American Football Soft-Shell Helmet Covers Reduce Head Impact Severity: A Critically Appraised Topic

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Kayla O’Connell University of Florida, Gainesville, FL, USA

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Christopher Brown University of Florida, Gainesville, FL, USA

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Patricia M. Tripp University of Florida, Gainesville, FL, USA

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Focused Clinical Question: Do soft-shell helmet covers reduce head impact severity in American football helmets? Clinical Bottom Line: There is consistent SORT level C evidence to support that soft-shell helmet covers reduce measures of head impact severity and measures of linear and rotational acceleration. The impact reductions occurred at magnitudes less than the average reported concussive impact, which limits the application of the evidence with respect to concussion incidence or risk among American football players.

Brown https://orcid.org/0000-0003-1405-0001

O’Connell (kayladoconnell@gmail.com) is corresponding author.

Soft-shell helmet covers reduce measures of head impact severity in laboratory experiments compared with standard American football helmets alone.

Further research utilizing human subject study designs is necessary to examine the effectiveness of soft-shell helmet covers during American football play.

Developing soft-shell helmet covers to minimize head impact exposures may need a team approach between equipment manufacturers, clinicians, and American football oversight organizations.

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  • 1.

    Stern RA, Riley DO, Daneshvar DH, Nowinski CJ, Cantu RC, McKee AC. Long-term consequences of repetitive brain trauma: chronic traumatic encephalopathy. PM R. 2011;3(10)(suppl 1):S460S467. doi:10.1016/j.pmrj.2011.08.008

    • Search Google Scholar
    • Export Citation
  • 2.

    Gavett BE, Stern RA, McKee AC. Chronic traumatic encephalopathy: a potential late effect of sport-related concussive and subconcussive head trauma. Clin Sports Med. 2011;30(1):179188. PubMed ID: 21074091 doi:10.1016/j.csm.2010.09.007

    • Search Google Scholar
    • Export Citation
  • 3.

    Montenigro PH, Alosco ML, Martin BM, et al. Cumulative head impact exposure predicts later-life depression, apathy, executive dysfunction, and cognitive impairment in former high school and college football players. J Neurotrauma. 2017;34(2):328340. PubMed ID: 27029716 doi:10.1089/neu.2016.4413

    • Search Google Scholar
    • Export Citation
  • 4.

    Pfister T, Pfister K, Hagel B, Ghali WA, Ronksley PE. The incidence of concussion in youth sports: a systematic review and meta-analysis. Br J Sports Med. 2016;50(5):292297. PubMed ID: 26626271 doi:10.1136/bjsports-2015-094978

    • Search Google Scholar
    • Export Citation
  • 5.

    Chandran A, Boltz AJ, Morris SN, et al. Epidemiology of concussions in national collegiate athletic association (NCAA) sports: 2014/15–2018/19. Am J Sports Med. 2022;50(2):526536. PubMed ID: 34898299 doi:10.1177/03635465211060340

    • Search Google Scholar
    • Export Citation
  • 6.

    Mack CD, Solomon G, Covassin T, Theodore N, Cárdenas J, Sills A. Epidemiology of concussion in the national football league, 2015–2019. Sports Health. 2021;13(5):423430. PubMed ID: 33872087 doi:10.1177/19417381211011446

    • Search Google Scholar
    • Export Citation
  • 7.

    Pellman EJ, Viano DC, Tucker AM, Casson IR, Waeckerle JF. Concussion in professional football: reconstruction of game impacts and injuries. Neurosurgery. 2003;53(4):799814. PubMed ID: 14519212 doi:10.1093/neurosurgery/53.3.799

    • Search Google Scholar
    • Export Citation
  • 8.

    Zuckerman SL, Reynolds BB, Yengo-Kahn AM, et al. A football helmet prototype that reduces linear and rotational acceleration with the addition of an outer shell. J Neurosurg. 2018;30(5):16341641. doi:10.3171/2018.1.jns172733

    • Search Google Scholar
    • Export Citation
  • 9.

    Choi GB, Smith EP, Duma SM, et al. Head impact exposure in youth and collegiate American football. Ann Biomed Eng. 2022;50(11):14881497. doi:10.1007/s10439-022-02974-5

    • Search Google Scholar
    • Export Citation
  • 10.

