Instrumented mouthguards in elite sports: Validity and head acceleration event (HAE) incidence in NCAA American Football

Abstract: Objectives: To determine the on-field validity of instrumented mouthguards (iMGs) in American football and to quantify head acceleration event (HAE) incidence in NCAA football players. Methods: Instrumented mouthguards were fitted to 35 male NCAA football players. Head kinematic data were collected during 64 player matches. On-field validity was determined through video review with positive predictive value (PPV) and sensitivity values calculated. HAE incidence was calculated as the number of HAEs per player match and stratified by Offense and Defense positions. Results: On-field validity of the Prevent Biometrics iMG in NCAA American Football indicates a sensitivity was 0.89 and PPV ranging from 0.76-0.98 based on false positive definitions. The incidence of PLA and PAA HAEs above a range of thresholds in Defense and Offense appear similar. The incidence of HAEs above 10 g was 11.2 and 11.3 HAEs per player match for Defense and Offense, respectively, while PAA incidence above 1.0 krad/s2 was 5.5 and 6.9 HAEs per player match for Defense and Offense, respectively. Incidence of HAEs above 30 g was 1.6 and 2.6 per player match and 0.9 and 1.4 for HAEs above 2.0 krad/s2 for Defense and Offense, respectively. Conclusion: The Prevent Biometrics iMG appears suitable for measuring HAEs in elite American football. The study provides a benchmark assessment of HAE incidence in elite American Football and lays a foundation for the development of position-specific interventions aimed at reducing HAE exposure.