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Parsanejad E, McKay MJ, Ross AG, Pappas E, Peek K. Heading in Football: insights from stakeholders in amateur football. SCI MED FOOTBALL 2024; 8:212-221. [PMID: 37293855 DOI: 10.1080/24733938.2023.2224282] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2023] [Indexed: 06/10/2023]
Abstract
Despite emerging research questioning the long-term effect of purposeful heading on players' brain health, heading-related perspectives and behaviours of stakeholders in amateur football in Australia (a country without heading guidelines) remain unknown. This study aimed to explore the current heading-related perspectives and behaviours of football stakeholders. In total, 290 players (aged over 11 years), 54 coaches, 34 non-coaching staff and 14 medical staff completed the survey. Of the 290 players, 56.5% reported being formally trained in heading, with female players less likely to be trained than male players (p < 0.05). Players were the least concerned about the long-term effects of heading, while medical staff were the most concerned (33.1% and 57.1%, respectively). From proposed strategies to reduce heading burden, a heading ban for all ages was least popular (2.3%), while teaching heading technique was most popular (67.3%). Our study provides insights into football stakeholders' heading-related perspectives, which could be used, along with scientific evidence, to inform pragmatic future heading guidelines.
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Affiliation(s)
- Elia Parsanejad
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Marnee J McKay
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Andrew G Ross
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Evangelos Pappas
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Kerry Peek
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Lima Y, Gouttebarge V, Bayraktar B. What do we know about beach soccer injuries? Systematic video analysis of four consecutive years with 580 match injuries. Res Sports Med 2024:1-11. [PMID: 38414221 DOI: 10.1080/15438627.2024.2324257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/16/2024] [Indexed: 02/29/2024]
Abstract
The aim of the present study was to evaluate the characteristics of match injury in male beach soccer players. Video recordings of all official beach soccer tournaments in which the European national male beach soccer teams participated from 2018 to 2021 were analysed by two sports medicine specialists retrospectively. Regarding each injury, data including the mechanism, location of the injury, whether the injury led to time-loss, and the relationship of the injury to the bicycle kick (BK), etc. were documented. A total of 632 injuries were documented, corresponding to 234.9 injuries/1000 player hours. Video footage was available for 580 injuries. Whilst 79.8% of medical attention injuries occurred due to opponent contact, 19.5% of time-loss injuries occurred due to non-contact, and 12.2% of indirect opponent contact (p < 0.01). The most common location of the BK related injury was the head/neck (68.7%), whereas most common location of the BK unrelated injury was the lower extremity (54.1%) (p < 0.01). The findings demonstrated that beach soccer injury incidence was quite high; the most common injury location was head/neck and head/neck injuries were associated with BK. In light of these results, some rule regulations, particularly those associated with BK, and the use of protective equipment should be considered to prevent these injuries.
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Affiliation(s)
- Yavuz Lima
- Cerrahpasa Faculty of Medicine, Sports Medicine Department, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Vincent Gouttebarge
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
- Section Sports Medicine, University of Pretoria, Pretoria, South Africa
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam, Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Sport, Amsterdam, Netherlands
| | - Bülent Bayraktar
- Sports Medicine Department, Istanbul University Faculty of Medicine, Istanbul, Turkey
- Turkish Football Federation, Medical Board, Istanbul, Turkey
- Acıbadem Sports/FIFA Medical Centre of Excellence Consultant, Istanbul, Turkey
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3
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Kozlowski KM, Rosston PA, Park AC, Hakimi AA, Socolovsky L, Wong BJF. A Thirteen-Year Analysis of Facial Fractures among Professional Soccer Players. Facial Plast Surg 2024; 40:120-126. [PMID: 36509105 DOI: 10.1055/a-1996-7595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This study aims to identify the epidemiology and effects of facial fractures on return to play (RTP) in Major League Soccer (MLS) and the English Premier League (EPL). A total of 39 MLS players and 40 EPL players who sustained facial fractures from 2007 to 2019 were identified. Data on player demographics, the injury, and the impact of their injury on RTP were collected. Elbow-to-head was the most common mechanism of injury (20.3%). The most common fracture involved the nasal bone (48.3%). Most players (90%) RTP the same season. Players who sustained nasal fractures missed significantly fewer games (p < 0.001) than those who suffered other craniofacial fractures. Players treated surgically missed significantly more games (3.21 vs. 0.71, p = 0.006) and days (30.1 vs. 8.70, p = 0.002) than those managed nonoperatively. Significantly more EPL players who sustained facial fractures wore headgear upon RTP compared to MLS players (82% vs. 56%, p <0 .01). Most professional soccer players who sustain a facial fracture RTP the same season, but their recovery time can vary depending on the type of fracture, injury management, or injury severity. Our findings can help inform future craniofacial injury management as well as guidelines on player safety and fracture prevention.
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Affiliation(s)
- Konrad M Kozlowski
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California
| | | | - Asher C Park
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California
| | - Amir A Hakimi
- Department of Otolaryngology - Head and Neck Surgery, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Leandro Socolovsky
- Department of Otolaryngology - Head and Neck Surgery, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Brian J-F Wong
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California
- Department of Otolaryngology - Head & Neck Surgery, University of California - Irvine, Orange, California
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Shibukawa K, Hoshikawa Y. Decrease in aerial challenges after revision of goal kick rules in Japan Professional Soccer League: explorative study of the possibility of a risk reduction for head injury, concussion, and brain damage by a rule revision. SCI MED FOOTBALL 2024; 8:15-20. [PMID: 36315233 DOI: 10.1080/24733938.2022.2142274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 11/05/2022]
Abstract
In 2019, FIFA revised the goal kick (GLK) rule such that a GLK could be performed even if the kicker had teammates in the penalty area. This study aimed to examine whether the rule revision reduced the frequency of aerial challenge (AC) and long GLKs (LGLKs), which are risk factors for head injury and concussion in soccer. We analyzed all official league matches (306 matches/season) of the Japan Professional Soccer League 1st Division before (2018 season) and after the rule revision (2020 season). The analysis categorized GLKs into short GLKs (SGLKs) and LGLKs, depending on the GLK distance, and included the frequency and causes of AC, in each match following a GLK, which were compared between the 2018 and 2020 seasons. The average number of LGLKs per match in the 2020 season (8.85) decreased compared to that in the 2018 season (14.20). Additionally, for ACs following a GLK, the frequency of ACs decreased from 6.08 to 3.92 per match. Meanwhile, the frequency of LGLKs tended to increase toward the end of the first and second halves in matches. The results of this study revealed that the 2019 GLK rule revision reduced the number of LGLKs and ACs.
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Affiliation(s)
- Kenichi Shibukawa
- Sports & Health Sciences Lab, Faculty of Sciences, Toho University, Chiba, Japan
| | - Yoshihiro Hoshikawa
- Department of Sports Science, Japan Women's College of Physical Education, Tokyo, Japan
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Hageman G, Hageman I, Nihom J. Chronic Traumatic Encephalopathy in Soccer Players: Review of 14 Cases. Clin J Sport Med 2024; 34:69-80. [PMID: 37403989 DOI: 10.1097/jsm.0000000000001174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 05/22/2023] [Indexed: 07/06/2023]
Abstract
OBJECTIVE Exposure to repetitive sports-related concussions or (sub)concussive head trauma may lead to chronic traumatic encephalopathy (CTE). Which impact (heading or concussion) poses the greatest risk of CTE development in soccer players? DESIGN Narrative review. SETTING Teaching hospital and University of Applied sciences. PATIENTS A literature search (PubMed) was conducted for neuropathologic studies in the period 2005-December 2022, investigating soccer players with dementia and a CTE diagnosis, limited to English language publications. 210 papers were selected for final inclusion, of which 7 papers described 14 soccer players. ASSESSMENT Magnetic resonance imaging studies in soccer players show that lifetime estimates of heading numbers are inversely correlated with cortical thickness, grey matter volume, and density of the anterior temporal cortex. Using diffusion tensor imaging-magnetic resonance imaging, higher frequency of headings-particularly with rotational accelerations-are associated with impaired white matter integrity. Serum neurofilament light protein is elevated after heading. MAIN OUTCOME MEASURES Chronic traumatic encephalopathy pathology, history of concussion, heading frequency. RESULTS In 10 of 14 soccer players, CTE was the primary diagnosis. In 4 cases, other dementia types formed the primary diagnosis and CTE pathology was a concomitant finding. Remarkably, 6 of the 14 cases had no history of concussion, suggesting that frequent heading may be a risk for CTE in patients without symptomatic concussion. Rule changes in heading duels, management of concussion during the game, and limiting the number of high force headers during training are discussed. CONCLUSIONS Data suggest that heading frequency and concussions are associated with higher risk of developing CTE in (retired) soccer players. However based on this review of only 14 players, questions persist as to whether or not heading is a risk factor for CTE or long-term cognitive decline.
