Getting a better fix on head injuries with a "smart" mouthguard

Paris with undergraduate research assistant Grant Birmingham.

When I tracked down mechanical engineer Anthony Paris in late May to catch up on an engineering INNOVATE project, we quickly migrated from his office over to a nearby conference room. The whiteboard there was covered with a lacy blue scrawl, an eruption of calculations that drew the eye and held it. But we didn’t talk about those at first. 

Instead, every few minutes he’d dash back to his office and return with something mechanical: a curved spine with an embedded rod on the side to reinforce it; two big white plastic blocks attached to one another by curved rods, simulating the lumbar spine attached to the pelvis; or a mouthpiece with three sugar cube-sized attachments that looked like something a dentist might try and shove into an unwilling mouth.

His current INNOVATE award will further research on the instrumented mouthguard. The funding bought him two portable force plates to continue testing the latest-generation device.

Paris is quick to point out that credit for his recent successes is shared with his INNOVATE Co-PIs, engineering professors John Lund and Jennifer Brock. Lund engineered the electronics and Brock wrote proposals and synthesized data, including high-speed video analysis.

First UAA iteration of a "smart" mouthguard.

A process of constant refinement

On the first iteration created at UAA, the team used an 18-year-old veteran soccer player to head balls with the mouthguard in place, recording impact to skull. ME undergraduate Tessa Kara was funded through the Office of Undergraduate Research and Scholarship (OURS) for this first round of testing.

Now, with a more compact second generation mouthpiece — the wireless transmitter and data logger are separate from the mouthpiece, so it’s slim and more compact — he’s just finished a round of testing with another subject, this time a young man. Over the course of two sessions, the test subject headed soccer balls 10 times at five different velocities, ranging from 8 to 28 miles per hour.

The testing went well. “We got great data!” Paris said, sounding both excited and relieved. “The device worked flawlessly."

Birmingham with the slimmer second-gen model.

The next step comes this summer, when he’ll position a third tester on the portable force plates so that when he maneuvers to head the ball, the force plates will also be gathering data on the interaction between the body and the ground. He’ll then have a complete loop, soccer ball to head, feet to floor.

The force plates echo earlier work with a biomedical team in Boise, Idaho on the biomechanics of soccer heading. There, a single force plate was permanently installed in a gym floor, and Paris dropped a soccer ball 35 feet onto a bowling ball positioned on the force plate, the curves of which duplicated those of the human head and simulated the impact between ball and head.

Increasing concern over concussive head injuries

All this effort is in service of getting detailed and accurate measurement of impact on the human skull. There is much public debate about appropriate treatment for sports concussions, from The New York Times topics page on football and head injuries to a story this April in the Anchorage Daily News about a local teen who experienced a serious concussion during an indoor flag football practice. New York University even hosted a debate earlier this month on banning college football due to head injuries.

For Paris, the cause of impact is less important than accurately measuring the accelerations of the head due to impact. In fact, improvised explosive devices (IEDs) deployed against soldiers in war are another critical application.

“Do accelerations of the head determine the type of brain injury someone has,” he asks. “Can they help determine how you would treat it?”

Consider a blow to the head during snowboarding. “How do you decide on return to play?" Paris asks. "How do you treat them? The same questions are true for boxing, IED blasts in the military and head-to-head impact in soccer or football."

 “Our goal is to continue development and make the instrumented mouthpiece small enough to be useful and practical in all these situations." Birmingham and two other undergraduate research assistants,  Lilan Smith and Kaelin Ellis, have joined Paris in data gathering.

Deriving angular accelerations: 'There's a bit of math there.'

What they measure

Paris and the INNOVATE team use accelerometers on the mouthpiece to measure linear accelerations. From those, they are able to mathematically determine angular accelerations. (That’s the poetic blue scrawl on the conference room whiteboard. Yes, “There’s a little bit of math there,” Paris quips.) 

What’s the difference between the two types of accelerations? For linear, think of the head moving forward and backward, side to side or up and down. For angular accelerations, think of the top of the head tipping backward, the chin coming up. In aviation, this is known as roll, pitch and yaw.

                                      Research includes video analysis of ball-to-head impact.

A visual Paris employs to explain the difference is a glass half-full of iced tea. Push it side to side and ice and liquid moves with the glass. That’s linear movement. 

Spin the glass, and the ice and liquid stay immobile while the glass moves around it. That’s angular movement. 

The accelerometers he’s using, by the way, are similar to what you’ll find in your iPhone, car airbags or Wii handheld devices. Even runners use them in their shoes. Part of what’s making the development of an instrumented mouthpiece possible is the decreasing size and cost of accelerometers.

