Emergency Face-Mask Removal Effectiveness: A Comparison of Traditional and Nontraditional Football Helmet Face-Mask Attachment Systems

Context: Football helmet face-mask attachment design changes might affect the effectiveness of face-mask removal. Objective: To compare the efficiency of face-mask removal between newly designed and traditional football helmets. Design: Controlled laboratory study. Setting: Applied biomechanics laboratory. Participants: Twenty-five certified athletic trainers. Intervention(s): The independent variable was face-mask attachment system on 5 levels: (1) Revolution IQ with Quick Release (OR), (2) Revolution IQ with Quick Release hardware altered (QRAlt), (3) traditional (Trad), (4) traditional with hardware altered (TradAlt), and (5) ION 4D (ION). Participants removed face masks using a cordless screwdriver with a backup cutting tool or only the cutting tool for the ION. Investigators altered face-mask hardware to unexpectedly challenge participants during removal for traditional and Revolution IQ helmets. Participants completed each condition twice in random order and were blinded to hardware alteration. Main Outcome Measure(s): Removal success, removal time, helmet motion, and rating of perceived exertion (RPE). Time and 3-dimensional helmet motion were recorded. If the face mask remained attached at 3 minutes, the trial was categorized as unsuccessful. Participants rated each trial for level of difficulty (RPE). We used repeated-measures analyses of variance (alpha = .05) with follow-up comparisons to test for differences. Results: Removal success was 100% (48 of 48) for OR, Trad, and ION; 97.9% (47 of 48) for TradAlt; and 72.9% (35 of 48) for QRAlt. Differences in time for face-mask removal were detected (F(4,20) = 48.87, P = .001), with times ranging from 33.96 +/- 14.14 seconds for QR to 99.22 +/- 20.53 seconds for QRAlt. Differences were found in range of motion during face-mask removal (F(4,20) = 16.25, P = .001), with range of motion from 10.10 degrees +/- 3.07 degrees for OR to 16.91 degrees +/- 5.36 degrees for TradAlt. Differences also were detected in RPE during face-mask removal (F(4,20) = 43.20, P = .001), with participants reporting average perceived difficulty ranging from 1.44 +/- 1.19 for OR to 3.68 +/- 1.70 for TradAlt. Conclusions: The OR and Trad trials resulted in superior results. When trials required cutting loop straps, results deteriorated.