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Affiliation(s)
- Gerard Hageman
- Department of Neurology, Medisch Spectrum Twente, Hospital Enschede, Enschede, the Netherlands; and
| | - Ivar Hageman
- Saxion University of Applied Sciences, Enschede, the Netherlands
| | - Jik Nihom
- Department of Neurology, Medisch Spectrum Twente, Hospital Enschede, Enschede, the Netherlands; and
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Kasum M, Gavic L, Mandic P, Tadin A. Knowledge of traumatic dental injuries and mouthguard behavior among Croatian soccer players. Dent Traumatol 2023; 39:555-564. [PMID: 37341423 DOI: 10.1111/edt.12862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 05/13/2023] [Accepted: 05/26/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVES/AIM Sports-related dental injuries occur frequently among athletes due to inadequate knowledge and prevention measures. The aim of the study was to assess knowledge, attitudes, and practices of active soccer players from all leagues in Croatia regarding traumatic dental injuries and the use of mouthguards. MATERIAL AND METHODS 393 respondents completed a questionnaire-based online survey from March 2022 to April 2022. The questionnaire consisted of 37 questions divided in four sections: demographic characteristics, experience with orofacial injuries, knowledge of emergency therapeutic procedures for dental injuries, and behaviors related to the use of a mouthguard. RESULTS Insufficient knowledge was confirmed by a total score of 2.8 ± 2.8 points, with a possible maximum of 11. Respondents' better knowledge can be associated with educational level (p = .002), playing position (p = .046), and personally experienced injuries to the face and jaw (p ≤ .001) and teeth (p = .022). Less than 40% of respondents suffered facial and jaw injuries while playing football and 18.6% suffered dental injuries. Although most respondents (93.9%) were familiar with mouthguards and 68.9% believed that they help prevent injuries while playing football, only 16% used them. CONCLUSION The study revealed significant gaps in knowledge regarding dental injuries and the practice of mouthguard usage among Croatian soccer players. Therefore, it is evident that additional education is needed to prevent dental injuries and take proper procedures when taking care of them among the examined population.
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Affiliation(s)
- Marin Kasum
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Lidia Gavic
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | | | - Antonija Tadin
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
- Department of Maxillofacial Surgery, Clinical Hospital Centre Split, Split, Croatia
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Ling DI, Hannafin JA, Prather H, Skolnik H, Chiaia TA, de Mille P, Lewis CL, Casey E. The Women's Soccer Health Study: From Head to Toe. Sports Med 2023; 53:2001-2010. [PMID: 37195359 PMCID: PMC10191093 DOI: 10.1007/s40279-023-01860-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVES Women are under-represented in the sports literature despite increasing rates of sports participation. Our objective was to investigate the risks and benefits of an elite women's soccer career in five health domains: general, musculoskeletal, reproductive endocrinology, post-concussion, and mental. METHODS An online survey was distributed to retired US college, semi-professional, professional, and national team soccer players using personal networks, email, and social media. Short validated questionnaires were used to evaluate the health domains, including the Patient-Reported Outcomes Measurement Information System (PROMIS), Single Assessment Numerical Evaluation (SANE), Post-Concussion Symptom Scale (PCSS), and Patient Health Questionnaire (PHQ). RESULTS A total of 560 eligible players responded to the survey over a 1-year period. The highest competitive levels were 73% college, 16% semi-professional, 8% professional, and 4% national team. The mean number of years since retirement was 12 (SD = 9), and 17.0% retired for involuntary reasons. The mean SANE scores (0-100 scale as percentage of normal) were knee = 75% (SD = 23), hip = 83% (SD = 23), and shoulder = 87% (SD = 21). The majority (63%) reported that their current activity level included participation in impact sports. A substantial proportion of players reported menstrual irregularities during their careers: 40% had fewer periods with increasing exercise and 22% had no periods for ≥ 3 months. The players (n = 44) who felt that post-concussion symptoms were due to soccer reported more time-loss concussions (F[2] = 6.80, p = 0.002) and symptom severity (F[2] = 30.26, p < 0.0001). Players who recently retired (0-5 years) reported the highest anxiety/depression scores and lowest satisfaction rates compared with those who retired 19+ years ago. CONCLUSION Health concerns include musculoskeletal injuries, post-concussion symptoms, and lower mental health in the early years following retirement. This comprehensive survey provides initial results that will lay the foundation for further analyses and prioritize research studies that can help all female athletes.
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Affiliation(s)
- Daphne I Ling
- Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Hospital for Special Surgery, New York, USA.
- Weill Cornell Medical College, New York, USA.
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Reeschke R, Haase FK, Dautzenberg L, Krutsch W, Reinsberger C. Training matters: Heading incidence and characteristics in children's and youth football (soccer) players. Scand J Med Sci Sports 2023; 33:1821-1830. [PMID: 37259619 DOI: 10.1111/sms.14408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/03/2023] [Accepted: 05/15/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Concerns about short- and long-term consequences of repetitive heading contributed to heading restrictions in youth football in some countries. This prospective longitudinal cohort study aims to describe heading exposure in children's and youth football over two seasons using standardized video analysis. METHODS All matches and training sessions of a male Under-11 (n = 29), Under-15 (n = 28), Under-19 (n = 38), and female Under-17 (n = 39) team were videotaped during the seasons 2019-2020 and 2020-2021. Heading frequencies and characteristics were analyzed. Individual heading exposure is presented as average incidence rates (IR) per 1000 match/training hours. RESULTS In 275 matches and 673 training sessions, 22 921 headers were observed. Heading IR per player in matches was 1256 (Under-11 m), 1608 (Under-15 m), 1050 (Under-17 f), and 1966 (Under-19 m). In training sessions, IR per player was 739 (Under-11 m), 2206 (Under-15 m), 1661 (Under-17 f), and 1419 (Under-19 m). Five Under-15 males headed the ball five to eight times per training on average. Most headers were performed without heading duels. Flight distance was predominantly 5-20 m (54%) in matches and <5 m (65%) in training. While head impact location most frequently was at frontal areas, one-third of all headers in Under-11 in matches hit temporal, parietal, and occipital parts of the head. CONCLUSION Heading incidence was low in the youngest age group, whereas (predominantly five) Under-15 males showed very high heading exposures in training. In assessment and regulation of heading burden, training sessions and individual heading behavior should specifically be addressed. Recommendations for heading the ball in practice should account for individual and age-related differences.
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Affiliation(s)
- Rebecca Reeschke
- Institute of Sports Medicine, Paderborn University, Paderborn, Germany
| | | | - Lena Dautzenberg
- Institute of Sports Medicine, Paderborn University, Paderborn, Germany
| | - Werner Krutsch
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Claus Reinsberger
- Institute of Sports Medicine, Paderborn University, Paderborn, Germany
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Gurau TV, Gurau G, Voinescu DC, Anghel L, Onose G, Iordan DA, Munteanu C, Onu I, Musat CL. Epidemiology of Injuries in Men's Professional and Amateur Football (Part I). J Clin Med 2023; 12:5569. [PMID: 37685638 PMCID: PMC10488230 DOI: 10.3390/jcm12175569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Background (1): Football is the most popular sport among men, associated with a certain risk of injury, which leads to short- and long-term health consequences. While the injury profile of professional footballers is known, little is known about the injury profile of amateur footballers; amateur football is a major and diverse area, the development of which should be a priority for football associations around the world and UEFA. The aim of this study was to perform a systematic review of epidemiological literature data on injuries in professional and amateur football players belonging to certain leagues. Methods (2): A systematic review according to the PRISMA guidelines was performed until June 2023 in the databases PubMed, Web of Science, Google Academic, Google Scholar, and Diva portal. Forty-six studies reporting injury incidence in professional and amateur men's football were selected and analyzed. Two reviewers independently extracted data and assessed study quality using an adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. Results (3): The overall incidence of injuries in professional male football players was 7.75 ± 2.28, 95% confidence interval, injuries/1000 h of exposure and that of amateur football players was 7.98 ± 2.95, 95% confidence interval, injuries/1000 h of exposure. The incidence of match injuries (30.64 ± 10.28, 95% confidence interval, injuries/1000 exposure hours) was 7.71 times higher than the training injury incidence rate (3.97 ± 1.35, 95% confidence interval, injuries/1000 h) in professional football players and 5.45 times higher in amateurs (17.56 ± 6.15 vs. 3.22 ± 1.4, 95% confidence interval, injuries/1000 h). Aggregate lower extremity injuries had the highest prevalence in both categories of footballers, being 83.32 ± 4.85% in professional footballers and 80.4 ± 7.04% in amateur footballers: thigh, ankle, and knee injuries predominated. Conclusions (4): Professional and amateur football players are at substantial risk of injury, especially during matches that require the highest level of performance. Injury rates have implications for players, coaches, and sports medicine practitioners. Therefore, information on football injuries can help develop personalized injury risk mitigation strategies that could make football safer for both categories of football players. The current findings have implications for the management, monitoring, and design of training, competition, injury prevention, especially severe injury, and education programs for amateur football players.
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Affiliation(s)
- Tudor Vladimir Gurau
- Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania;
| | - Gabriela Gurau
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (G.G.); (C.L.M.)