Sports where helmets are common have an advantage, Paris says. The data logger and transmitter can be installed in the helmet; even football helmets with mouth guards attached offer an advantage because wiring to the transmitter could pass through the attachment mechanism. 

Boxing, like many sports performed without a helmet, offers more challenge.

But since lots of contact sports require mouthguards anyway, why not use them more fully to measure impact to the skull? Paris aims to refine the mouthguard into a smaller and smaller device.

“John Lund said it best,” Paris recalls. “ ‘In 20 years, nobody will be putting a dumb piece of plastic in their mouth.’ ” 

Why would you, when you could use a “smart” mouthguard that delivers nuanced information about the impact status of your brain?

Paris is enthusiastic about the capabilities of the new mouthguard and the acceleration data his team is collecting. He’s exploring patent opportunities now. 

Honored with an Exemplar Award for student mentoring 

This spring, Paris was singled out for a special honor given to faculty who do an exceptional job mentoring students outside the traditional classroom setting. The presentation took place during the Undergraduate Research Symposium this spring; Brock accepted the award for Paris, who was obligated to attend committee meetings for engineering curriculum updates at the time. 

It was at least fitting that she received it for him; she had nominated him after witnessing his work with undergraduates. In her letter, she wrote, "He encourages his students to set high goals, and it is worth noting that two of his research mentees have been accepted at top graduate programs, one at Columbia University in New York and another at the University of Oxford in England."

One of the groups he mentored developed a spinal rod bender, used during back surgery, for which a patent application has been filed. 

“He’s a one-man undergraduate research program!” Brock said when she happened by the conference room where we were talking. She even arranged to frame the award so it could hang on his wall instead of compete for space on a jam-packed desk.

Julia DelSignore, left.

Andrew Cochrane, right,Tessa Kara, center.

Two students also nominated him for the Exemplar. One was Andrew Cochrane, who double majored in mechanical and electrical engineering and received the $2,000 Discovery Award for his academic achievements. 

The other was Julia DelSignore, who collaborated on early soccer impact testing and received a Discovery grant to help with travel expenses to present research at the 12th Pan American Congress of Applied Mechanics in Port of Spain, Trinidad. DelSignore is pictured at left with professors Paris and Brock during the Trinidad conference. You can download a PDF of their paper here.

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Anthony Paris

Anthony Paris joined UAA's faculty as an assistant professor of engineering in 2007. He was a research assistant professor at Boise State University in Idaho before that. He earned his B.S.  and M.S. in mechanical engineering at Washington University in St. Louis, and his doctorate in theoretical and applied mechanics from University of Illinois at Urbana-Champaign.

When he’s not in the lab gathering data or working calculations on the whiteboard, Paris can be found practicing yoga at a local Anchorage studio.

Funding story: A novel encompassing Alaska's three whaling eras

New England whalers like the one above sailed Alaska waters in the 1800s.

Novelist and UAA professor Don Rearden received INNOVATE funding this year to support research for his latest creative endeavor, a novel about whales that traverses the three great epochs of Alaska whaling history – pre-contact, commercial whaling of the 1800s, and modern-day subsistence whaling under the governance of the Alaska Eskimo Whaling Commission.

“The good thing about getting this award is that it allowed me to say, ‘I have this project I am working on, and the university is sponsoring me,' ” Rearden says.

That support helped him secure a Scholar in Residence position for a week this summer at the New Bedford Whaling Museum in Massachussetts, where he begins gathering some of the historical detail that will color his work.

Why a novel for such an epic history? And, frankly, is there room for another after Melville’s Moby-Dick? And just how gutsy was it to go after INNOVATE funding for creative writing in a competitive field choked with scientists anxious for laboratory research space and time.

Rearden says that for the most part, he chose fiction because the documentary non-fiction work on whaling already had been done. He cites John Bockstoce and his 1986 work from University of Washington Press, Whales, Ice & Men: The History of Whaling in the Western Arctic, among others.

But the idea of a fictionalized history had been alive in him for some time. For one thing, he and close friend and colleague Shannon Gramse had tossed around the idea of a screenplay that would cover Alaska’s great whaling eras. He’s moving ahead on a novel because the story is just so big, he says, and novels reach a wider audience than screenplays. And besides, “We’ll probably still do a screenplay once the novel is done,” he says. And he hopes to convince poet Gramse to provide some poems for the novel.

Power of story

But for Rearden, there is an even more personally compelling reason to choose fiction over non-fiction. In his view, it contains the power of story – elements of character, voice and predicament that can reel an audience in  -- right through to the last page.

Herman Melville

Certainly Melvillle knew that, and yes, his famous Moby-Dick intimidates Rearden.

“That’s an amazing work, so yes it’s scary,” Rearden acknowledges. That’s why Rearden plans to give Melville a nod right upfront in his own novel.

