{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T12:28:52Z","timestamp":1792844932565,"version":"4.5.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100031882","name":"world rugby","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100031882","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sports Med"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In elite rugby union, suspected concussions lead to immediate removal from play for either permanent exclusion or a temporary 12-min assessment as part of the Head Injury Assessment 1 (HIA1) protocol. The study aims to retrospectively identify a head acceleration event (HAE) severity measure associated with HIA1 removals in elite rugby union using instrumented mouthguards (iMGs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      HAEs were recorded from 215 men and 325 women, with 30 and 28 HIA1 removals from men and women, respectively. Logistical regression was calculated to identify whether peak power, maximum principal strain (MPS) and\/or the Head Acceleration Response Metric (HARM) were associated with HIA1 events compared to non-cases. Optimal threshold values were determined using the Youden Index. Area under the curve (AUC) was compared using a paired-sample approach. Significant differences were set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All three severity measures (peak power, HARM, MPS) were associated with HIA1 removals in both the men\u2019s and women\u2019s game. Peak power performed most consistent of the three severity measures for HIA1 removals based on paired-sample AUC comparisons in the men\u2019s and women\u2019s games. The HARM and MPS were found to perform lower than peak linear acceleration in the women\u2019s game based on AUC comparisons (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006 and 0.001, respectively), with MPS performing lower than peak angular acceleration (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Peak power, a measure based on fundamental mechanics and commonly communicated in sports performance, was the most effective metric associated with HIA1 removals in elite rugby. The study bridges the gap by identifying a consistent HAE severity measure applicable across sexes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40279-025-02308-0","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T03:38:14Z","timestamp":1758253094000},"page":"589-597","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Peak Power: A Severity Measure for Head Acceleration Events Associated with Suspected Concussions"],"prefix":"10.1007","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4666-4473","authenticated-orcid":false,"given":"Gregory","family":"Tierney","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Tucker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Tooby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Starling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9anna","family":"Falvey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Salmon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Hudson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Stokes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Kemp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"O\u2019Halloran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Cross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Bussey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Allan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"2308_CR1","doi-asserted-by":"publisher","first-page":"1888","DOI":"10.1080\/14763141.2021.2016929","volume":"23","author":"G Tierney","year":"2024","unstructured":"Tierney G. 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KS and MB have received research funding from World Rugby. LS, RT, EF, DS and JB are employed by or contracted as consultants to World Rugby. GT previously conducted consultancy work for World Rugby. KS and SK are employed by the Rugby Football Union. SH receives funding for his PhD studies from the Rugby Football Union and Premiership Rugby. BJ is a consultant with Premiership Rugby and the Rugby Football League. MC is employed by Premiership Rugby and was previously employed by the Rugby Football Union. POH has previously been contracted by the Rugby Football Union and is employed by Marker Diagnostics UK Ltd, a company developing salivary biomarker testing for sport related concussion. DA and JT declare they have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}},{"value":"Anonymised data are available upon reasonable request by contacting Lindsay Starling (lindsay.starling@worldrugby.org).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Availability of Data and Material"}},{"value":"This project was approved by the University\u2019s Research Ethics Committee, University of Ulster (#REC-21\u20130061) and University of Otago Human Ethics Committee (#H21-056). The study was performed in accordance with the standards of ethics outlined in the Declaration of Helsinki.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"All participants provided written consent.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"Not applicable.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"GT conceptualised the research project. All authors were involved in the design and data collection for the study. GT and DA were responsible for the analysis and interpretation of the results. GT and DA drafted the manuscript. All authors critically reviewed and edited the manuscript prior to submission. All authors have read and approved the final version of the paper and agree to be accountable for the work.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 Contributions"}}]}}