Swartz Erik E, Mihalik Jason P, Decoster Laura C, Al-Darraji Sossan, Bric Justin
Department of Kinesiology, University of New Hampshire, Durham;
Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill;
J Athl Train. 2015 Jul;50(7):681-7. doi: 10.4085/1062-6050-50.4.04. Epub 2015 May 14.
American football has the highest rate of fatalities and catastrophic injuries of any US sport. The equipment designed to protect athletes from these catastrophic events challenges the ability of medical personnel to obtain neutral spine alignment and immobilization during airway and chest access for emergency life-support delivery.
To compare motion, time, and difficulty during removal of American football helmets, face masks, and shoulder pads.
Quasi-experimental, crossover study.
Controlled laboratory.
We recruited 40 athletic trainers (21 men, 19 women; age = 33.7 ± 11.2 years, height = 173.1 ± 9.2 cm, mass = 80.7 ± 17.1 kg, experience = 10.6 ± 10.4 years).
INTERVENTION(S): Paired participants conducted 16 trials in random order for each of 4 helmet, face-mask, and shoulder-pad combinations. An 8-camera, 3-dimensional motion-capture system was used to record head motion in live models wearing properly fitted helmets and shoulder pads.
MAIN OUTCOME MEASURE(S): Time and perceived difficulty (modified Borg CR-10).
Helmet removal resulted in greater motion than face-mask removal, respectively, in the sagittal (14.88°, 95% confidence interval [CI] = 13.72°, 16.04° versus 7.04°, 95% CI = 6.20°, 7.88°; F(1,19) = 187.27, P < .001), frontal (7.00°, 95% CI = 6.47°, 7.53° versus 4.73°, 95% CI = 4.20°, 5.27°; F1,19 = 65.34, P < .001), and transverse (7.00°, 95% CI = 6.49°, 7.50° versus 4.49°, 95% CI = 4.07°, 4.90°; F(1,19) = 68.36, P < .001) planes. Face-mask removal from Riddell 360 helmets took longer (31.22 seconds, 95% CI = 27.52, 34.91 seconds) than from Schutt ION 4D helmets (20.45 seconds, 95% CI = 18.77, 22.12 seconds) or complete ION 4D helmet removal (26.40 seconds, 95% CI = 23.46, 29.35 seconds). Athletic trainers required less time to remove the Riddell Power with RipKord (21.96 seconds, 95% CI = 20.61°, 23.31° seconds) than traditional shoulder pads (29.22 seconds, 95% CI = 27.27, 31.17 seconds; t(19) = 9.80, P < .001).
Protective equipment worn by American football players must eventually be removed for imaging and medical treatment. Our results fill a gap in the evidence to support current recommendations for prehospital emergent management in patients wearing protective football equipment. Helmet face masks and shoulder pads with quick-release designs allow for clinically acceptable removal times without inducing additional motion or difficulty.
在所有美国体育运动中，美式橄榄球的死亡和灾难性损伤发生率最高。旨在保护运动员免受这些灾难性事件伤害的装备，对医护人员在进行气道和胸部急救以提供紧急生命支持时获得中立脊柱对线和固定的能力构成了挑战。
比较美式橄榄球头盔、面罩和肩垫移除过程中的运动、时间和难度。
准实验性交叉研究。
受控实验室。
我们招募了40名运动训练师（21名男性，19名女性；年龄 = 33.7 ± 11.2岁，身高 = 173.1 ± 9.2厘米，体重 = 80.7 ± 17.1千克，经验 = 10.6 ± 10.4年）。
配对参与者对4种头盔、面罩和肩垫组合中的每一种以随机顺序进行16次试验。使用一个8摄像头的三维运动捕捉系统记录佩戴合适头盔和肩垫的活体模型中的头部运动。
时间和感知难度（改良的博格CR - 10）。
移除头盔导致的运动在矢状面（14.88°，95%置信区间[CI] = 13.72°，16.04°，而移除面罩为7.04°，95% CI = 6.20°，7.88°；F(1,19) = 187.27，P <.001）、额面（分别为7.00°，95% CI = 6.47°，7.53°和4.73°，95% CI = 4.20°，5.27°；F(1,19) = 65.34，P <.001）和横断面（分别为7.00°，95% CI = 6.49°，7.50°和4.49°，95% CI = 4.07°，4.90°；F(1,19) = 68.36，P <.001）平面上均大于移除面罩。从Riddell 360头盔移除面罩的时间（31.22秒，95% CI = 27.52，34.91秒）比从Schutt ION 4D头盔移除面罩的时间（20.45秒，95% CI = 18.77，22.12秒）或完全移除ION 4D头盔的时间（26.40秒，95% CI = 23.46，29.35秒）更长。运动训练师移除带有RipKord的Riddell Power肩垫所需时间（21.96秒，95% CI = 20.61°，23.31°秒）比移除传统肩垫所需时间（29.22秒，95% CI = 27.27，31.17秒；t(19) = 9.80，P <.001）更少。
美式橄榄球运动员佩戴之防护装备最终必须移除以便进行成像和治疗。我们的结果填补了证据空白，以支持目前对佩戴橄榄球防护装备患者的院前紧急处理建议。带有快速释放设计的头盔面罩和肩垫可实现临床上可接受的移除时间，且不会引起额外的运动或困难。
