2022) · Journal of Medical Research and Surgery · doi:10.52916/jmrs224081 · Cited by 17
“Measurements collected by head-impact monitoring systems provided real-time data, but lacked clinical utility due to error rates and low specificity in predictive concussion [73] However, these monitoring systems did indicate that sustaining an impact of 90 g does not result in acute observable balance and neurocognit…”
Background
Sleep and Psychiatric Disorders in Persons With Mild Traumatic Brain Injury
Mollayeva, T., D’Souza, A., & Mollayeva, S. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0800-z · Cited by 17
Head Impact Telemetry System’s Video-based Impact Detection and Location Accuracy
Campbell, K. R., Marshall, S. W., Luck, J. F., Pinton, G., Stitzel, J. D., Boone, J. S., Guskiewicz, K. M., & Mihalik, J. P. (2020) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002371 · Cited by 17
Video Analysis and Verification of Direct Head Impacts Recorded by Wearable Sensors in Junior Rugby League Players
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Understanding and Managing Trauma-Induced Vestibular Deficits
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Evaluating the validity of self-report as a method for quantifying heading exposure in male youth soccer
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National Athletic Trainers' Association Position Statement: Reducing Intentional Head-First Contact Behavior in American Football Players
Swartz, E. E., Register‐Mihalik, J. K., Broglio, S. P., Mihalik, J. P., Myers, J. L., Guskiewicz, K. M., Bailes, J. E., & Hoge, M. (2022) · Journal of Athletic Training · doi:10.4085/1062-6050-0062.21 · Cited by 17
Self-citation
Evaluation of the Effectiveness of Newer Helmet Designs with Emergent Shell and Padding Technologies Versus Older Helmet Models for Preserving White Matter Following a Season of High School Football
Diekfuss, J. A., Yuan, W., Dudley, J. A., DiCesare, C. A., Panzer, M. B., Talavage, T. M., Nauman, E. A., Bonnette, S., Slutsky‐Ganesh, A. B., Clark, J. F., et al. (2021) · Annals of Biomedical Engineering · doi:10.1007/s10439-021-02863-3 · Cited by 15
Limb biomechanics in combat sports: insights from wearable sensor technology
Xue, H., Han, C., & Zhu, D. (2025) · Frontiers in Bioengineering and Biotechnology · doi:10.3389/fbioe.2025.1663592 · Cited by 27
“These include an individual ’ s concussion history, age, sex, genetic predispositions, and even the rotational components of the impact, which are particularly dif ﬁ cult to measure accurately (O ’ Connor et al., 2017).”
Influential
Patterns of head impact exposure in men’s and women’s collegiate club water polo
Cecchi, N. J., Monroe, D. C., Phreaner, J. J., Small, S. L., & Hicks, J. W. (2020) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2020.03.008 · Cited by 14
Laboratory evaluation of a wearable head impact sensor for use in water polo and land sports
Cecchi, N. J., Monroe, D. C., Oros, T. J., Small, S. L., & Hicks, J. W. (2020) · Proceedings of the Institution of Mechanical Engineers Part P Journal of Sports Engineering and Technology · doi:10.1177/1754337120901974 · Cited by 14
“because many head impact sensors have been demonstrated to suffer from poor accuracy and/or reliability in capturing these kinematic measures relative to biofidelic headforms.(15,16) There are a wide variety of commercially available head impact sensors, including mastoid skin patch sensors, helmet-mounted sensors, mo…”
Background
Modelling of the Brain for Injury Simulation and Prevention
Yang, K. H., & Mao, H. (2019) · Biological and medical physics, biomedical engineering · doi:10.1007/978-3-030-04996-6_5 · Cited by 14
A data-driven hybrid recurrent neural network and model-based framework for accurate impact force estimation
Bahmanpour, M., Kalhori, H., & Li, B. (2025) · Mechanical Systems and Signal Processing · doi:10.1016/j.ymssp.2025.112503 · Cited by 13
An Evaluation of the Emerging Techniques in Sports-Related Concussion
Brown, J. C., Goldszer, I. M., Brooks, M., & Milano, N. J. (2023) · Journal of Clinical Neurophysiology · doi:10.1097/wnp.0000000000000879 · Cited by 13
Quantifying head impacts and neurocognitive performance in collegiate boxers
Doan, B. K., Heaton, K. J., Self, B., Samuels, M. A. B., & Adam, G. E. (2021) · Journal of Sports Sciences · doi:10.1080/02640414.2021.2001175 · Cited by 12
AI-Based Denoising of Head Impact Kinematics Measurements With Convolutional Neural Network for Traumatic Brain Injury Prediction
Zhan, X., Liu, Y., Cecchi, N. J., Callan, A. A., Flao, E. L., Gevaert, O., Zeineh, M., Grant, G. A., & Camarillo, D. B. (2024) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2024.3392537 · Cited by 15
“To calculate the injury metrics, researchers have developed wearable sensor technologies to measure head kinematics with systems like the Head Impact Telemetry System (HITS) [10], Xpatch [11], head-band/skullcap mounted sensors [12] and instrumented mouth-guards [13], [14].”
Method
Influence of the frame of reference on head acceleration events recorded by instrumented mouthguards in community rugby players
Bussey, M. D., Davidson, P. L., Salmon, D., Romanchuk, J., Tong, D., & Sole, G. (2022) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2022-001365 · Cited by 13
Comparison of frequency and magnitude of head impacts experienced by Peewee boys and girls in games of youth ice hockey
Post, A., Karton, C., Thevenot, O., Hoshizaki, T. B., Robidoux, M. A., & Gilchrist, M. D. (2020) · Computer Methods in Biomechanics & Biomedical Engineering · doi:10.1080/10255842.2020.1805442 · Cited by 12
“This inconsistency may be a reflection of the measurement systems used, as head and helmet telemetry sensors have been reported to suffer from errors measuring impact magnitude (Jadischke et al. 2013; O’Connor et al. 2017).”
The Effectiveness of Regulations and Behavioral Interventions on Head Impacts and Concussions in Youth, High-School, and Collegiate Football: A Systematized Review
Phillips, N. L., & Crisco, J. J. (2020) · Annals of Biomedical Engineering · doi:10.1007/s10439-020-02624-8 · Cited by 12
Adaptive Machine Learning Head Model Across Different Head Impact Types Using Unsupervised Domain Adaptation and Generative Adversarial Networks
Zhan, X., Sun, J., Liu, Y., Cecchi, N. J., Flao, E. L., Gevaert, O., Zeineh, M., & Camarillo, D. B. (2024) · IEEE Sensors Journal · doi:10.1109/jsen.2023.3349213 · Cited by 11
“Such systems involve the head impact telemetry system (HITS) [16], Xpatch [17], headband/skullcap mounted sensors [18], and instrumented mouthguards [19], [20] which leverage the accelerometers and gyroscopes to measure the head kinematics.”
Background
Exploring the Vitreoretinal Interface: A Key Instigator of Unique Retinal Hemorrhage Patterns in Pediatric Head Trauma
Song, H. H., Thoreson, W. B., Dong, P., Shokrollahi, Y., Gu, L., & Suh, D. W. (2022) · Korean Journal of Ophthalmology · doi:10.3341/kjo.2021.0133 · Cited by 11
“For example, properly heading a soccer ball produces almost purely linear acceleration but head-tohead collisions in soccer, football, rugby, and other sports can produce significant levels of both angular and linear acceleration [17,24].”
Background
The relationship between fluid biomarkers and clinical outcomes in sports-related concussions: a systematic review
Meyer, J. E., Bartolomei, C., Sauer, A., Sajatovic, M., & Bailey, C. M. (2020) · Brain Injury · doi:10.1080/02699052.2020.1802780 · Cited by 12
[Inferior vena cava thrombosis responsible for chronic Budd-Chiari syndrome during hepatic and digestive amyloidosis].
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Video Analysis of Concussion Exposures in a National Collegiate Athletic Association Division I Football Team
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Impact and workload are dominating on-field data monitoring techniques to track health and well-being of team-sports athletes
Cheng, R., & Bergmann, J. (2022) · Physiological Measurement · doi:10.1088/1361-6579/ac59db · Cited by 10
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Smart Textile Impact Sensor for e-Helmet to Measure Head Injury
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A non-invasive biomechanical model of mild TBI in larval zebrafish
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Background
Magnetic Resonance Elastography-Based Technique to Assess the Biomechanics of the Skull-Brain Interface: Repeatability and Age-Sex Characteristics
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Reliability of a neck strength test in schoolboy rugby players
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Cutting to the Pathophysiology Chase: Translating Cutting-Edge Neuroscience to Rehabilitation Practice in Sports-Related Concussion Management
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The Biomechanics of Ice Hockey: Health and Performance Using Wearable Technology
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“[16] Head impact and associated acceleration magnitudes.”
Development of a Head Acceleration Event Classification Algorithm for Female Rugby Union
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Measurement of Head Kinematics Using Instrumented Mouthguards During Introductory Boxing Courses in U.S. Military Academy Cadets
Fetchko, T. J., Hart, G. J., Aderman, M. J., Ross, J. D., Malvasi, S. R., Roach, M. H., Cameron, K. L., & Rooks, T. F. (2023) · Military Medicine · doi:10.1093/milmed/usad249 · Cited by 8

