LSU experiments with new technology to diagnose head injuries

The last explanation that Jack Marucci ever wants to hear is, “This is how we’ve always done it.” In the LSU director of athletic training’s line of work, you either stay current or you fall well behind.

That thinking has been the impetus for LSU’s football program experimenting with new forms of technology in each of the last three seasons, all in an effort to improve the medical staff’s ability to diagnose head injuries and potentially prevent some of those ailments.

“We’ve always been looking for the next step," Marucci said. "We’ve always kept an open mind.

“So I’m always envisioning something else coming in. Now there may be something better, and if there’s something better than this, we’re going to look at it. And if you hear some rumors about new stuff coming out, then we’re going to try it.”

Dozens of football programs have fitted players’ helmets with impact sensors in order to learn more about the force and volume of hits that players absorb. Others are participating in comprehensive studies -- complete with bloodwork and clinical tests -- whose developing data banks might help researchers better understand how body function changes in the wake of a concussion.

One such initiative is the Concussion Assessment Research and Education (CARE) Consortium, a $30 million alliance between the NCAA and the Department of Defense that will test an estimated 35,000 male and female college athletes and service academy cadets over a three-year period. Among the participating programs are football powers like Oklahoma, Michigan, Nebraska, Florida, Georgia, Wisconsin and UCLA.

“They say concussions, mild TBI [traumatic brain injury], is the invisible injury,” said Dr. Christopher Giza, the director of UCLA’s Steve Tisch BrainSPORT Program and a member of the CARE Consortium’s operating committee. “It’s not always immediately evident that somebody’s had an injury, and part of current concussion care and part of the CARE Consortium are to help create some standardized measures that will help people with less experience be able to identify concussions or at least suspect a concussion so that they can protect that athlete from going back prematurely.”

Complicating matters further is that each individual responds differently to a concussive blow, thus recovery timetables can also differ widely.

“What makes some people drug addicts and alcoholics and other people not?” asked Tim Bream, the director of athletic training services at Penn State. “It’s the same thing. Why are some people a little more predisposed to having longer-lasting symptoms or residual, chronic effects of a mild traumatic brain injury? I think that’s what everybody’s trying to find out.”

Research initiatives like the CARE Consortium and the Head Health Network collaboration between LSU, Penn State and potentially other NCAA programs could produce answers to those questions.

Pooling resources creates a larger data bank, and it can also be beneficial for the athletes at the participating schools in the long run. Selected players at both Penn State and LSU will wear helmets lined with an impact-sensing smart fabric that connects remotely with a computer application to show the force and direction of the blows they absorb in real time. Researchers at LSU will now have access to a virtual reality tool developed at Penn State that tests short-term memory, providing insight into how the brain functions differently after a concussive impact.

“There’s a lot of theories floating around out there about mild traumatic brain injuries, but I think the more research that can be done to see if any of the theories can support it, the better,” Bream said.

There are helmet sensors, headbands lined with Kevlar, special skull caps, redesigned helmets and even computerized mouthpieces on the market. Some products are more useful than others, but all of them aim to make contact sports safer.

LSU experimented with one such mouthpiece last season, asking selected players to wear the Vector MouthGuard made by i1 Biometrics during practices and games. The mouthpiece was fitted with chip technology that could detect in real time the magnitude and direction of the hits LSU players were absorbing on the field.

Based on how the players chomped down on the mouthpiece, an LSU trainer on the sideline monitoring the action via an iPad application could instantly tell how hard the player was hit and where the contact occurred via a 3D rendering.

“What we’re interested in doing is looking at what drills are leading to greater impacts, a two-point stance versus a three-point stance, a turf versus a grass,” said i1 Biometrics president and CEO Jesse Harper.

The directional data also became a useful teaching tool at LSU, where Les Miles’ coaches received hard evidence when players were not tackling properly since the computer application shows exactly where on the head the contact occurred.

“They’ll argue with the coach and say, ‘No, coach, I’m not.’ And you can show video, but the video’s only going to tell you so much,” said LSU graduate assistant athletic trainer Sarah Thompson, who monitored the application on the sidelines last fall. “This really will help drive the point home and say, ‘Look, you are ducking your head. This is not safe. You need to change your tactics. You need to relearn how to tackle, basically.’”

Marucci credited Harper’s company for being a responsive test partner during the season. If there was a problem with the mouthguard, it’s that it was, as LSU fullback Connor Neighbors explained, “extremely uncomfortable.”

That was a guiding thought in developing the pressure-sensing fabric that fits between the padding and shell of LSU test subjects’ helmets this season, Head Health Network president Curtis Cruz said. There is no pleading with a player to wear anything, no reliability issues that accompany some helmet sensors. The goal was to provide the same real-time data as the mouthpiece with a product that is so unobtrusive that the player might not even know it was there.

“What we wanted to do was design something that just sits in the helmet and works and doesn’t bother you or get in the way and just blends into practice and what they do seamlessly,” Cruz said.

Anything to make data collection go as smoothly as possible, while also providing the data that can help medical personnel change the game. The researchers’ goals are many: learn how to diagnose concussions more effectively; use test results to build treatment plans that will aid in return to play; develop a set of best practices -- Marucci is particularly passionate about eliminating two-a-day workouts during preseason camp, a tradition he described as “antiquated” -- that can reduce the number of head injuries.

They believe it can happen, and that today’s push for technological advancement and research will preserve football’s tomorrow.

“As we learn more and more about the best way to tackle and to take your head out of the game, I think as kids grow up, it’s going to change the game and how it looks a little bit and what it means to play it,” Cruz said. “We’re just going to know more going forward so that the game can be played with a reasonable level of risk and a high standard of care for when injuries do occur.”