As the two boys sparred inside the Aquinas Institute gymnasium, Dave Robertson watched ringside, offering encouragement and coaching to his son: “Get out of the corner! Keep your hands up!”
His son, 15-year-old Mike Robertson, is a third-year boxer at Aquinas Institute, which claims to have the only in-house high school boxing program in the country.
This week, young Robertson and most of his teammates were fitted with high-tech headbands, equipped with sensors that help coaches, trainers and parents evaluate the blows students receive each time they step in the ring. The Linx IAS, a product of Rochester-based BlackBox Biometrics, is one of many such wearable technologies flooding the market.
The sophisticated technology is another tool for helping protect athletes and refine their training — highlighting, for example, which boxers take the most hits to the head, and thus need to work on keeping their hands up. But when it comes to integrating technology, sport and health science, gaps remain.
“We are still, as a scientific field, trying to establish a relationship between hits to the head and something bad to the brain,” said Dr. Jeffrey Bazarian, who has served as an adviser to BlackBox and is an emergency medicine professor with a concussion and research program at the University of Rochester Medical Center.
“It is tempting to think about this like cigarette smoking (increasing the risk of lung cancer). … But it’s not a one-to-one relationship. It gets complicated,” he said. “I don’t think anybody knows how this information is supposed to be used.”
Lightweight and about the size of a stick of gum, the Linx Impact Assessment System can be slipped into a custom headband or skullcap to be worn with almost any sport. Other companies are marketing clips, patches and helmet inserts.
The technology can help coaches coach better, and medical professionals assess an athlete’s condition. But Linx IAS and these other sensors are not medical devices and cannot prevent concussions.
Beyond tallying the number and magnitude of blows, the sensors record head movement to show where and how each hit is absorbed. Data is relayed in real time to a smartphone or tablet app. With the Linx, each blow is measured in degree of force from 1 to 100, color-coded (green is low impact, yellow is medium, and red is high), tabulated and tracked by individual across sports and over time. In addition to big hits, there is concern about the cumulative effect of repeated hits.
Injuries on rise
Each year, as many as 3.8 million people are affected by a sports- or recreation-related brain injury, according to the Institute of Medicine. And the number of young people sustaining such injury is rising, with a 2011 Centers for Disease Control and Prevention study finding that the number of concussions suffered by those 18 and younger rose from 150,000 to 250,000.
The focus has been on football. But more attention is shifting to the frequency in other sports, from hockey to cycling and boxing to Mike Robertson’s other two sports: soccer and lacrosse. The Centers for Disease Control lists girls soccer as having the second-highest frequency of brain injury of team sports. Still others suggest girls hockey might offer the highest exposure.
Aquinas is one of several programs locally — soon to be joined by the Rochester Rhinos — that are helping test the Linx IAS gear. The Rhinos expect to use it in every Junior Rhinos practice and for anyone with the professional Rhinos soccer team recovering from a concussion, as a means to monitor a player’s return to competition.
While many questions remain, the technology already is proving useful for some nervous parents.
“My first year boxing, I fought in the Mission Bouts,” Mike Robertson said of the annual Aquinas matches. His dad watched. His mom did not. Afterward, “she hugged me. She was crying. She didn’t want me to get hurt.”
The color-coded and blow-by-blow force measurements of the Linx has eased concern in the Robertson family, both father and son said, showing the hits are landing in the lower-impact green and yellow zones.
“The more I looked at it, the more I liked the idea of it — even though it will never replace the eyes of a trainer,” said Dom Arioli, longtime coach of Aquinas’ co-ed boxing program and owner of ROC Boxing and Fitness.
“I am watching every spar that goes on. Every round,” said Arioli, who also has coached boxers from the all-girls Our Lady of Mercy High School the past five years at his gym. “But when they are in there boxing, all I have to do is turn quick and I might not catch a blow that is thrown … might get one or two blows I didn’t catch that are in the yellow zone.”
On sale soon
Linx IAS won three awards at this month’s International CES, the Consumer Electronics Show in Las Vegas, and should go on sale in late March, with a suggested retail price of $199.
The technology continues to evolve. Linx IAS has been two years in development, and David Borkholder, chief technology officer for BlackBox and professor of microsystems engineering at Rochester Institute of Technology, expects refinements will lead to different criteria or baselines based on age, gender and sport.
“Looking at soccer and football … even in the absence of any concussion, there are some changes in the brain over the course of a season,” Borkholder said. “They (doctors and researchers) don’t understand what that means yet. I think the data that we gather, over time, is going to make the technology even more important for the athletes.”
Reaction from students, parents and coaches interviewed for this story has been positive, though some speculated that in competitive situations — particularly where scholarships or pay is on the line — people might become resistant to sensors, fearing the tabulations or scores could work against them and limit their advancement.
If such devices become commonplace, could colleges or teams one day seek or use these “scores” when evaluating whether to sign or keep an athlete? More immediately, who should have access? Arioli said he wants to review the data before parents do.
“The ability to have full access is there but, you know, we are just starting with it. I don’t want people to jump to conclusions before myself and my coaches look at it first,” he said. “We are supposed to be the ‘experts.’ “
Some are taking a wait-and-see approach.
The New York State Public High School Athletic Association allows athletes to wear the devices, but assistant director Todd Nelson said the group otherwise has no position on their usefulness.
Said Bazarian: “There is potential for the sensors to be able to do things really cool. But, boy, we have a lot of work to do.”
Is sooner better?
Despite considerable attention to the issue, a lot remains unknown or undefined. A New York state law, enacted in 2012, requires removal of students from athletics or any school-sponsored activity if they are suspected of suffering a concussion. They must be cleared by a physician before returning, but there is no set protocol established in the law. Similarly, the American Academy of Pediatrics has not given any guidance on how long youths should rest and refrain from activity.
“That has left a void,” Bazarian said.
Youths often are directed to refrain from any activity for five to seven days. But a study released earlier this month concluded that more is not necessarily better. The study, published in the journal Pediatrics and conducted by researchers at the Medical College of Wisconsin, found little difference between those who instead were placed on strict rest for one or two days, except that those who were sedentary longer developed more symptoms.
“We might want to think about trying to get people back to activity sooner,” Bazarian said, noting that the study mirrors the approach taken at the University of Rochester Medical Center. “One or two days (strict rest) is probably all that you need.”
That does not mean suiting up and getting back in the game, but going back to school and other non-contact activities. There are caveats, of course. The randomized study, involving youths ages 11 to 22 who went to the emergency room within 24 hours of a concussion, excluded those with attention deficit disorder or learning disabilities.
What the Linx IAS and other such devices offer is another tool. And not just for youths.
At ROC Boxing, older athletes are using the technology to monitor their exposure in number and magnitude of hits, as they seek to extend their ability to get into the ring for years to come.
“Ultimately, we hope that the technology will help to keep athletes in the game for longer,” BlackBox’s Borkholder said.