| | - Doina Carina Voinescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Lucretia Anghel
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Gelu Onose
- Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Ar-Seni”, 041915 Bucharest, Romania;
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Daniel Andrei Iordan
- Department of Individual Sports and Kinetotherapy, Faculty of Physical Education and Sport, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
- Center of Physical Therapy and Rehabilitation, ‘Dunărea de Jos’ University of Galati, 800008 Galati, Romania
| | - Constantin Munteanu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iaşi, 700454 Iaşi, Romania;
| | - Ilie Onu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iaşi, 700454 Iaşi, Romania;
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (G.G.); (C.L.M.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
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Espahbodi S, Hogervorst E, Macnab TMP, Thanoon A, Fernandes GS, Millar B, Duncan A, Goodwin M, Batt M, Fuller CW, Fuller G, Ferguson E, Bast T, Doherty M, Zhang W. Heading Frequency and Risk of Cognitive Impairment in Retired Male Professional Soccer Players. JAMA Netw Open 2023; 6:e2323822. [PMID: 37459095 PMCID: PMC10352859 DOI: 10.1001/jamanetworkopen.2023.23822] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/01/2023] [Indexed: 07/20/2023] Open
Abstract
Importance Although professional soccer players appear to be at higher risk of neurodegenerative disease, the reason remains unknown. Objective To examine whether heading frequency is associated with risk of cognitive impairment in retired professional soccer players. Design, Setting, and Participants A UK nationwide cross-sectional study was conducted between August 15, 2020, and December 31, 2021, in 459 retired male professional soccer players older than 45 years and registered with the Professional Footballers' Association or a League Club Players' Association. Exposure Data on heading frequency in 3 bands-0 to 5, 6 to 15, and more than 15 times per match or training session and other soccer-specific risk factors, such as player position and concussion-were collected through a self-reported questionnaire. Main Outcomes and Measures Cognitive impairment was defined using the Telephone Interview for Cognitive Status-modified as scores of less than or equal to 21. Hopkins Verbal Learning Test, verbal fluency, and independent activities of daily living were also assessed. Test Your Memory and physician-diagnosed dementia/Alzheimer disease were self-reported via the questionnaire. Adjusted odds ratios (AORs) with 95% CIs were calculated. Results Of 468 retired male professional soccer players who completed questionnaires (mean [SD] age, 63.68 [10.48]; body mass index, 27.22 [2.89]), 459 reported heading frequency: 114 headed 0 to 5 times, 185 headed 6 to 15 times, 160 headed more than 15 times per match, and 125 headed 0 to 5 times, 174 headed 6 to 15 times, and 160 headed more than 15 times per training session during their careers. The prevalence of cognitive impairment was 9.78% (0-5 times), 14.78% (6-15 times), and 15.20% (>15 times) per match (P = .51). Compared with players reporting 0 to 5 headers per match, the AORs were 2.71 (95% CI, 0.89-8.25) for players reporting 6 to 15 headers per match and 3.53 (95% CI, 1.13-11.04) for players reporting more than 15 headers per match (P = .03 for trend). Corresponding AORs for heading frequency per training session were 2.38 (95% CI, 0.82-6.95) for those reporting 6 to 15, and 3.40 (95% CI, 1.13-10.23) for those reporting more than 15 in comparison with those who reported 0 to 5 (P = .03 for trend). Concussion involving memory loss was also associated with a greater risk of cognitive impairment (AOR, 3.16; 95% CI, 1.08-9.22). Similar results were observed with other cognitive tests and self-reported physician-diagnosed dementia/Alzheimer disease. Conclusions and Relevance The findings of this study suggest that repetitive heading during a professional soccer career is associated with an increased risk of cognitive impairment in later life. Further study is needed to establish the upper threshold for heading frequency to mitigate this risk.
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Affiliation(s)
- Shima Espahbodi
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, Academic Rheumatology, City Hospital, Nottingham, UK
| | - Eef Hogervorst
- NCSEM, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Tara-Mei Povall Macnab
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, Academic Rheumatology, City Hospital, Nottingham, UK
| | - Ahmed Thanoon
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, Academic Rheumatology, City Hospital, Nottingham, UK
| | - Gwen Sacha Fernandes
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Bonnie Millar
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, Academic Rheumatology, City Hospital, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - Ashley Duncan
- National Institute for Health Research ARC EM, University of Nottingham, Nottingham, UK
| | - Maria Goodwin
- NCSEM, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Mark Batt
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
| | | | - Gordon Fuller
- Centre for Urgent and Emergency Research, University of Sheffield, Sheffield, UK
| | - Eamonn Ferguson
- Pain Centre Versus Arthritis, Academic Rheumatology, City Hospital, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
- School of Psychology, University of Nottingham, Nottingham, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
| | - Tobias Bast
- Pain Centre Versus Arthritis, Academic Rheumatology, City Hospital, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
- School of Psychology, University of Nottingham, Nottingham, UK
- Neuroscience@Nottingham, University of Nottingham, Nottingham, UK
| | - Michael Doherty
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, Academic Rheumatology, City Hospital, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - Weiya Zhang
- Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, Academic Rheumatology, City Hospital, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
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11
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Peek K, Duffield R, Cairns R, Jones M, Meyer T, McCall A, Oxenham V. Where are We Headed? Evidence to Inform Future Football Heading Guidelines. Sports Med 2023; 53:1335-1358. [PMID: 37285067 PMCID: PMC10289964 DOI: 10.1007/s40279-023-01852-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2023] [Indexed: 06/08/2023]
Abstract
Given the scientific and public concern regarding the short-, medium- and long-term consequences of heading on brain health, being proactive about developing and implementing guidelines that help reduce the burden (volume, impact magnitude and injury risk) of heading in young and beginner players appears justified. This narrative review explores the evidence underpinning strategies that could be incorporated into future heading guidelines to reduce heading burden in players across all levels of football. A four-step search strategy was utilised to identify all data-based papers related to heading in football. Eligibility criteria for inclusion were: (1) original data, (2) study population included football players, (3) outcome measures included one or more of the following: number of headers, measurement of head acceleration during heading, or head/brain injury incidence, and (4) published in English or English translation available. In total, 58 papers were included that outlined strategies based on (1) game or team development, (2) player skill development and (3) equipment. In particular, greater emphasis existed for small-sided games (particularly in young players) where fewer headers are observed when compared with the conventional 11 versus 11 game, as well as reducing headers from goal kicks and corners. Evidence also existed for developing a heading coaching framework that focusses on technical proficiency as well as neuromuscular neck exercises integrated into general injury reduction exercise programs, enforcement of rules related to deliberate head contact and using lower-pressure match and training balls. To mitigate potential risks of heading on brain health, a number of pragmatic strategies have been examined in scientific studies and may be considered as part of future heading guidelines.
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Affiliation(s)
- Kerry Peek
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Rob Duffield
- School of Sport, Exercsie & Rehabilitation, Faculty of Health, University of Technology Sydney, Sydney, NSW Australia
- Football Australia, Sydney, NSW Australia
| | - Ross Cairns
- Newcastle Sports Medicine, Warners Bay, NSW Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | - Mark Jones
- Football Australia, Sydney, NSW Australia
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Alan McCall
- School of Sport, Exercsie & Rehabilitation, Faculty of Health, University of Technology Sydney, Sydney, NSW Australia
- Football Australia, Sydney, NSW Australia
| | - Vincent Oxenham
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW Australia
- Department of Neuropsychology, Royal North Shore Hospital, Sydney, NSW Australia
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12
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Peek K, Versteegh T, Veith S, Whalan M, Edwards S, McKay M, Gardner AJ. Injury-Reduction Programs Containing Neuromuscular Neck Exercises and the Incidence of Soccer-Related Head and Neck Injuries. J Athl Train 2023; 58:519-527. [PMID: 36645836 PMCID: PMC10496449 DOI: 10.4085/1062-6050-0340.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
CONTEXT Concern is growing among soccer players, coaches, and parents regarding head and neck injuries, including concussion, particularly from heading a ball. Thus, we need to explore soccer-specific head injury risk-reduction initiatives. One such initiative is to condition the neck musculature of young players by adding neuromuscular neck exercises to existing injury-reduction exercise programs. OBJECTIVE To investigate the effect of neuromuscular neck exercises completed as part of an injury risk-reduction exercise program on the incidence of soccer-related head and neck injuries in adolescent soccer players. DESIGN Prospective cohort study. SETTING Two sports high schools and 6 soccer clubs during the 2021 soccer season. PATIENTS OR OTHER PARTICIPANTS A total of 364 male and female soccer players, aged 12 to 18 years. INTERVENTION(S) Members of 1 sports high school and 2 soccer clubs performed neuromuscular neck exercises as part of an injury-reduction program during training (neck training group). Members of another sports high school and 4 soccer clubs performed an injury-reduction program but without neck exercises (comparison group). MAIN OUTCOME MEASURE(S) Self-reported injury data were collected from each player at the end of the season and used to calculate incidence rate ratios (IRRs) with 95% CIs. RESULTS In total, 364 players completed the study, including 146 players in the neck training group and 218 players in the comparison group. Despite players in the neck training group being less likely to self-report a concussion (IRR = 0.23; 95% CI = 0.03, 1.04) and pain on heading a ball (IRR = 0.62; 95% CI = 0.34, 1.07), only a lower incidence of possible concussive events (IRR = 0.38; 95% CI = 0.14, 0.90; P < .05) was significant. CONCLUSIONS Integrating neuromuscular neck exercises into injury-reduction exercise programs has the potential to reduce the risk of adolescent soccer players sustaining a possible concussive event, concussion, or pain on heading a ball.
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Affiliation(s)
- Kerry Peek
- Discipline of Physiotherapy, University of Sydney, New South Wales, Australia
| | | | - Stella Veith
- Centre of Medical and Exercise Physiology, School of Medicine, University of Wollongong, New South Wales, Australia
| | - Matt Whalan
- Centre of Medical and Exercise Physiology, School of Medicine, University of Wollongong, New South Wales, Australia
| | - Suzi Edwards
- Discipline of Physiotherapy, University of Sydney, New South Wales, Australia
| | - Marnee McKay
- Discipline of Physiotherapy, University of Sydney, New South Wales, Australia
| | - Andrew John Gardner
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
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13
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Predicting Severity of Head Collision Events in Elite Soccer Using Preinjury Data: A Machine Learning Approach. Clin J Sport Med 2023; 33:165-171. [PMID: 36730765 PMCID: PMC9983750 DOI: 10.1097/jsm.0000000000001087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 09/15/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To develop machine learning (ML) models that predict severity of head collision events (HCEs) based on preinjury variables and to investigate which variables are important to predicting severity. DESIGN Data on HCEs were collected with respect to severity and 23 preinjury variables to create 2 datasets, a male dataset using men's tournaments and mixed dataset using men's and women's tournaments, to perform ML analysis. Machine learning analysis used a random forest classifier based on preinjury variables to predict HCE severity. SETTING Four elite international soccer tournaments. PARTICIPANTS Elite athletes participating in analyzed tournaments. INDEPENDENT VARIABLES The 23 preinjury variables collected for each HCE. MAIN OUTCOME MEASURES Predictive ability of the ML models and association of important variables. RESULTS The ML models had an average area under the receiver operating characteristic curve for predicting HCE severity of 0.73 and 0.70 for the male and mixed datasets, respectively. The most important variables for prediction were the mechanism of injury and the event before injury. In the male dataset, the mechanisms "head-to-head" and "knee-to-head" were together significantly associated ( P = 0.0244) with severity; they were not significant in the mixed dataset ( P = 0.1113). In both datasets, the events "corner kicks" and "throw-ins" were together significantly associated with severity (male, P = 0.0001; mixed, P = 0.0004). CONCLUSIONS ML models accurately predicted the severity of HCE. The mechanism and event preceding injury were most important for predicting severity of HCEs. These findings support the use of ML to inform preventative measures that will mitigate the impact of these preinjury factors on player health.