But Rearden brings something unique to this Northern whale writing adventure. His boyhood spent in rural Alaska with his schoolteacher mother and law-enforcement dad exposed him to the hold that an active spirit life can have among villagers. He found it magical and life changing.

He arrived in Akiak as a second grader. And while some of the boys were compelled to box him about when he first arrived, he found village life not just satisfactory, but wholly engaging. He was thrilled to be out riding dog sleds and learning how to set fish traps under the ice.

But, even more, there were the mythical stories everyone told,  “…that idea of ghosts and spirits -- this other world that is just really real for everyone.” Remote communities then had fewer distractions … “we had just one phone in the whole village,” he remembers. The spirits and monsters that peopled local stories thrived, and quickly turned Rearden into a serious student of the culture.

Even in elementary school, he knew he would be a storyteller. “I read a lot. And even before I could be, I knew I wanted to be a writer.”

His family returned to his birth state, Montana, but they were back in Alaska by the time Rearden hit eighth grade. His affection for the relationships and shared village culture – transmitted in stories -- only grew.

“I am a firm believer that all that was right with humanity up to 10,000 years ago was because of story. The way to be a human being. We have lost that.

“We don’t tell stories that are meaningful anymore, that people can learn how to be better people from. That’s why I am drawn to fiction, and I’ll try to do that.”

Therein lies a hint to the novel’s characters that he’s currently searching out. What voice will be the storyteller? And what role will a whale play?

The oldest mammals 

Conceivably, says Rearden, a whale that spanned all three of these eras could still be swimming gracefully through the ocean. Some whales are commonly thought to live at least 100 years.

But in a 2001 column, science writer Ned Rozell cited research that proposed lifespans much longer than that. In, “Bowhead Whales May be the Oldest Mammals,” scientists aged whales through chemicals in their eyes and from embedded ivory harpoons discovered by hunters. The oldest whale they studied could potentially have been 245 years old – a survivor through early indigenous whaling and the East Coast industrialized fleets of the 1800s.

Abandonment of the Whalers in the Arctic in 1871, from an old print.

Then, questing after lucrative whale oil, whaling fleets ventured farther and farther north, until September, 1871, when 32 of some 41 ships got stuck hard fast in the Arctic ice.  More than 1,200 people survived, but the catastrophe -- and the simultaneous discovery of kerosene as an alternative fuel -- delivered a crippling blow to that whaling era.

Not lost to Rearden’s fertile imagination is the circling back to the Arctic that the current Beaufort and Chukchi Sea oil exploration means. The collapse of the fishing fleets of the 1800s coincided with the discovery of fossil fuels and the rapid industrialization of modern times.

Now that same enormous appetite for energy has brought us back to the home of the bowheads, home of that once sought-after lamp oil.

The draw for Rearden to a whaling novel includes a fascination for what science is currently learning about whales – their intelligence and the capacity some have for language and culture.

But there is more: the power of the whale in Alaska Native culture.

“Some of it just fascinates me,” Rearden says, “How story  affects behavior. So, when it’s whaling season, everyone gets along in the village. There are no bad thoughts, no arguments, because the whale would be able to sense that. There are stories about that, and I’ll definitely work with that idea.”

The notion of an old whale that has survived both pre-contact and industrialized whaling, a whale that has lived that long and then allows itself to be taken in the third, subsistence era – “it’s because something was right about that,” Rearden says, “for the whale to give itself. “

Perhaps we are coming full circle, he thinks, “to where we advance enough that we have the understanding of whales that these ancient people did. Maybe we are regaining something that was lost.”

'There was an asterisk'

And finally, what about that question of hutzpah, a creative writer going after research funds from the INNOVATE awards.

Rearden smiles. “There was that asterisk on the application, and it said the research could be for creative works. And I thought, could I get that?” He decided to try.

But he also did it for his students. He teaches newcomers who need help with the writing process through the College Preparatory and Developmental Studies. He also teaches the novel Ishmael by Daniel Quinn in the University Honors College.

And he sits on a committee that awards undergraduate research grants. Sometimes awards in the humanities go unasked for, and un-awarded.  “I am always telling my students they really should apply, for their creative work. I couldn’t be a hypocrite myself, and not apply.”

To Rearden, his INNOVATE award signals that UAA, which prides itself in being a home for research, definitely casts its support to work in the creative arts.
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Don Rearden

Don Rearden is a new dad this year, father to young Atticus. His wife, Annette, is a professor in the School of Nursing. After his long stays in rural Alaska sharing and enjoying Native foods, he confesses a fondness for Akutaq, Eskimo ice cream, and being an accomplished hunter of moose and caribou. He has worked at UAA seven years, and has his master's degree in Creative Writing. His first novel, The Raven's Gift, was published in 2011.