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Background: The relationship between head impact dose andobservable functional deficits remains unclear. While studieshave almost exclusively examined American football athletes,in Olympic athletes there are almost no data that explore thisrelationship.

Objective: We aimed to use an impact monitoring mouthguard(IMM) to quantify head impact doses in Olympic and non-Olympic Sports, identifying high-energy impacts on video as‘No-go’ per the NFL protocol.

Design: Retrospective meta-analysis from American football,basketball, boxing, ice hockey, karate, lacrosse, mixed martialarts, rugby, tae-kwon-do, soccer.

Setting: Sporting field.

Patients (or Participants): 4500 impacts over 800 player-games.

Interventions (or Assessment of Risk Factors): Impact doseswhere the athlete was observed as ‘no-go’.

Main Outcome Measurements: Kinetic energy transfer (KE),risk-weighted exposure (RWE), peak scalar linear acceleration(PLA), peak scalar linear velocity (PLV), peak scalar angularacceleration (PAA), peak scalar angular velocity (PAV), impactlocation, impact direction, ‘No-go’ status.

Results: The median KE, RWE, PLA, PAA, PLV and PAV was 5J, 0.0002, 20 g, 1500 rad/s2, 10 rad/s and 1.5 m/s, respectively.American football athletes sustained the highest energyimpact doses, boxers and mixed-martial artists sustained thehighest cumulative dose for a day of competition. Ice hockeyhad the highest rate of ‘no-go’ impacts versus total impactscollected. Karate had the highest rotational kinematics. Of thenine (9) highest energy impacts to the side and rear of thehead, all were ‘no-go’ impacts. Of the top eight (8) highestenergy impacts to the front of the head, none were ‘no-go’impacts.

Conclusions: ‘No-go’ observations occurred in high energyimpact doses to the rear and the sides of the head, while similarimpact doses to the forehead seemed tolerable. ProspectiveOlympic athlete impact monitoring could help identify riskyexposures.