Reducing risk of head injury in youth soccer: An extension of behavioral skills training for heading

Assessing the association between on-field heading technique and head impact kinematics in a cohort of female youth soccer players

There is concern that exposure to soccer headers may be associated with neurological sequelae. Training proper heading technique represents a coachable intervention that may reduce head acceleration exposure. The objective was to assess relationships between heading technique and head kinematics in female youth soccer players. Fourteen players (mean age = 14.4 years) wore instrumented mouthpieces during practices and games. Headers were reviewed by three raters to assign a technique score. Mixed models and LASSO regression evaluated associations of technique with peak linear acceleration (PLA), rotational acceleration (PRA), rotational velocity (PRV), and head impact power ratio (HIP Ratio) while adjusting for session type and ball delivery. Two hundred eighty-nine headers (n = 212 standing, n = 77 jumping) were analyzed. Technique score (p = 0.043) and the technique score - session type interaction (p = 0.004) were associated with PRA of standing headers, whereby each 10-unit increase in technique score was associated with an 8.6% decrease in PRA during games but a 5.1% increase in PRA during practices. Technique was not significantly associated with any other kinematic metrics; however, peak kinematics tended to decrease as technique score increased. LASSO regression identified back extension and shoulder/hip alignment as important predictors of peak kinematics. Additional research on heading technique and head acceleration is recommended.

Differences in the technical performance of heading between men and women football players during FIFA World Cup 2022 and FIFA Women's World Cup 2023 matches

Objectives

To compare the incidence of headers, attempted headers, and other head impacts, and the difference in heading descriptors, including technical performance, between men and women in a purposive sample of FIFA World Cup 2022 (FWC22) and FIFA Women's World Cup (FWWC23) matches.

Methods

Video analysis of all observed headers, attempted headers and other head impacts during eight FWC matches (FWC22 (n=4); FWWC23 (n=4)) where the same national teams competed. Heading descriptors (including ball delivery method, purpose of the header and involvement of other players) and technical performance of each header (including controlled or uncontrolled header, use of upper body, point of head contact) were analysed using negative binomial regression analyses with men as the reference group (reported as incidence rate ratios (IRR)). Timing of eye closure was analysed using a t-test; α-error, p=<0.05.

Results

From 973 head impacts, 845 (87%) were headers (FWC22 mean 5.0 headers/player/match, FWWC23 mean 4.6 headers/player/match), 93 (10%) were attempted headers and 35 (4%) were unintentional head impacts. When compared with men, women were less likely to perform controlled headers (73% vs 83%, IRR 1.20, p=0.01), use their foreheads (IRR 2.36, p=<0.001) and their upper body during the header (80% vs 88%, IRR 1.29, p=0.005). Women also closed their eyes earlier before the header (1.91 vs 1.56 frames, d=0.41, p=0.002).

Conclusion

There were significant differences in heading technique between women and men, which could be important to address in training to improve heading performance and potentially reduce short-term and long-term burden of heading.

Behavioral skills training produces acquisition and generalization of run-blocking skills of high school football players

Behavioral skills training (BST) has been used to improve football players' performance in one prior study, but limited data were collected on how the skill generalized from the training environment to the natural environment. The purpose of this study was to further evaluate the effects of BST in enhancing football players' performance while also evaluating the generalization of a skill taught in a training environment (i.e., practice) to the natural environment (i.e., game-simulated scrimmage). This study included five high school offensive line football players and recorded their run-blocking skills in the training context and a game context in baseline and following BST. The results showed that BST improved performance in the training environment, with run-blocking skills slightly generalizing from the training environment to game-simulated scrimmages. When BST was conducted in the natural environment, it further improved the participants' run-blocking skills.

