Instrumented mouthguards in NCAA American football: Validity and head acceleration event incidence

A growing body of evidence suggests that repetitive head acceleration events (HAEs), even in the absence of diagnosed concussion, could have implications for long-term neurological function. This study aims to determine the on-field validity of instrumented mouthguards (iMGs) in American football and to quantify HAE incidence in NCAA football players. Instrumented mouthguards were fitted to 35 male NCAA football players. Head kinematic data were collected during 68 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. On-field validity of the Prevent Biometrics iMG in NCAA American Football indicates a sensitivity of 0.89 and PPV of 0.98 based on false positive definitions. The mean incidence of HAEs above a range of peak linear acceleration (PLA) and peak angular acceleration (PAA) 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. The Prevent Biometrics iMG appears suitable for measuring HAEs in elite American football and benchmark HAE incidence in elite American Football lays a foundation for the development HAE mitigation strategies.