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14
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Cheever K, King J, Kawata K. The association between contact sport exposure and cervical sensorimotor dysfunction: a scoping review of implications for future musculoskeletal injury risk. Chiropr Man Therap 2022; 30:50. [PMID: 36434725 PMCID: PMC9701076 DOI: 10.1186/s12998-022-00458-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 10/13/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND While morphological changes to the cervical spine have been observed for over 40 years in response to contact sport participation, little is known about the secondary effects of the cervical impairment on future musculoskeletal injury and disability. OBJECTIVES AND DESIGN A scoping review was performed to discuss the relationship between contact sport participation and morphological changes to the cervical spine. Moreover, the correlation between morphological changes in the musculoskeletal structures of the cervical spine and resultant deficits in cervical sensorimotor and neuromotor function are discussed. Lastly, how alterations in cervical sensorimotor function may affect overall risk of musculoskeletal injury is discussed. METHODS The scientific literature was searched in PubMed, Sport Discus, and Web of Science pertaining to contact-sport athletes and/or cervical pathology and the cervicocephalic network. The Asksey and O'Malley's framework and PRISMA for Scoping Reviews were used to conduct and report the following review. Included articles were grouped into three categories: (1) Morphological changes to the cervical spine in contact sport athletes. (2) The role of the neuromotor pathways of the cervical spine in maintenance of postural tone and coordination of the extremities. (3) The correlation between altered cervical sensorimotor function and a resultant increase in musculoskeletal injury risk. RESULTS Our search identified 566 documents, of which 405 underwent full-text screening, resulting in 54 eligible studies for the review. Widespread cervical sensorimotor dysfunction was observed in contact sport athletes. Independently, cervical sensorimotor function was demonstrated to play a critical role in postural control and limb coordination. However, limited research exists exploring the interaction between contact sport participation and altered cervical sensorimotor function, as well as an associated increase in musculoskeletal injury risk. CONCLUSIONS Limited evidence exists linking cervical injury and/or observed deficits in cervical sensorimotor and neuromotor function to musculoskeletal injury risk. Longitudinal studies combining imaging measures (e.g., MRI, DEXA), cervical functional test, and prospective injury risk are needed to further explore the correlation between resultant cervical sensorimotor deficits following contact sport impacts and future musculoskeletal injury risk.
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Affiliation(s)
- Kelly Cheever
- Applied Biomechanics Laboratory, Department of Kinesiology, College of Health, Community and Policy, University of Texas at San Antonio, One UTSA Cir, San Antonio, TX, 78429, USA.
| | - Jeffery King
- grid.30760.320000 0001 2111 8460Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI USA
| | - Keisuke Kawata
- grid.411377.70000 0001 0790 959XDepartment of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN USA ,grid.411377.70000 0001 0790 959XProgram in Neuroscience, College of Arts and Sciences, Indiana University, Bloomington, IN USA
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15
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Horan D, Büttner F, Blake C, Hägglund M, Kelly S, Delahunt E. Injury incidence rates in women's football: a systematic review and meta-analysis of prospective injury surveillance studies. Br J Sports Med 2022; 57:471-480. [PMID: 36229168 DOI: 10.1136/bjsports-2021-105177] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To review the literature to establish overall, match and training injury incidence rates (IIRs) in senior (≥18 years of age) women's football (amateur club, elite club and international). DESIGN Systematic review and meta-analysis of overall, match and training IIRs in senior women's football, stratified by injury location, type and severity. DATA SOURCES MEDLINE via PubMed; EMBASE via Ovid; CINAHL via EBSCO and Web of Science were searched from earliest record to July 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES (1) football players participating in a senior women's football league (amateur club or elite club) or a senior women's international football tournament; (2) the study had to report IIRs or provide sufficient data from which this outcome metric could be calculated through standardised equations; (3) a full-text article published in a peer-reviewed journal before July 2021; (4) a prospective injury surveillance study and (5) case reports on single teams were ineligible. RESULTS 17 articles met the inclusion criteria; amateur club (n=2), elite club (n=10), international (n=5). Overall, match and training 'time-loss' IIRs are similar between senior women's elite club football and international football. 'Time-loss' training IIRs in senior women's elite club football and international football are approximately 6-7 times lower than their equivalent match IIRs. Overall 'time-loss' IIRs stratified by injury type in women's elite club football were 2.70/1000 hours (95% CI 1.12 to 6.50) for muscle and tendon, 2.62/1000 hours (95% CI 1.26 to 5.46) for joint and ligaments, and 0.76/1000 hours (95% CI 0.55 to 1.03) for contusions. Due to the differences in injury definitions, it was not possible to aggregate IIRs for amateur club football. CONCLUSION Lower limb injuries incurred during matches are a substantial problem in senior women's football. The prevention of lower limb joint, ligament, muscle and tendon injuries should be a central focus of injury prevention interventions in senior women's amateur club, elite club and international football. PROSPERO REGISTRATION NUMBER CRD42020162895.
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Affiliation(s)
- Dan Horan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland .,High Performance Department, Football Association of Ireland, Dublin, Ireland
| | - Fionn Büttner
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
| | - Martin Hägglund
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Football Research Group, Linköping University, Linköping, Sweden
| | - Seamus Kelly
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
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16
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Chaychi S, Valera E, Tartaglia MC. Sex and gender differences in mild traumatic brain injury/concussion. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 164:349-375. [PMID: 36038209 DOI: 10.1016/bs.irn.2022.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The high incidence of concussions/mild traumatic brain injury and the significant number of people with persisting concussion symptoms as well as the concern for delayed, neurodegenerative effects of concussions makes them a major public health concern. There is much to learn on concussions with respect to pathophysiology as well as vulnerability and resiliency factors. The heterogeneity in outcome after a concussion warrants a more personalized approach to better understand the biological and psychosocial factors that may affect outcome. In this chapter we address biological sex and gender as they impact different aspects of concussion including incidence, risk factors and outcome. As well, this chapter will provide a more fulsome overview of intimate partner violence, an often-overlooked cause of concussion in women. Applying the sex and gender lens to concussion/mild traumatic brain injury is imperative for discovery of its pathophysiology and moving closer to treatments.
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Affiliation(s)
- Samaneh Chaychi
- Memory Clinic, Krembil Brain Institute, University Health Network, Toronto, ON, Canada; Canadian Concussion Centre, Krembil Brain Institute, University Health Network, Toronto, ON, Canada
| | - Eve Valera
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, United States
| | - Maria Carmela Tartaglia
- Memory Clinic, Krembil Brain Institute, University Health Network, Toronto, ON, Canada; Canadian Concussion Centre, Krembil Brain Institute, University Health Network, Toronto, ON, Canada; Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.
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17
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Abstract
OBJECTIVES The aim of this study was to investigate the incidence and characteristics of match and training injuries in elite-level national male beach soccer players. METHOD The incidence, mechanism, location, type, severity, and burden of injuries of the Turkish national beach soccer team were recorded between 2017 and 2019. RESULTS A total of 136 injuries occurred during the study period. Total injury incidence was 238.9 injuries/1,000 match hours (MHs) and 37.7 injuries/1,000 training hours (THs) (p < 0.001). Twenty-seven injuries led to time-loss, and the incidences for match and training injuries were 36.7 and 7.9 per 1,000 hours, respectively. Of medical attention injuries (MAI) caused by trauma, 54.6% (n = 53) were due to another player and, 60.9% (n = 14) of time-loss injuries (TLI) caused by trauma were due to non-contact trauma (p < 0.001). While 82% (n = 91) of training injuries occurred in lower extremities, 29% (n = 9) of match injuries occurred in the head/neck region (p < 0.001). Head injury incidence was 45.9 per 1,000 match hours. Of MAI, 50% (n = 57) were contusion, and 32.1% (n = 9) of TLI were strain (p < 0.001). Also, the most common injury subtype was foot/toe contusion during match and training (19.4%; n = 6, 27.9%; n = 31, respectively). The majority of injuries 91.9% (n = 125) had slight severity. CONCLUSION Head trauma, tendon injury, and foot/toe contusion are important for clinical practice in beach soccer. Protective measures (rule regulation, use of protective equipment, etc.) should be considered to prevent these injuries.
