Brad Jacobson, Assistant Professor of Sports Medicine, and Jacob Gdovin, in cooperation with Erie Shriners’ Hospital for Children and several other organizations, have won the National Athletic Trainers Association’s Scholarly Manuscript of the Year for their research in cervical spinal cord injuries.
Jacobson and Gdovin developed a method for managing potential cervical spinal cord injuries on the football field, called “pack and fill.” The method comes as an alternative to the “all-or-nothing endeavor,” which is the current method recommended by the National Athletic Trainers’ Association.
“The all-or-nothing endeavor is, if you have to remove the helmet to gain access to the airway, then you have to remove, according to their suggestion, everything. Helmet and shoulder pads. We challenged that,” Jacobson said.
The removal of the helmet and shoulder pads create too much movement in the head and neck, according to Jacobson. The pack and fill method, by comparison, allows for the shoulder pads to stay on and reduces potentially damaging movement.
“We said, if the helmet has to come off, we’re saying that the shoulder pads can stay on. And you remove the helmet, keep the head and neck in a neutral position, and then pack and fill that void,” said Jacobson. “Any movement can be critical to cause damage, or further damage to the spinal cord.”
Testing the potential superiority of the pack-and-fill method required a cooperation between Mercyhurst and Erie Shriners’ Children Hospital, which contains a motion capture lab, according to Jacobson.
Motion capture technology, which is the same technology used to create video games, provides an accurate method for tracking motion and testing the pack-and-fill method.
“We had to get landmarks where we could compare the movement of the head to the torso, and then you could do a comparison of how much movement actually occurred,” said Jacobson. “The data was significant. We had a tremendous difference in the amount of what’s called excursion, movement out of a plane.”
Kevin Cooney, PP, Manager of the Rehabilitation and Movement Analysis Labaratory at Erie Shriners’ Hospital for Children, was willing to work Jacobson and Gdovin in pursuit of this project. The motion capture allowed them to analyze very minute movement which the video camera could not pick up.
“The use of the motion capture technology provided accuracy which allowed for comparison of the two techniques,” Cooney said.
The analysis required the creation of a mathematical model for cervical spine movement.
“It was challenging. This type of model had never been used or created before,” Cooney said.
The typical positioning of the cameras in the lab was also changed to allow for accurate filming. The cameras are usually filming a subject without any obstructions, said Cooney. However, this analysis would film a stationary subject while ignoring the athletic trainers doing the movement around it.
“We were dealing with all these variables that we didn’t typically have. We had to reposition the cameras to allow tracking the individual athletes, and not have the line-of-sight blocked by the athletic trainers,” Cooney said.
The project could never been done without cooperation between Mercyhurst and Shriners, said Jacobson.
Jacob Gdovin, now a Ph.D. candidate in Biomechanics at Ole Miss, was invited to join the project as a junior and became one of the primary authors of the award-winning article.
“He did a tremendous job from start to finish with this. He went far and above what most of our other students did for their baccalaureate research project,” said Jacobson. “It also led to Jake and I being hired by Sports Medicine Concepts out of Livonia, N.Y. to go and present to NFL teams. We presented to five NFL teams, their whole medical teams.”
Jacobson and Gdovin presented to the Houston Texans, Indianapolis Colts, Dallas Cowboys, New York Jets, and New York Giants. In addition, their research may lead to the revision of the NATA position statement on how to treat injuries on field.
“We’re hoping our research may cause change of that position statement, saying instead of the all-or-nothing endeavor, pack-and-fill is an alternative to this. There’s our study and one other study that supports our findings,” Jacobson said.
Gdovin was unable to be reached for comment by the time of this publication.