Implementing Head Impact Sensors in Collegiate Men’s and Women’s Rugby: Successes and Challenges in Characterizing Concussion

Head impact sensors allow researchers to learn more about human tolerance to head impact exposure and concussion. Previous on-field data collection has worked to quantify concussion biomechanics, based primarily on helmeted male athletes. Data from unhelmeted and female athletes still need to be collected and quantified to understand how concussion tolerance varies by sex and loading environment. The primary goal of this study was to instrument collegiate rugby players with head impact sensors embedded in mouthguards and to report head impact and concussion biomechanics. Over four seasons of data collection, four males and 15 females sustained concussions. To reduce underreporting, we collected weekly graded symptom surveys from all players. Kinematics were only collected for two male concussions and three female concussions due to different challenges with the instrumentation. The secondary goal of this study was to discuss head impact sensors that are used on-field and explore their practicality and limitations. We present our experience using two instrumented mouthguards, the Wake Forest Instrumented Retainer and the Prevent Biometrics Intelligent Instrumented Mouthguard, to measure head impacts in athletes. Not enough injury data were collected to quantify unhelmeted concussion tolerance. Still, the following reports may provide foundational and reference cases for future research, in addition to discussion of data quality, sex-specific athlete compliance, general usability, and provide recommendations for future head impact sensor use.