Sensors are great, but they're still no safeguard against head injuries

By Neil Versel

Neil_Versel_LargeA story in Sunday's New York Times about wireless devices that can help detect blows to the head in athletes is bringing fresh attention to the issue of sports-related concussions and how digital health technology can help better monitor and treat head injuries. It also is reaffirming the fact that body-worn sensors are not meant to be substitutes for expert medical care.

As Cambridge, Mass.-based sensor maker MC10 explained to MobiHealthNews a few months ago, its product is not designed to diagnose concussions, but rather to detect signs of head trauma. That's exactly what Dr. Robert C. Cantu, medical director of the Sports Legacy Institute at Boston University School of Medicine, told the Times.

"[Sensors] give you a rough estimate of total number of hits to the head the person has taken,” Cantu is quoted as saying. "You don’t want to get a high number of hits," Cantu explained, "because there is no hit that is good for your head."

However, he added this caveat: "There's no magic number you can read on a device that means you have a concussion. … Many more factors besides forces are involved."

Stefan Duma, who runs the Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, told the Times that devices such as the CheckLight, a sensor-equipped beanie from MC10 and Reebok said to be hitting the market this month – a year later than previously planned – for the price of $150, and the forthcoming xPatch from Seattle-based X2 Biosystems, are probably helpful. "They may help us understand more about the risks that come with head impacts," he said in the article.

However, he came up with several scenarios in which a wearable sensor like the xPatch could backfire. You don't even have to be a coach to appreciate this tactic: "Players might target people and get their lights blinking to get them removed from the game," Duma suggested.

Duma has been measuring head impacts on Virginia Tech football players with sensors embedded in their helmets for 11 years, according to the Times. But only recently has the issue of concussions in athletes come to the fore. One might call it epidemic.

The National Football League has 32 teams, each with 53-man active rosters, for a total of 1,696 players – not counting those on practice squads and others listed as inactive due to injury. The PBS show "Frontline" and the ESPN show "Outside the Lines" have teamed up to track concussions in the NFL, based on official team injury reports. By their count, there were 170 reported concussions during the 2012 season. That works out to about one concussion for every 10 players. By any measure, that's a lot.

It might be a little harder to count concussions in other arenas. Teams in the National Hockey League, for example, play injuries close to the vest, since they aren't required to be any more specific than "upper body" or "lower body." However, Sports Illustrated counts 18 NHL players whose careers were ended by concussions, including at least three hall-of-famers.

Major League Baseball player Ryan Freel, who reportedly committed suicide at age 36 last December, claimed in a 2009 interview to have had "nine or 10" concussions, and also had problems with alcoholism.

Those are just the pros. We really have no idea how many amateur and youth athletes suffer head injuries, but I'm sure it's a lot. I know I've had a couple over the years as a weekend warrior. The 11-year-old son of a friend of mine recently was out of school for nearly three weeks because he sustained a concussion from playing ice hockey.

Fortunately, awareness of the problem of traumatic head injuries is growing. No longer are athletes of any age or skill level being forced back into the game prematurely at the risk of having their toughness or commitment challenged.

I'm not ready to give up playing sports for fun, but I'm certainly being more careful than I used to be. Equipment may be better, but it's not perfect. A recent feature in Bicycling magazine described how US standards for bike helmets haven't changed since 1999, and that those standards are based on a test that dates to the 1950s. "Bicycle helmets do an outstanding job of keeping our skulls intact in a major crash. But they do almost nothing to prevent concussions and other significant brain injuries," the story says.

Researchers have developed a new class of helmets that do help safeguard against concussions, but they aren't legal for sale in the US because product safety regulations are so difficult to change. The best we can hope for now is continued heightened awareness of head injuries and, yes, better detection of symptoms from innovations such as wearable sensors.

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