Video Analysis and Verification of Direct Head Impacts Recorded by Wearable Sensors in Junior Rugby League Players

Background Rugby league is a high-intensity collision sport that carries a risk of concussion. Youth athletes are considered to be more vulnerable and take longer to recover from concussion than adult athletes. Purpose To review head impact events in elite-level junior representative rugby league and to verify and describe characteristics of X-patch(TM)-recorded impacts via video analysis. Study Design Observational case series. Methods The X-patch(TM) was used on twenty-one adolescent players (thirteen forwards and eight backs) during a 2017 junior representative rugby league competition. Game-day footage, recorded by a trained videographer from a single camera, was synchronised with X-patch(TM)-recorded timestamped events. Impacts were double verified by video review. Impact rates, playing characteristics, and gameplay situations were described. Results The X-patch(TM)-recorded 624 impacts >= 20g between game start and finish, of which 564 (90.4%) were verified on video. Upon video review, 413 (73.2%) of all verified impacts >= 20g where determined to be direct head impacts. Direct head impacts >= 20g occurred at a rate of 5.2 impacts per game hour; 7.6 for forwards and 3.0 for backs (range = 0-18.2). A defender's arm directly impacting the head of the ball carrier was the most common event, accounting for 21.3% (n = 120) of all impacts, and 46.7% of all "hit-up" impacts. There were no medically diagnosed concussions during the competition. Conclusion The majority (90.4%) of head impacts >= 20g recorded by the X-patch(TM) sensor were verified by video. Double verification of direct head impacts in addition to cross-verification of sensor-recorded impacts using a secondary source such as synchronised video review can be used to ensure accuracy and validation of data.