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Affiliation(s)
- Yavuz Lima
- Sports Medicine Clinic, Balıkesir Atatürk City Hospital, Balıkesir, Turkey
| | - Bulent Bayraktar
- Istanbul Faculty of Medicine, Sports Medicine Department, Istanbul University, Istanbul, Turkey.,Turkish Football Federation, Istanbul, Turkey.,Acıbadem Sports/FIFA Medical Centre of Excellence Consultant, Istanbul, Turkey
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18
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Espahbodi S, Fernandes G, Hogervorst E, Thanoon A, Batt M, Fuller CW, Fuller G, Ferguson E, Bast T, Doherty M, Zhang W. Foot and ankle Osteoarthritis and Cognitive impairment in retired UK Soccer players (FOCUS): protocol for a cross-sectional comparative study with general population controls. BMJ Open 2022; 12:e054371. [PMID: 35379624 PMCID: PMC8981329 DOI: 10.1136/bmjopen-2021-054371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Professional footballers commonly experience sports-related injury and repetitive microtrauma to the foot and ankle, placing them at risk of subsequent chronic pain and osteoarthritis (OA) of the foot and ankle. Similarly, repeated heading of the ball, head/neck injuries and concussion have been implicated in later development of neurodegenerative diseases such as dementia. A recent retrospective study found that death from neurodegenerative diseases was higher among former professional soccer players compared with age matched controls. However, well-designed lifetime studies are still needed to provide evidence regarding the prevalence of these conditions and their associated risk factors in retired professional football players compared with the general male population. OBJECTIVES To determine whether former professional male footballers have a higher prevalence than the general male population of: (1) foot/ankle pain and radiographic OA; and (2) cognitive and motor impairments associated with dementia and Parkinson's disease. Secondary objectives are to identify specific football-related risk factors such as head impact/concussion for neurodegenerative conditions and foot/ankle injuries for chronic foot/ankle pain and OA. METHODS AND ANALYSIS This is a cross-sectional, comparative study involving a questionnaire survey with subsamples of responders being assessed for cognitive function by telephone assessment, and foot/ankle OA by radiographic examination. A sample of 900 adult, male, ex professional footballers will be recruited and compared with a control group of 1100 age-matched general population men between 40 and 100 years old. Prevalence will be estimated per group. Poisson regression will be performed to determine prevalence ratio between the populations and logistic regression will be used to examine risk factors associated with each condition in footballers. ETHICS AND DISSEMINATION This study was approved by the East Midlands-Leicester Central Research Ethics Committee on 23 January 2020 (REC ref: 19/EM/0354). The study results will be disseminated at national and international meetings and submitted for peer-review publication.
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Affiliation(s)
- Shima Espahbodi
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, Nottinghamshire, UK
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Gwen Fernandes
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, Nottinghamshire, UK
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Eef Hogervorst
- NCSEM, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Ahmed Thanoon
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, Nottinghamshire, UK
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Mark Batt
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, University of Nottingham, Nottingham, UK
- Sports Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Gordon Fuller
- Centre for Urgent and Emergency Research, The University of Sheffield, Sheffield, UK
| | - Eamonn Ferguson
- Psychology, University of Nottingham, Nottingham, Nottinghamshire, UK
| | - Tobias Bast
- Psychology, University of Nottingham, Nottingham, Nottinghamshire, UK
- Neuroscience@Nottingham, University of Nottingham, Nottingham, Nottinghamshire, UK
| | - Michael Doherty
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, Nottinghamshire, UK
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Weiya Zhang
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, Nottinghamshire, UK
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, University of Nottingham, Nottingham, UK
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19
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Nutt S, McKay MJ, Gillies L, Peek K. Neck strength and concussion prevalence in football and rugby athletes. J Sci Med Sport 2022; 25:632-638. [DOI: 10.1016/j.jsams.2022.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
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20
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Forsythe B, Knapik DM, Crawford MD, Diaz CC, Hardin D, Gallucci J, Silvers-Granelli HJ, Mandelbaum BR, Lemak L, Putukian M, Giza E. Incidence of Injury for Professional Soccer Players in the United States: A 6-Year Prospective Study of Major League Soccer. Orthop J Sports Med 2022; 10:23259671211055136. [PMID: 35360881 PMCID: PMC8961375 DOI: 10.1177/23259671211055136] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/10/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Despite an abundance of injury research focusing on European professional
soccer athletes, there are limited injury data on professional soccer
players in the United States. Purpose: To describe the epidemiology of injury across multiple years in Major League
Soccer (MLS) players. Study Design: Descriptive epidemiology study. Methods: A web-based health management platform was used to prospectively collect
injury data from all MLS teams between 2014 and 2019. An injury was defined
as an incident that required medical attention and was recorded into the
health management platform anytime over the course of the 2014-2019 seasons.
Injuries and exposure data were recorded in training and match settings to
calculate injury incidence. Results: A total of 9713 injuries were recorded between 2014 and 2019. A mean 1.1
injuries per year per player were identified, with midfielders sustaining
the largest number of injuries. The most common injuries were hamstring
strains (12.3%), ankle sprains (8.5%), and adductor strains (7.6%). The mean
time missed per injury was 15.8 days, with 44.2% of injuries resulting in no
days missed. Overall injury incidence was 8.7 per 1000 hours of exposure,
declining over the course of the investigation, with a 4.1-times greater
mean incidence during matches (14.0/1000 h) than training (3.4/1000 h). Conclusion: Between 2014 and 2019, the most commonly reported injuries in MLS players
were hamstring strains, ankle sprains, and adductor strains. Injury
incidence during matches was 4.1 times greater when compared with training,
while overall injury incidence was found to decline during the course of the
study period.
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Affiliation(s)
| | | | | | | | | | | | - Holly Jacinda Silvers-Granelli
- Major League Soccer, New York, New York, USA
- Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, USA
| | | | | | | | - Eric Giza
- Department of Orthopaedics, University of California–Davis, Davis, California, USA
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21
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Porfido T, Caccese J, Gutt J, Wentworth C, Peek K, Bretzin AC, Esopenko C. A standardized method for quantifying and characterizing repetitive head impacts in soccer matches using video footage. SCI MED FOOTBALL 2022; 6:331-339. [DOI: 10.1080/24733938.2022.2056233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Tara Porfido
- School of Graduate Studies, Rutgers Biomedical and Health Sciences, Newark, NJ, 07107 USA
| | - Jaclyn Caccese
- School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH, 43210 USA
| | - Jessica Gutt
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, 07107 USA
| | - Conor Wentworth
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, 07107 USA
| | - Kerry Peek
- Discipline of Physiotherapy, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW 2006 Australia
| | - Abigail C Bretzin
- Penn Injury Science Center, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, 19104 USA
| | - Carrie Esopenko
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences, Newark, NJ, 07107 USA
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22
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Dave U, Kinderknecht J, Cheng J, Santiago K, Jivanelli B, Ling DI. Systematic review and meta-analysis of sex-based differences for concussion incidence in soccer. PHYSICIAN SPORTSMED 2022; 50:11-19. [PMID: 33357128 DOI: 10.1080/00913847.2020.1868955] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To compare concussion incidence in male and female soccer players due to the specific concussion-causing activity. METHODS/DATA SOURCES PubMed, EMBASE, and Cochrane Library were searched for studies published between January 2000 and February 2020. Search terms included 'sex,' 'gender,' 'sex differences,' 'brain injury,' 'sports,' 'athletes,' 'incidence,' 'epidemiology,' 'symptoms,' and 'injury rate.' Studies that contained data on concussion incidence in soccer and featured comparisons by sex and soccer activity were included. Studies that were not written in English, contained data on non-sports-related concussions, or were conference abstracts were excluded. RESULTS Six studies were included in this meta-analysis, each of which contributed the number of concussions in males and females for a specific soccer activity. Concussion incidence rates were calculated using athlete-exposures as the denominator and a rate ratio was measured by dividing the concussion rate among female soccer players by the rate among male soccer players. Female soccer players were shown to have a greater rate of concussions from heading [1.65 (95% CI: 1.35, 2.03, p < 0.001)] and goalkeeping [1.63 (95% CI: 1.22, 2.17, p = 0.001)]. There were 3 studies comparing sex differences for general play. While the pooled rate ratio was statistically significant [1.51 (95% CI: 1.12, 2.04), p = 0.007], this result was largely driven by 1 study. CONCLUSION Concussion incidence rates were significantly higher in female soccer players compared to male players while heading. There is also some evidence to suggest that the incidence is higher for female goalkeepers. Soccer coaches and health care providers need to recognize this sex difference when coaching or treating players.
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Affiliation(s)
- Udit Dave
- Department of Biology, Georgetown University, Washington, D.C., U.S.A
| | - James Kinderknecht
- Sports Medicine Institute, Hospital for Special Surgery, New York, N.Y., U.S.A
| | - Jennifer Cheng
- Department of Physiatry, Hospital for Special Surgery, New York, N.Y., U.S.A
| | - Kristen Santiago
- Department of Physiatry, Hospital for Special Surgery, New York, N.Y., U.S.A
| | - Bridget Jivanelli
- Kim Barrett Memorial Library, Hospital for Special Surgery, New York, N.Y., U.S.A
| | - Daphne I Ling
- Sports Medicine Institute, Hospital for Special Surgery, New York, N.Y., U.S.A.,Department of Population Health Sciences, Weill Cornell Medical College, New York, N.Y., U.S.A
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23
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Blyth RJ, Alcock M, Tumilty DS. Why are female soccer players experiencing a concussion more often than their male counterparts? A scoping review. Phys Ther Sport 2021; 52:54-68. [PMID: 34419893 DOI: 10.1016/j.ptsp.2021.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 07/30/2021] [Accepted: 08/01/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND The risk of concussion is particularly high in female soccer players. There is no consensus as to why female soccer players are at an elevated risk. OBJECTIVE To synthesise current evidence investigating reasons for the increased concussion rate in female soccer players. SOURCES Searching of six databases (MEDLINE, Scopus, CINAHL, SportDiscus, Web of Science and the Cochrane Library) and grey literature was performed between 13/07/2020-31/07/2020. Keywords were concussion-related terms, terms relating to female football/soccer and terms relating to the mechanism/cause. No constraints were placed on publication date and quantitative or exploratory studies meeting inclusion criteria were eligible. Exclusion criteria were studies not published in English and qualitative studies. RESULTS Several hypotheses were identified to explain increased concussion rates in female soccer players, these include, reduced neck strength/anthropometrics, increased head acceleration, increased ball-to-head concussions, differences in hormones and brain structure/function, and reduced visual awareness. CONCLUSION Promising ideas/reasons have been identified for increased concussion rates in female soccer players. Despite hypothesis generation there is scarce high-level evidence which is required to guide injury prevention and/or rule changes to protect female soccer players. The level of evidence for included studies is level 2-3 with most being observational cross-sectional or cohort studies.
