Objective Current equestrian helmet standards do not include angular acceleration for certification even though it is known that it is the dominant cause of brain injury. Therefore, the objective was to develop an improved test method, including oblique impacts, to evaluate helmets sold on the European market.

Design The study presents a novel method to preform consumer testing of equestrian helmets.

Setting Four physical tests were conducted, shock absorption with straight perpendicular impact and three oblique impact tests. Computer simulations based on the test measurements were made to evaluate injury risk.

Participants In total, 28 equestrian helmet models sold on the European market were included.

Interventions (or Assessment of Risk Factors) Identify the best preforming helmet on the European market.

Outcome Measures Linear acceleration (g) and the strain in the grey matter of a finite element brain model were used to estimate the risk of brain injuries. Helmets equipped with and without Multi-directional Impact Protection System (MIPS).

Main Results In only two helmets a linear acceleration lower than 180 g was measured, which corresponds to a low risk of skull fracture. The simulations indicated that the strain in the grey matter of the brain during oblique impacts varied between helmets from 16% to 51%, where 26% corresponds to 50% risk for a concussion. The two helmets equipped with MIPS performed in general better than the others.

Conclusions All helmets need to reduce rotational acceleration more effectively. A helmet that meets the current standards does not necessarily prevent concussion.