Comparing video feedback and video modeling plus video feedback for improving soccer skills

This study compared the effects of video feedback (VF) as a stand-alone intervention and video modeling plus video feedback (VMVF) for improving soccer players' static ball control skills. Research has suggested that VF alone and VMVF produce substantial improvements for young athlete's skills, though no studies have compared the two. Therefore, we used a multiple-baseline-across-participants design with embedded alternating treatments to compare VF and VMVF. Two 10-year-old female soccer players and one 9-year-old male soccer player participated. The first author implemented the VF and VMVF training procedures and assessed the same three target behaviors across participants. The results suggested that VF and VMVF produced similar increases in performance for two of three participants and that VMVF produced slightly greater increases for one participant. In addition, both interventions were effective at substantially improving ball control skills from baseline levels and relative to a control skill.

Soccer's AI transformation: deep learning's analysis of soccer's pandemic research evolution

Introduction

This paper aims to identify and compare changes in trends and research interests in soccer articles from before and during the COVID-19 pandemic.

Methods

We compared research interests and trends in soccer-related journal articles published before COVID-19 (2018-2020) and during the COVID-19 pandemic (2021-2022) using Bidirectional Encoder Representations from Transformers (BERT) topic modeling.

Results

In both periods, we categorized the social sciences into psychology, sociology, business, and technology, with some interdisciplinary research topics identified, and we identified changes during the COVID-19 pandemic period, including a new approach to home advantage. Furthermore, Sports science and sports medicine had a vast array of subject areas and topics, but some similar themes emerged in both periods and found changes before and during COVID-19. These changes can be broadly categorized into (a) Social Sciences and Technology; (b) Performance training approaches; (c) injury part of body. With training topics being more prominent than match performance during the pandemic; and changes within injuries, with the lower limbs becoming more prominent than the head during the pandemic.

Conclusion

Now that the pandemic has ended, soccer environments and routines have returned to pre-pandemic levels, but the environment that have changed during the pandemic provide an opportunity for researchers and practitioners in the field of soccer to detect post-pandemic changes and identify trends and future directions for research.

Behavior analytic contributions to public health and telehealth

The Journal of Applied Behavior Analysis is launching a special series on the topics of public health and telehealth. The special series begins with the articles in this issue and will continue for the next 2 to 3 issues with an open submission window until September 1, 2020. Behavior analysis has much to offer with respect to public health and much to gain from continued and expanded use of telehealth. This paper outlines the importance of these topics in the current crisis and in our ongoing evolution as a field. The historical literature in behavior analysis is reviewed for each topic along with suggestions for future research. The articles from the special series will be combined with historical contributions from JABA into a virtual issue. We encourage continued submissions on these topics even after the special series is completed as future papers will also be incorporated into the special issue.

Leveraging applied behavior analysis research and practice in the service of public health

Human behavior plays a central role in all domains of public health. Applied behavior analysis (ABA) research and practice can contribute to public health solutions that directly address human behavior. In this paper, we describe the field of public health, identify points of interaction between public health and ABA, summarize what ABA research has already contributed, and provide several recommendations for how ABA research and practice could continue to promote public health outcomes. A clearer focus on behavior and widespread adoption of research designs and interventions informed by the ABA literature could lead to better public health outcomes. Reciprocally, better integration of public health goals and strategies into ABA research, harnessing of technology, and more collaboration would help diversify and disseminate our applied science and could yield more effective and scalable interventions to prevent and treat public health problems.

Combining a Hudl App With Telehealth to Increase Home Exercise Program Adherence in People With Chronic Diseases Experiencing Financial Distress: Randomized Controlled Trial

Background

Patients with chronic diseases often need to adhere to long-term individualized home exercise programs (HEPs). Limited adherence to long-term exercise given during physical therapy (PT) visits reduces the capacity of exercise to manage or improve symptoms related to chronic disease. In addition, a lower socioeconomic status negatively impacts exercise adherence. To mitigate this, apps that motivate people to exercise could be a viable option. Using an app through telehealth may help adults with chronic diseases to achieve long-term HEP adherence. However, because apps for rehabilitation are an emerging field, the feasibility of the app needs to be evaluated.

