The use of padded headgear in Australian youth football players: Video footage analysis of player behaviour and impact severity

NAME 1. A pseudo randomised control trial with use of padded headgear in Australian youth football players: Analysis of impact severity and player behaviour WHY 2. In junior metropolitan Australian rules football, the use of headgear is not mandated in a controlled way. Although the Australian Football League has a position statement (AFL Community: Helmets & Mouthguards), large, prospective randomised controlled trials regarding efficacy are lacking. Whether or not youth football clubs encourage or mandate the use of headgear is entirely at the clubs’ discretion. This has the potential to leave young players open to risk which is currently unknown. A few preliminary studies conducted in the early 2000s investigated attitudes towards the use of headgear in youth football and found that players largely cited discomfort as the reason for not wearing protective headgear and the lack of evidence of effectiveness. This was, however, prior to the recent proliferation of sports concussion research and introduction of mandated headgear use at a number of junior metropolitan football clubs. This prior work also only reported on outcomes for male athletes. This study aims to address evidence gaps on the topic of headgear in Australian youth football, by investigating the association between player use of headgear and player behaviour on the field through video footage analysis of game play behaviour and analysis of impact severity with use of biosensing equipment. WHAT 3. Materials. Use of commercially available Steeden® Padded Headgear (i.e., a lightweight, soft padded head gear) https://steeden.gnsports.com/16969/Super-Lite-Headgear/pd.php , and use of the commercially purchased X-Patch. This is a 1 cm × 2 cm electronic device which contains a triaxial linear accelerometer and measures continuously at a frequency of 1 kHz. It records time stamped 100 ms of data for linear acceleration that exceed 10 g. Video footage analysis for verification of X-Patch recorded impacts and observation of player behaviour will be conducted using the Video Surveillance of Concussive Injury in Australian Football, developed by Makdissi & Davis, 2016 (https://doi.org/10.1016/j.jsams.2016.02.014). 4. Procedure. Participants will have the X-Patch attached to the skin behind the ear using a double-sided adhesive and secured with sporting tape by trained research assistants. All teams will be allocated to wear headgear in the first (Q1 + Q2) or second half (Q3 +Q4) across 5 games. WHO 5. Research assistants will consist of undergraduate and postgraduate psychology students who were selected on the basis of academic and professional experience. These staff will receive basic training in handling and attaching the X-Patch/headgear. There is no further expert knowledge required for this intervention. 6. Delivery will be provided individually to players and face-to-face. Researcher assistants will provide headgear to players and determine when it should be worn by randomising halves in which headgear will be worn by the team. WHERE 7. The intervention will occur during ‘in-vivo’ settings, at the time and field location participants are scheduled to play throughout the football season in 2019 (southern metropolitan Melbourne). WHEN/HOW MUCH 8. Each youth football game lasts 1.5 hours. We aim to observe 2 male and 2 female teams for 5 games each resulting in a total of 20 games (i.e., 20 observations). All games are scheduled on Sunday as per the South Metro Junior Football League. As abovementioned, the teams will wear headgear for one half of the game (approximately 30 minutes) with efforts to counterbalance allocation across the 20 games between teams. 100% of participating players will wear the X-Patch for the entirety of the game behind the ear with a counterbalance between the left and right ear. TAILORING 9. We will ensure the appropriately sized headgear will be worn by each player. We will do this by fitting the headgear ahead of time during the first game using visual inspection and player self-report of comfort. MODIFICATIONS 10. We don’t expect any modification occurring throughout the season. The study was not modified at all after its commencement. HOW WELL 11. Adherence was assessed by research assistants documenting whether or not player wore headgear during their assigned half of the match across the five matches observed. 12. Actual adherence or fidelity cannot be assessed at this point in time.