{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:02:41Z","timestamp":1790704961200,"version":"4.1.0"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,5]]},"abstract":"\nObject<\/jats:title>\nIn spite of ample literature pointing to rotational and combined impact dosage being key contributors to head and neck injury, boxing and mixed martial arts (MMA) padding is still designed to primarily reduce cranium linear acceleration. The objects of this study were to quantify preliminary linear and rotational head impact dosage for selected boxing and MMA padding in response to hook punches; compute theoretical skull, brain, and neck injury risk metrics; and statistically compare the protective effect of various glove and head padding conditions.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nAn instrumented Hybrid III 50th percentile anthropomorphic test device (ATD) was struck in 54 pendulum impacts replicating hook punches at low (27\u201329 J) and high (54\u201358 J) energy. Five padding combinations were examined: unpadded (control), MMA glove\u2013unpadded head, boxing glove\u2013unpadded head, unpadded pendulum\u2013boxing headgear, and boxing glove\u2013boxing headgear. A total of 17 injury risk parameters were measured or calculated.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nAll padding conditions reduced linear impact dosage. Other parameters significantly decreased, significantly increased, or were unaffected depending on padding condition. Of real-world conditions (MMA glove\u2013bare head, boxing glove\u2013bare head, and boxing glove\u2013headgear), the boxing glove\u2013headgear condition showed the most meaningful reduction in most of the parameters. In equivalent impacts, the MMA glove\u2013bare head condition induced higher rotational dosage than the boxing glove\u2013bare head condition. Finite element analysis indicated a risk of brain strain injury in spite of significant reduction of linear impact dosage.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nIn the replicated hook punch impacts, all padding conditions reduced linear but not rotational impact dosage. Head and neck dosage theoretically accumulates fastest in MMA and boxing bouts without use of protective headgear. The boxing glove\u2013headgear condition provided the best overall reduction in impact dosage. More work is needed to develop improved protective padding to minimize linear and rotational impact dosage and develop next-generation standards for head and neck injury risk.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.12.jns111478","type":"journal-article","created":{"date-parts":[[2012,2,7]],"date-time":"2012-02-07T14:58:59Z","timestamp":1328626739000},"page":"1070-1080","source":"Crossref","is-referenced-by-count":40,"title":["Boxing and mixed martial arts: preliminary traumatic neuromechanical injury risk analyses from laboratory impact dosage data"],"prefix":"10.3171","volume":"116","author":[{"given":"Adam J.","family":"Bartsch","sequence":"first","affiliation":[{"name":"Spine Research Laboratory and"},{"name":"Cleveland Traumatic Neuromechanics Consortium;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward C.","family":"Benzel","sequence":"additional","affiliation":[{"name":"Spine Research Laboratory and"},{"name":"Cleveland Traumatic Neuromechanics Consortium;"},{"name":"Department of Neurological Surgery, Neurological Institute, Cleveland Clinic;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent J.","family":"Miele","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Neurological Institute, Cleveland Clinic;"},{"name":"United Hospital Center Neurosurgery & Spine Center, Clarksburg, West Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas R.","family":"Morr","sequence":"additional","affiliation":[{"name":"Scientific Expert Analysis (SEA), Ltd., Columbus, Ohio; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Prakash","sequence":"additional","affiliation":[{"name":"Cleveland Traumatic Neuromechanics Consortium;"},{"name":"Department of Mechanical Engineering, Case Western Reserve University, Cleveland;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns111478","series-title":"Standard Test Methods for Equipment and Procedures Used in Evaluating the Performance Characteristics of Protective Headgear. 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