Objective

To address HEP adherence in participants with chronic diseases who are experiencing financial distress, we aim to evaluate the feasibility of and satisfaction with the Hudl Technique app and telehealth and satisfaction with PT care and to monitor HEP adherence and compliance (ie, percentage of participant-recorded videos sent) in participants using the app with telehealth compared with those using standard HEPs on paper.

Methods

We recruited patients scheduled for outpatient PT. We performed a randomized controlled trial in which the experimental group received weekly HEP demonstrations through app videos on a tablet with feedback on their self-recorded HEP video performance from the telehealth physical therapist. The control group received HEPs on paper without feedback, as is customary in PT practice. Demographic, clinical, and health coverage information was collected for screening and baseline measurements. Adherence and compliance were evaluated. Both groups completed surveys at 8 and 24 weeks on their satisfaction with PT care, and the experimental group also completed a survey on their satisfaction with the app with telehealth use. Descriptive and nonparametric statistics were used for within-group and between-group comparisons and analyzed with JMP, version 13.

Results

Overall, 45 adults with chronic diseases who were experiencing financial distress were randomized into experimental (23/45, 51%) and control (22/45, 49%) groups, with 74% (17/23) and 86% (19/22) participants completing the 24-week HEP, respectively. The experimental group had an HEP adherence frequency of 4 (SD 2) to 5 (SD 2) times per week at 8 and 24 weeks (P=.14), whereas HEP adherence decreased in the control group from 4 (SD 2) to 3 (SD 2) times per week (P=.07), with a significant difference (P=.01) between groups at 24 weeks. Of the total participants, 68% (15/22) sent videos. They sent 68% (16/24) of the requested number of videos on average. The average score for PT care satisfaction was maintained at 87% in the experimental group (P=.99), whereas it decreased from 89% at 8 weeks to 74% at 24 weeks (P=.008) in the control group. App-related adverse events were not observed.

Conclusions

The Hudl app/telehealth platform is feasible for delivering HEPs and maintaining HEP adherence in participants with chronic diseases who are experiencing financial distress.

Trial Registration

ClinicalTrials.gov NCT02659280; https://clinicaltrials.gov/ct2/show/NCT02659280

Using Behavioral Skills Training With Video Feedback to Prevent Risk of Injury in Youth Female Soccer Athletes

Female athletes are at a greater risk for anterior cruciate ligament (ACL) injuries than males. Current training programs for ACL injury reduction focus on muscle strengthening, appropriate movement patterns, and balance training. However, there is limited research on effective strategies to teach youth female soccer athletes how to properly perform desired movements associated with a decreased risk of ACL injuries. Behavioral skills training (BST) programs have been shown to be effective in teaching a wide variety of skills, but research on applications to sports is limited. This study evaluated a BST package for teaching a stepwise agility program to 3 youth female soccer athletes that consisted of verbal instructions, modeling, rehearsal, and feedback, which included video replay. Results showed a significant improvement in the number of steps the participants performed correctly relative to baseline, as well as maintenance of skills at follow-up. Implications for coaches and athletes, as well as limitations and directions for future research, are discussed.

Concussion in soccer: a comprehensive review of the literature

Sports-related concussion has been examined extensively in collision sports such as football and hockey. However, historically, lower-risk contact sports such as soccer have only more recently garnered increased attention. Here, we review articles examining the epidemiology, injury mechanisms, sex differences, as well as the neurochemical, neurostructural and neurocognitive changes associated with soccer-related concussion. From 436 titles and abstracts, 121 full texts were reviewed with a total of 64 articles identified for inclusion. Concussion rates are higher during competitions and in female athletes with purposeful heading rarely resulting in concussion. Given a lack of high-level studies examining sports-related concussion in soccer, clinicians and scientists must focus research efforts on large-scale data gathering and development of improved technologies to better detect and understand concussion.