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Affiliation(s)
- Rebecca Jane Blyth
- School of Physiotherapy, University of Otago, 325 Great King Street, North Dunedin, Dunedin, 9016, New Zealand.
| | - Mark Alcock
- School of Physiotherapy, University of Otago, 325 Great King Street, North Dunedin, Dunedin, 9016, New Zealand
| | - Dr Steve Tumilty
- School of Physiotherapy, University of Otago, 325 Great King Street, North Dunedin, Dunedin, 9016, New Zealand
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24
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Achenbach L, Klein C, Luig P, Bloch H, Schneider D, Fehske K. Collision with opponents-but not foul play-dominates injury mechanism in professional men's basketball. BMC Sports Sci Med Rehabil 2021; 13:94. [PMID: 34412662 PMCID: PMC8375128 DOI: 10.1186/s13102-021-00322-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/10/2021] [Indexed: 11/25/2022]
Abstract
Background To identify injury patterns and mechanisms in professional men’s basketball by means of video match analysis.
Methods In Germany, injuries are registered with the statutory accident insurance for professional athletes (VBG) by clubs or club physicians as part of occupational accident reporting. Moderate and severe injuries (absence of > 7 days) sustained during basketball competition in one of four seasons (2014–2017 and 2018–2019) in the first or second national men’s league in Germany were prospectively analyzed using a newly developed standardized observation form. Season 2017–2018 was excluded because of missing video material. Results Video analysis included 175 (53%) of 329 moderate and severe match injuries. Contact patterns categorized according to the different body sites yielded eight groups of typical injury patterns: one each for the head, shoulders, and ankles, two for the thighs, and three for the knees. Injuries to the head (92%), ankles (76%), shoulders (70%), knees (47%), and thighs (32%) were mainly caused by direct contact. The injury proportion of foul play was 19%. Most injuries (61%) occurred in the central zone below the basket. More injuries occurred during the second (OR 1.8, p = 0.018) and fourth quarter (OR 1.8, p = 0.022) than during the first and third quarter of the match. Conclusion The eight identified injury patterns differed substantially in their mechanisms. Moderate and severe match injuries to the head, shoulders, knees, and ankles were mainly caused by collision with opponents and teammates. Thus, stricter rule enforcement is unlikely to facilitate safer match play.
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Affiliation(s)
- Leonard Achenbach
- Department of Orthopedics, König-Ludwig-Haus, Julius-Maximilians-University Würzburg, Brettreichstraße 11, 97074, Würzburg, Germany.
| | - Christian Klein
- German Statutory Accident Insurance for the Administrative Sector (Department of Sports Injury Prevention), VBG, Hamburg, Germany
| | - Patrick Luig
- German Statutory Accident Insurance for the Administrative Sector (Department of Sports Injury Prevention), VBG, Hamburg, Germany
| | - Hendrik Bloch
- German Statutory Accident Insurance for the Administrative Sector (Department of Sports Injury Prevention), VBG, Hamburg, Germany
| | | | - Kai Fehske
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Medical Center Würzburg, Würzburg, Germany
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25
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Gilbert AW, Bering JM, Anderson LC. Addressing head injury risk in youth football: are heading guidelines the answer? SCI MED FOOTBALL 2021; 6:340-346. [DOI: 10.1080/24733938.2021.1967435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Alexander W. Gilbert
- 133 Union Street East, Dunedin
- Centre for Science Communication, University of Otago, Dunedin, New Zealand
| | - Jesse M. Bering
- Centre for Science Communication, University of Otago, Dunedin, New Zealand
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26
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Beaudouin F, Demmerle D, Fuhr C, Tröß T, Meyer T. Head Impact Situations in Professional Football (Soccer). Sports Med Int Open 2021; 5:E37-E44. [PMID: 33718592 PMCID: PMC7946547 DOI: 10.1055/a-1338-1402] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022] Open
Abstract
To assess head impact incidents (HIIs) and to distinguish diagnosed head injuries from other incidents, a video observation analysis of match HIIs was conducted in the German Bundesliga (2017/18 season). Video recordings of each match were screened to identify the respective events. Head injury data were identified by a prospective injury registry. HII and head injury incidence rates (IR) were calculated with 95% CIs. The total number of HIIs was 1,362 corresponding to an IR of 134.9/1000 match hours (95% CI 127.9–142.2). In 123 HII (IR 12.2, 95% CI 10.2–14.5) the contact was classified as severe. Head contact with the opponent was the most frequent cause (85%). The most frequent mechanism was in 44% (combined) the arm and elbow-to-head, followed by head-to-head and hand-to-head contacts (each 13%). In 58%, the HIIs occurred during header duels. Twenty-nine head injuries were recorded (IR 2.9, 95% CI 2.0–4.1). Concussions/traumatic brain injuries accounted for 48%, head/facial fractures 24%, head/facial contusions 21%, and lacerations/abrasions 7%. The number of HIIs not classified as concussions/more severe trauma was high. Identification of HIIs and head injury severity should be improved during on-field assessment as many head injuries might go unrecognised based on the large number of HIIs.
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Affiliation(s)
- Florian Beaudouin
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Daniel Demmerle
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Christoph Fuhr
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tobias Tröß
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
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27
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Lhee SH, Jain R, Madathur Sadasivam M, Kim S, Bae M, Yu J, Lee DY. Sports injury and illness incidence among South Korean elite athletes in the 2018 Asian Games: a single-physician prospective study of 782 athletes. BMJ Open Sport Exerc Med 2021; 7:e000689. [PMID: 33614125 PMCID: PMC7871279 DOI: 10.1136/bmjsem-2019-000689] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2020] [Indexed: 11/20/2022] Open
Abstract
Objective The increasing incidence of sports injury among athletes calls for systemic surveillance of injuries and illnesses in this field to develop preventive measures. The patterns of injuries and illnesses that occurred among Korean athletes during the 2018 Asian Games held in Indonesia were studied. Methods We recorded the occurrence of all injuries and illnesses reported to the chief medical officer, coordinated with the help of an instant social messaging application in real time. Results A total of 782 elite athletes participated in 46 sporting events. A total of 141 (18.03%) injuries were recorded, with 121 (15.47%) athletes suffering at least one injury. Out of 141 injuries 80 (56.74%) were in male athletes and 61 (43.26%) were in female athletes. The highest number of injuries was seen among sport climbing athletes (n=10, 71.43%), followed by sepak takraw. A total of 16 (11.35%) injuries were expected to prevent athletes from participation in competition/training. Most of the injuries occurred during training (46.10%), with lower lumbar spine being the most common part injured. A total of 209 (26.72%) illnesses were reported, with at least one illness in 170 (21.73%) athletes. The incidence among female athletes (26.90%) was comparable with that of male athletes (26.90%). Maximum illness rate was reported in table tennis (100%). The most common system involved was gastrointestinal (n=93, 44.49%), followed by respiratory (n=53, 25.36%). Environmental factors were causative in 111 athletes (53.11%) and infection in 79 (37.79%). Illnesses resulted in loss of at least 1 day among 30 (14.35%) athletes. Conclusion Overall 15.47% of athletes suffered at least one injury and 21.73% suffered at least one illness; the incidence of injury and illness varied depending on the type of sports.
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Affiliation(s)
- Sang-Hoon Lhee
- Orthopedic Surgery, CM General Hospital, Seoul, Korea (the Republic of).,Department of Mechanical Engineering, KAIST, Daejeon, Korea (the Republic of)
| | - Rahul Jain
- Orthopedic Surgery, CM General Hospital, Seoul, Korea (the Republic of)
| | | | - Sejun Kim
- Medical and Science, Korean Sport & Olympic Committee, Jincheon-gun, Chungcheongbuk-do, Korea (the Republic of)
| | - Moonjung Bae
- Medical and Science, Korean Sport & Olympic Committee, Jincheon-gun, Chungcheongbuk-do, Korea (the Republic of)
| | - Jungjin Yu
- Orthopaedics, CM Hospital of Korean Olympic Committee Jincheon National Training Center, Cheonan-si, Chungcheongnam-do, Korea (the Republic of)
| | - Do Young Lee
- Orthopedic Surgery, CM General Hospital, Seoul, Korea (the Republic of)
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28
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Peek K, Vella T, Meyer T, Beaudouin F, McKay M. The incidence and characteristics of purposeful heading in male and female youth football (soccer) within Australia. J Sci Med Sport 2021; 24:603-608. [PMID: 33414022 DOI: 10.1016/j.jsams.2020.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/25/2020] [Accepted: 12/14/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To quantify the incidence and characteristics of purposeful headers and unintentional head impacts during male and female youth football (soccer) games in Australia. DESIGN Cross-sectional observational study. METHODS Ten match-videos (total n=110) per playing age (under 13-20 males; under 13-17 females) from the 2019 National Premier League season were coded for purposeful headers and unintentional head impacts. Total headers and head impacts as well as incidence rate (IR) per 1000 match-hours for different match characteristics were calculated. RESULTS Purposeful headers accounted for 99% (n=4615, IR:1618) of total head impacts. The IR of purposeful headers per 1000 match-hours was highest for under-15 males (IR:2117) and under-17 females (IR:2090) followed by under-20 males (IR:1761). Midfielders completed the most headers in all female age groups (mean IR:713) and under 13-14 males (mean IR:891), with defenders completing the most headers in under 15-20 males (mean IR:760). Heading duels accounted for 16% of total headers with most headers performed during free play (68%), throw-ins (15%), free kicks (12%) and corner kicks (5%). Only 57 head impacts (IR:20) were coded as unintentional head impacts resulting from being struck by the ball or opponent body part with 4 (IR:1.4) requiring medical attention. CONCLUSIONS Heading is a complex skill. Given the propensity of youth players of all ages to purposefully head the ball, consideration should be given to coaching heading technique based on specific game scenarios for their playing position and age group. The findings of this study can be used to inform heading guidelines.