Authors: O'Connor, K. L., Rowson, S., Duma, S. M., & Broglio, S. P.
Affiliations: NeuroTrauma Research Laboratory, University of Michigan, Ann Arbor;
Virginia Tech - Wake Forest University School of Biomedical Engineering & Sciences (US)
University of Michigan (US)
ORCID: Rowson, Steven
Broglio, Steven P.
Venue: Journal of Athletic Training
Publisher: National Athletic Trainers' Association
Published: 2017-03-01
Volume: 52
Issue: 3
Pages: 206-227
ISSN: 1062-6050 (ISSN-L)
DOI: 10.4085/1062-6050.52.2.05
PMC: PMC5384819
OpenAlex: W2605194641
Cited by: 210
References: 121
Citations by year: 2026: 12 · 2025: 18 · 2024: 29 · 2023: 19 · 2022: 31 · 2021: 36 · 2020: 29 · 2019: 19 · 2018: 9 · 2017: 7
FWCI: 2.32
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Journal of Athletic Training (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
Physical Sciences › Engineering › Biomedical Engineering › Automotive and Human Injury Biomechanics
Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
Keywords: head impact monitoring, sports-related concussion, impact sensors, accelerometer, concussion diagnosis, concussion prevention, angular acceleration, linear acceleration, athlete exposure
MeSH terms: Acceleration, Adolescent, Adult, Athletic Injuries, Biomechanical Phenomena, Boxing, Brain Concussion, Child, Female, Football, Head, Head Protective Devices, Hockey, Humans, Male, Soccer, Sports Medicine, Telemetry, Young Adult, Athletes

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Head-Impact–Measurement Devices: A Systematic Review

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