    Rowson S, Duma SM, Beckwith JG, et al. Rotational head kinematics in football impacts: an injury risk function for concussion. Ann Biomed Eng. 2012;40(1):113. PubMed ID: 22012081 doi:10.1007/s10439-011-0392-4

    • Search Google Scholar
    • Export Citation
  • 11.

    Beckwith JG, Greenwald RM, Chu JJ, et al. Head impact exposure sustained by football players on days of diagnosed concussion. Med Sci Sports Exerc. 2013;45(4):737746. PubMed ID: 23135363 doi:10.1249/MSS.0b013e3182792ed7

    • Search Google Scholar
    • Export Citation
  • 12.

    Campolettano ET, Gellner RA, Smith EP, et al. Development of a concussion risk function for a youth population using head linear and rotational acceleration. Ann Biomed Eng. 2020;48(1):92103. PubMed ID: 31659605 doi:10.1007/s10439-019-02382-2

    • Search Google Scholar
    • Export Citation
  • 13.

    Mihalik JP, Chandran A, Powell JR, et al. Do head injury biomechanics predict concussion clinical recovery in college American football players? Ann Biomed Eng. 2020;48(11):25552565. PubMed ID: 33136240 doi:10.1007/s10439-020-02658-y

    • Search Google Scholar
    • Export Citation
  • 14.

    Jorge. Guardian Caps. Guardian sports. Published 2022. Accessed September 28, 2022. https://guardiansports.com/guardian-caps/

  • 15.

    Guardian Cap Debuts at Training Camps League-wide. NFL.com. Published July 27, 2022. Accessed September 28, 2022. https://www.nfl.com/playerhealthandsafety/equipment-and-innovation/engineering-technology/guardian-cap-debuts-at-training-camps-league-wide

    • Search Google Scholar
    • Export Citation
  • 16.

    Guardian Cap Results: “Exceeded Our Expectations.” NFL.com. Accessed March 13, 2023. https://www.nfl.com/playerhealthandsafety/equipment-and-innovation/engineering-technology/guardian-cap-results-exceeded-our-expectations

    • Search Google Scholar
    • Export Citation
  • 17.

    Guardian caps: Are the soft-shelled football helmet covers effective at limiting head injuries? ESPN.com. Published September 5, 2021. Accessed September 28, 2022. https://www.espn.com/nfl/story/_/id/32140546/guardian-caps-soft-shelled-football-helmet-covers-effective-limiting-head-injuries

    • Search Google Scholar
    • Export Citation
  • 18.

    Hindle BR, Lorimer A, Winwood P, Keogh JWL. A systematic review of the biomechanical research methods used in strongman studies. Sports Biomech. 2020;19(1):90119. PubMed ID: 31132028 doi:10.1080/14763141.2019.1598480

    • Search Google Scholar
    • Export Citation
  • 19.

    OCEBM Levels of Evidence Working Group. The Oxford levels of evidence 2. Published online 2011. https://www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence

    • Search Google Scholar
    • Export Citation
  • 20.

    Bailey AM, Funk JR, Crandall JR, Myers BS, Arbogast KB. Laboratory evaluation of shell add-on products for American football helmets for professional linemen. Ann Biomed Eng. 2021;49(10):27472759. PubMed ID: 34378120 doi:10.1007/s10439-021-02842-8

    • Search Google Scholar
    • Export Citation
  • 21.

    Breedlove KM, Breedlove E, Nauman E, Bowman TG, Lininger MR. The ability of an aftermarket helmet add-on device to reduce impact-force accelerations during drop tests. J Athl Train. 2017;52(9):802808. PubMed ID: 28771033 doi:10.4085/1062-6050-52.6.01

    • Search Google Scholar
    • Export Citation
  • 22.

    Nakatsuka AS, Yamamoto LG. External foam layers to football helmets reduce head impact severity. Hawaii J Med Public Health. 2014;73(8):256261. PubMed ID: 25157327

    • Search Google Scholar
    • Export Citation
  • 23.

    Crisco JJ, Fiore R, Beckwith JG, et al. Frequency and location of head impact exposures in individual collegiate football players. J Athl Train. 2010;45(6):549559. PubMed ID: 21062178 doi:10.4085/1062-6050-45.6.549

    • Search Google Scholar
    • Export Citation
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