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Affiliation(s)
- Kerry Peek
- Discipline of Physiotherapy, Faculty of Medicine and Health, University of Sydney, Australia.
| | - Teale Vella
- Discipline of Physiotherapy, Faculty of Medicine and Health, University of Sydney, Australia
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Medical Faculty, Saarland University, Germany
| | - Florian Beaudouin
- Institute of Sports and Preventive Medicine, Medical Faculty, Saarland University, Germany
| | - Marnee McKay
- Discipline of Physiotherapy, Faculty of Medicine and Health, University of Sydney, Australia
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29
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Lacki JF. High training/competition ratio, less incidence of injury? Professional football calendar exploration. APUNTS SPORTS MEDICINE 2021. [DOI: 10.1016/j.apunsm.2020.100338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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30
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Wada T, Churei H, Yokose M, Iwasaki N, Takahashi H, Uo M. Application of Glass Fiber and Carbon Fiber-Reinforced Thermoplastics in Face Guards. Polymers (Basel) 2020; 13:polym13010018. [PMID: 33374594 PMCID: PMC7793102 DOI: 10.3390/polym13010018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 12/03/2022] Open
Abstract
Face guards (FGs) are protectors that allow for the rapid and safe return of athletes who are to play after sustaining traumatic facial injuries and orbital fractures. Current FGs require significant thickness to achieve sufficient shock absorption abilities. However, their weight and thickness render the FGs uncomfortable and reduce the field of vision of the athlete, thus hindering their performance. Therefore, thin and lightweight FGs are required. We fabricated FGs using commercial glass fiber-reinforced thermoplastic (GFRTP) and carbon fiber-reinforced thermoplastic (CFRTP) resins to achieve these requirements and investigated their shock absorption abilities through impact testing. The results showed that an FG composed of CFRTP is thinner and lighter than a conventional FG and has sufficient shock absorption ability. The fabrication method of an FG comprising CFRTP is similar to the conventional method. FGs composed of commercial FRTPs exhibit adequate shock absorption abilities and are thinner and lower in weight as compared to conventional FGs.
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Affiliation(s)
- Takahiro Wada
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.Y.); (M.U.)
- Correspondence: ; Tel.: +81-03-5803-5469
| | - Hiroshi Churei
- Department of Sports Medicine/Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan;
| | - Mako Yokose
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.Y.); (M.U.)
| | - Naohiko Iwasaki
- Department of Oral Biomaterials Development Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (N.I.); (H.T.)
| | - Hidekazu Takahashi
- Department of Oral Biomaterials Development Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (N.I.); (H.T.)
| | - Motohiro Uo
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.Y.); (M.U.)
- Department of Materials Engineering, Graduate School of Engineering, The University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑ku, Tokyo 113-8656, Japan
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31
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Akkurt S, Tanriverdi F, Kalay N, Karaca ZCO, Unluhizarci K, Sucan S, Karakus M, Kelestimur HF. INVESTIGATION OF PITUITARY DYSFUNCTION IN RETIRED PROFESSIONAL SOCCER PLAYERS. REV BRAS MED ESPORTE 2020. [DOI: 10.1590/1517-869220202606215617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: It is well-known that pituitary dysfunction can develop as a result of traumatic brain injuries. One reason for such injuries is collision during contact sports. Objectives: The aim of this study was to investigate the effects of heading the ball and concussion on pituitary function in retired soccer players. Methods: Thirty-two retired soccer players, with an average age of 43.38 ± 5.49 (35-59) and 26 sedentary individuals with an average age of 43.31±6.38 (35-59) were included in this study. The subjects were questioned about their soccer-playing background, history of head trauma and concussion, and cardiometabolic diseases. One day one, blood samples were taken to investigate the baseline hematologic and biochemical parameters. On day two, the ACTH stimulation test was conducted, and on day three, glucagon stimulation tests were carried out. Resting EKG, transthoracic ECHO and exercise stress tests (for MET values) were also conducted. For the statistical analysis, The Student's t-test was used to compare the results of the two groups. The level of significance adopted was p<0.05. Results: It was identified that 5 out of 32 soccer players (16%) had experienced concussion during their soccer careers. The growth hormone (GH) levels of 3 retired soccer players (9.2%) and 3 sedentary individuals (10%) was below 1 ng/dl, which was accepted as the threshold value. There were no significant differences between hematological, biochemical and cardiometabolic parameters of the soccer players with low GH levels and those with normal GH levels. There was no significant relationship between the number of headers performed and GH deficiency. Conclusion: Although low GH levels were detected in almost 10% of the retired soccer players, the frequency of hypopituitarism was not higher than in the sedentary control group. Level of evidence I; Prognostic Studies.
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32
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Cassoudesalle H, Laborde B, Orhant E, Dehail P. Video analysis of concussion mechanisms and immediate management in French men's professional football (soccer) from 2015 to 2019. Scand J Med Sci Sports 2020; 31:465-472. [PMID: 33038045 DOI: 10.1111/sms.13852] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 09/20/2020] [Accepted: 09/30/2020] [Indexed: 12/01/2022]
Abstract
In this study, the concussion mechanisms were analyzed in male professional competition football, with the main objective to specify the frequency of head-to-head impact, and immediate management of the concussed players was described in order to check its compliance with the recommendations of football's governing bodies. Based on continuously recorded data from the French Football Federation (FFF), a retrospective database of all reported concussions during matches in the 1st and 2nd French Male leagues was generated comprising seasons 2015/16-2018/19. Injury mechanisms, playing action, immediate medical assessment and management of concussed players, and foul play-referee's decision, were analyzed from video recordings. In total, 41 concussions were reported (incidence rate of 0.44/1000 hours of match exposure [95% CI: 0.40 to 0.49]) of which 36 were identified and analyzed on video sequences. The commonest playing action leading to concussion was aerial challenge (61%), and the main mechanism was head-to-head impact (47%). Following the head impact, 28% of concussed players were not medically assessed on pitch and 53% returned to play the same match. Head-to-head impact was not associated with systematic medical assessment, nor with foul play. In conclusion, the main cause of concussions involved head-to-head impact occurring when two players challenge for heading the ball in the air. The detection of potential concussive head impacts and the immediate management of players possibly concussed during matches remain insufficient according to the international recommendations. Some rules changes, with particular vigilance in case of head-to-head impact, should be discussed.
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Affiliation(s)
- Hélène Cassoudesalle
- Neurorehabilitation Unit, University Hospital of Bordeaux, Bordeaux, France.,University of Bordeaux, INSERM, BPH, U1219, "Handicap, Activity, Cognition & Health" Team, Bordeaux, France
| | - Bertrand Laborde
- Neurorehabilitation Unit, University Hospital of Bordeaux, Bordeaux, France
| | - Emmanuel Orhant
- Medical Service Director, Federation Francaise de Football, Paris, France
| | - Patrick Dehail
- Neurorehabilitation Unit, University Hospital of Bordeaux, Bordeaux, France.,University of Bordeaux, INSERM, BPH, U1219, "Handicap, Activity, Cognition & Health" Team, Bordeaux, France
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33
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Cassoudesalle H, Bildet M, Petit H, Dehail P. Head impacts in semiprofessional male Soccer players: a prospective video analysis over one season of competitive games. Brain Inj 2020; 34:1685-1690. [PMID: 33070665 DOI: 10.1080/02699052.2020.1831067] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Soccer exposes players to head injuries and involves repeated intentional head impacts through heading the ball. Our objective was to investigate the rate of both intentional headers and involuntary head impacts in semiprofessional male soccer players during one season. In this prospective cohort study, we followed 54 men (16-35 years) playing in two soccer clubs participating in the same regional French championship throughout the 2017-2018 season. All head impacts that occurred in competitive games were analyzed using video recordings. Player position, game exposure, referee's decision were also reported. Head impact incidence rate (IR) per 1000 player-hours, with the 95% confidence intervals (CIs) were calculated. Results: Headers IR was 3584.7 per 1000 player-hours (95% CI = 3431.9, 3737.5). Forwards and center-backs performed a higher number of headers. Involuntary head impacts IR was 44.1/1000 player-hours (95% CI = 27.1, 60.9). Just under half led the referee to stop playing time for a caregiver examination. Three concussions with a loss of consciousness after a head-to-head impact in a heading duel were recorded. Conclusions: Intentional headers were relatively common, contrary to involuntary head impacts that were however mainly due to heading duels. Head-to-head impact should lead to a systematic exit from the game for suspicion of concussion.
