IU researchers begin study on subconcussive hits in football
By Catherine Winkler
Tuesday, September 10, 2019
School of Public Health faculty members Kei Kawata and Jon Macy, left and second from left, discuss data with Bloomington North High School football player Noah Ponce, second from right, and School of Education faculty member Jesse Steinfeldt (Photo Credit: Emma Witzke)
Among the typical bright lights and high-pitched whistles of a local high school football practice, there are a few not-so-typical additions to the field: computerized mouthguards, sensors transmitting data and laptops assessing G-force, with IU professors and Ph.D. students on the sideline. It’s all part of a new study focusing on subconcussive hits in high school football athletes over time, and it comes at a particularly pivotal moment for the sport: participation in high school football has declined dramatically in recent years thanks to concerns over concussions.
Subconcussive hits, according to the Concussion Legacy Foundation, include hits that are considered below the concussion threshold: the brain is shaken, but not so violently that the damage to brain cells is severe enough to cause symptoms as would show up with a concussion. Subconcussive hits are very common during football, making this study’s outcome even more important. Jesse Steinfeldt is an Associate Professor in Counseling and Educational Psychology and one of the researchers working on the study.
This is really a truly groundbreaking study . . . no study to date has examined all of these outcomes together, and no studies have examined all of these outcomes over time.
Jesse Steinfeldt
“This is really a truly groundbreaking study in its comprehensiveness,” Steinfeldt said. “There is data on many of the outcomes we are measuring, but no study to date has examined all of these outcomes together, and no studies have examined all of these outcomes over time.”
Five different measurements will help the team in the study:
Impact – each football player has a computerized mouthguard that is equipped with an accelerometer and a gyroscope to measure every single impact that a player endures, along with the angle of each impact
Neurological imaging – players will undergo an MRI to get some brain image mapping results
Tracking eye movement--each player will be assessed for potential ocularmotor impairment
Cognitive functioning – researchers will look at how well players process information
Biomarkers – blood and saliva samples are collected to measure important blood biomarkers associated with head impacts
School of Public Health doctoral student Megan Huibregtse shows North player Reece Lozano the mouthguard participating students are wearing as part of the study. (Photo Credit: Emma Witzke)
The study also involves cross-country runners representing the control group: healthy athletes of the same age and gender who are involved in a non-contact sport.
The team is extensive and reaches across many disciplines: it includes clinical neuroscientists, neuroimaging scientists, sports psychologists, health policy makers, and biostatisticians from around IU, all led by Kei Kawata, Assistant Professor at the School of Public Health. Kawata has been involved in two of the most robust and extensive subconcussion studies in the past, but is hoping the current study will answer more questions about subconcussive hits.
“We don’t know the effects of several years of high school football head impact exposure,” Kawata said. “Simultaneously, we are in the midst of pursuing funding so we can study this important topic in a large scale.”
The first MRI for each student was done in July, with follow-up imaging to be done in December. Every month, the research team will go to North and collect biomarker data, cognitive data and ocular movement data from participants. The players will also have their mouthguard data diligently tracked and recorded on a daily basis.
This fall marks the pilot portion of the study, with the team awaiting final word on a $3.3 million NIH grant application to fund a four-year longitudinal study addressing this issue. If successful in procuring that grant money, Steinfeldt says they will follow a cohort of kids from freshman through senior year at North, Bloomington South, Edgewood and Mooresville High Schools. Ultimately, the study can have a massive impact, with the hope of gathering data that can influence policy.
North cross country runners take a lap while the football team practices. Cross country students are included in the study as the control group. (Photo Credit: Emma Witzke)
“There simply is not enough empirical data. Instead we have reactionary public opinion that football is harmful and football players get CTE – neither are empirically supported, but both are floating in the public consciousness,” Steinfeldt said. “In terms of potential policy, I think of it as being analogous to a pitch count in baseball. In youth baseball, a kid can't pitch more than 85 pitches in a game. Even if he has a no hitter, the policy is to take him out because there is empirical data indicating that pitching after that volume point is related to injury, both overuse and acute. So in terms of cumulative hits in football, perhaps our study will identify a number of hits wherein it is necessary for a kid to rest for a day (or some period of time), then he will be fine to continue without risk.”
Jon Macy, an Associate Professor at the School of Public Health, says the data the team is working to gather from the study could change football for the better.
“A major goal of the study is to be able to make policy recommendations to ensure the safety of the players, thus increasing participation in the sport, an important physical activity opportunity for large numbers of adolescents,” Macy said.
As a Sport Psychologist and former college and professional football player himself, Steinfeldt is well aware of the spotlight on the dangers of football.
“I am taking the position that we can help football become safer by providing some data based guidelines for practice and play – parents can continue to feel comfortable allowing their kids to play this great sport, which has opened so many personal and professional doors for me and can do so for millions of others,” Steinfeldt said.
