Ready for Impact? A validity and feasibility study of instrumented mouthguards (iMGs)

Abstract

Objectives Determine the validity and feasibility of current Instrumented mouthguards (iMGs) and associated systems. Methods Phase 1; Four iMG systems (Football Research Inc [FRI], HitIQ, ORB, Prevent) were compared against dummy headform laboratory criterion standards (25, 50, 75, 100 g). Phase 2; Four iMG systems were evaluated for on-field validity of iMG-triggered events against video-verification to determine true-positives, false-positives and false-negatives (20 SD 9 player matches per iMG). Phase 3; Four iMG systems were evaluated by eighteen rugby players, for perceptions of fit, comfort and function. Phase 4; Three iMG systems (FRI, HitIQ, Prevent) were evaluated for practical feasibility (system usability scale; SUS) by four practitioners. Results Phase 1; Total concordance correlation coefficient was 98.3%, 95.3%, 42.5% and 97.9% for FRI, HitIQ, ORB and Prevent. Phase 2; Different on-field kinematics were observed between iMGs. Positive predictive values were 0.98, 0.90, 0.53 and 0.94 for FRI, HitIQ, ORB and Prevent. Sensitivity values were 0.51, 0.40, 0.71 and 0.75 for FRI, HitIQ, ORB and Prevent. Phase 3; player perceptions of fit, comfort and function were 77%, 6/10, 55% for FRI, 88%, 8/10, 61% for HitIQ, 65%, 5/10, 43% for ORB, and 85%, 8/10, 67% for Prevent. Phase 4; SUS was 51.3-50.6/100, 71.3-78.8/100, and 83.8-80.0/100 for FRI, HitIQ, and Prevent. Conclusion This study shows that differences between current iMG systems exist. Sporting organisations can use these findings to ensure accurate head acceleration event data are obtained and system adoption is optimized, to support player welfare initiatives directly related to long-term brain health.

Validation of an Instrumented Mouthguard

“…The measured raw and filtered iMG acceleration timeseries data had total CCC values of 90.7% and 96.7% respectively, when compared to the ATD reference measurement system, and would have met the threshold of 80% or greater to meet a threshold for application to measure on field kinematics [19]. For total CCC values this study found the results of the filtered iMG of 97% to be similar, to the CCC values reported by Jones et al, [18] which investigated the validity and feasibility of a number of different iMG systems.…”

“…With the need to accurately utilise new technology to help understand issues within sport such as concussion by measuring head impacts and more importantly using that data to understand brain deformation of the athletes in question. There is a need for a standardised testing and data handling process to ensure that the observed results are comparable and that a suitable decision can be made by researchers and practitioners about what measurement device is appropriate to use [18]. Therefore, future studies should incorporate standardised data processing techniques when validating and comparing iMG systems or using iMG systems to measure head impact accelerations.…”

“…use [18]. Therefore, future studies should incorporate standardised data processing techniques when validating and comparing iMG systems or using iMG systems to measure head impact accelerations.…”

“…The advancement and miniaturisation of technology has given rise to the use of iMGs in the field as a means of overcoming the physical limitations associated with sensor placement and attachment [15]. There are a number of iMGs that have been used to further understand the HIE in sport [8,[15][16][17], however there are limited validation and feasibility studies that evaluate the iMGs suitability for research and practice [2,18,19]. For example, differences observed across individual validation studies could be due to the different specification of sensors used, positioning of the sensors, and the different methodological and processing methods used by the researchers [2,8,13,17,19,20].…”