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Affiliation(s)
- Hélène Cassoudesalle
- Physical and Rehabilitation Medicine Unit, University Hospital of Bordeaux , Bordeaux, France.,Bordeaux Public Health Research Center- U1219, Handicap Activity Cognition & Health Team, University of Bordeaux, INSERM, F-33000 , Bordeaux, France
| | - Maxime Bildet
- Physical and Rehabilitation Medicine Unit, University Hospital of Bordeaux , Bordeaux, France
| | - Hervé Petit
- Physical and Rehabilitation Medicine Center, Korian Medical Clinic « Les Grands Chênes » , Bordeaux, France
| | - Patrick Dehail
- Physical and Rehabilitation Medicine Unit, University Hospital of Bordeaux , Bordeaux, France.,Bordeaux Public Health Research Center- U1219, Handicap Activity Cognition & Health Team, University of Bordeaux, INSERM, F-33000 , Bordeaux, France
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34
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Hänni S, Vedung F, Tegner Y, Marklund N, Johansson J. Soccer-Related Concussions Among Swedish Elite Soccer Players: A Descriptive Study of 1,030 Players. Front Neurol 2020; 11:510800. [PMID: 33071939 PMCID: PMC7538773 DOI: 10.3389/fneur.2020.510800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 08/24/2020] [Indexed: 11/24/2022] Open
Abstract
Objective: There are growing concerns about the short- and long-term consequences of sports-related concussion, which account for about 5–9% of all sports injuries. We hypothesized there may be sex differences in concussion history and concussion-related symptoms, evaluated among elite soccer players in Sweden. Design: Retrospective survey study. Participants and Setting: Soccer players (n = 1,030) from 55 Swedish elite soccer teams. Questionnaires were completed prior to the start of the 2017 season. Assessment of Risk Factors: Player history of soccer-related concussion (SoRC), symptoms and management following a SoRC were evaluated. Main Outcome Measures: Before the start of the season the players completed a baseline questionnaire assessing previous concussions. The Sports Concussion Assessment Tool 3 was included with regard to symptom evaluation. Results: Out of 993 responding players 334 (34.6%) reported a previous SoRC and 103 players (10.4%) reported a SoRC during the past year. After sustaining a SoRC, 114 players (34.2%) reported that they continued their ongoing activity without a period of rest, more commonly female (44.9%) than male players (27.7%; P = 0.002). Symptom resolution time was 1 week or less for 61.3% of the players that reported having persisting symptoms. A positive correlation was observed between number of previous concussions and prevalence of three persisting symptoms: fatigue (P < 0.001), concentration/memory issues (P = 0.002) and headache (P = 0.047). Conclusion: About 35% of male and female elite soccer players in Sweden have experienced a previous SoRC, and about 10% experienced a SoRC during the last year. Female players continued to play after a SoRC, without a period of rest, more often than males. A higher risk of persisting symptoms was observed in players with a history of multiple concussions.
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Affiliation(s)
- Sofie Hänni
- Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden
- Department of Surgical Sciences, Anesthesiology, Uppsala University, Uppsala, Sweden
- *Correspondence: Sofie Hänni
| | - Fredrik Vedung
- Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden
| | - Yelverton Tegner
- Division of Health, Medicine and Rehabilitation, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Niklas Marklund
- Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden
- Department of Clinical Sciences Lund, Neurosurgery, Skane University Hospital, Lund University, Lund, Sweden
| | - Jakob Johansson
- Department of Surgical Sciences, Anesthesiology, Uppsala University, Uppsala, Sweden
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35
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Blyth RJ, Tumilty S. Why are female footballers getting concussed more often than their male counterparts? A scoping review protocol. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1819073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Steve Tumilty
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
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36
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Kinalski MDA, Collares K, Correa MB. Prospective analysis of craniofacial soccer incidents during FIFA competitions: an observational study. Braz Oral Res 2020; 34:e106. [PMID: 32876122 DOI: 10.1590/1807-3107bor-2020.vol34.0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 01/20/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of this prospective epidemiological study was to evaluate the occurrence of incidents involving the craniofacial region of soccer players during three official FIFA competitions. The craniofacial incidents were identified by video analysis of all 144 matches of two FIFA World Cups (2014/2018) and the 2017 FIFA Confederations Cup. Data collection included incident type, incident severity, site affected, incident cause and referee decision. The multivariate Poisson regression model was performed to analyze the associations between covariates. A total of 238 incidents were observed in the craniofacial region (1.6 incidents/match), representing a rate of 48.5 incidents per 1000 hours. At least 80.6% of the matches presented at least one incident, and, in more than 60%, the referee's decision was no foul. According to severity, 26.8% of the incidents were classified as having mild or high severity. Incidents involving lacerations or fracture presented higher severity compared with hits (IRR 3.45[95%CI: 1.89-6.30]). Head-to-head impacts showed an incidence of severe incidents twice as high as those involving upper extremities (IRR 2.01[95%CI:1.07-3.76]). A high number of craniofacial incidents were observed in the last FIFA competitions. Head-to-head impacts and lacerations or fractures were associated with higher incident severity.
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Affiliation(s)
| | - Kaue Collares
- School of Dentistry, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
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Klein C, Luig P, Henke T, Bloch H, Platen P. Nine typical injury patterns in German professional male football (soccer): a systematic visual video analysis of 345 match injuries. Br J Sports Med 2020; 55:bjsports-2019-101344. [PMID: 32847807 DOI: 10.1136/bjsports-2019-101344] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2020] [Indexed: 01/12/2023]
Abstract
AIM We aimed to systematically analyse the videos of acute injuries in professional men's football and describe typical injury patterns. METHODS Injuries were registered with the German statutory accident insurance for professional athletes as part of occupational accident reporting. Following each season (2014-2017), video footage of the two highest divisions in German male football was searched for moderate and severe acute match injuries. Two raters then independently assessed the injuries for: game situation, player and opponent behaviour, referee decision, and injury mechanisms. RESULTS The total data set included 7493 acute injuries. Of these, 857 (11%) were moderate or severe match injuries. The video search yielded 345 (40%) clearly identifiable injuries and of those 170 (49%) were contact injuries. We describe nine typical injury patterns: one each for head and shoulder injuries, two for thigh and ankle, and three for knee injuries. The nine patterns are called: (1) Head-to-head injury. (2) Collision-and-fall shoulder injury. (3) Sprinter's thigh injury. (4) Perturbation-and-strain thigh injury. (5) Tackle knee injury. (6) Tackle-and-twist knee injury. (7) Non-contact knee injury. (8) Attacked ankle injury. (9) Collision-and-twist ankle injury. Thigh injuries occurred primarily in non-contact situations (44/81), mostly while the player was sprinting (23/44). Knee injuries were often caused by direct external impact (49/84)-mainly suffered by the tackler during a tackle (17/49). CONCLUSION The nine common injury patterns in football differed substantially in their mechanisms and causes.
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Affiliation(s)
- Christian Klein
- Faculty of Sports Science, Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Bochum, Germany
- Department for Sports Injury Prevention, VBG, Hamburg, Germany
| | - Patrick Luig
- Faculty of Sports Science, Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Bochum, Germany
- Department for Sports Injury Prevention, VBG, Hamburg, Germany
- German Handball Federation, Dortmund, Germany
| | - Thomas Henke
- Faculty of Sports Science, Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Bochum, Germany
| | - Hendrik Bloch
- Department for Sports Injury Prevention, VBG, Hamburg, Germany
| | - Petra Platen
- Faculty of Sports Science, Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Bochum, Germany
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Feddermann-Demont N, Chiampas G, Cowie CM, Meyer T, Nordström A, Putukian M, Straumann D, Kramer E. Recommendations for initial examination, differential diagnosis, and management of concussion and other head injuries in high-level football. Scand J Med Sci Sports 2020; 30:1846-1858. [PMID: 32557913 PMCID: PMC9290574 DOI: 10.1111/sms.13750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/09/2020] [Accepted: 06/04/2020] [Indexed: 12/22/2022]
Abstract
Head injuries can result in substantially different outcomes, ranging from no detectable effect to transient functional impairments to life‐threatening structural lesions. In high‐level international football (soccer) tournaments, on average, one head injury occurs in every third match. Making the diagnosis and determining the severity of a head injury immediately on‐pitch or off‐field is a major challenge for team physicians, especially because clinical signs of a brain injury can develop over several minutes, hours, or even days after the injury. A standardized approach is useful to support team physicians in their decision whether the player should be allowed to continue to play or should be removed from play after head injury. A systematic, football‐specific procedure for examination and management during the first 72 hours after head injuries and a graduated Return‐to‐Football program for high‐level players have been developed by an international group of experts based on current national and international guidelines for the management of acute head injuries. The procedure includes seven stages from the initial on‐pitch examination to the graduated Return‐to‐Football program. Details of the assessments and the consequences of different outcomes are described for each stage. Criteria for emergency management (red flags), removal from play (orange flags), and referral to specialists for further diagnosis and treatment (persistent orange flags) are provided. The guidelines for return to sport after concussion‐type head injury are specified for football. Thus, the present paper presents a comprehensive procedure for team physicians after a head injury in high‐level football.
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Affiliation(s)
- Nina Feddermann-Demont
- University Hospital and University of Zurich, Zurich, Switzerland.,Swiss Concussion Center, Schulthess Clinic, Zurich, Switzerland
| | - Georges Chiampas
- US Soccer Federation, Chicago, IL, USA.,Departments of Emergency and Orthopedics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbruecken, Germany
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Margot Putukian
- University Health Services, Princeton University, Princeton, NJ, USA.,Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Dominik Straumann
- University Hospital and University of Zurich, Zurich, Switzerland.,Swiss Concussion Center, Schulthess Clinic, Zurich, Switzerland
| | - Efraim Kramer
- Division of Sports Medicine, University of Pretoria, Pretoria, South Africa
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Vedung F, Hänni S, Tegner Y, Johansson J, Marklund N. Concussion incidence and recovery in Swedish elite soccer - Prolonged recovery in female players. Scand J Med Sci Sports 2020; 30:947-957. [PMID: 32100894 DOI: 10.1111/sms.13644] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 12/06/2019] [Accepted: 02/05/2020] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Sport-related concussions are an increasingly recognized health problem. Soccer is the most popular sport in the world although recent studies on concussion incidence are scarce. Here, a nationwide prospective study on concussion incidence, symptom severity, risk factors, gender differences, and return-to-play after concussion was performed in 51 Swedish elite soccer teams during the 2017 season. METHODS In the 1st and 2nd soccer leagues for men and women, a Sport Concussion Assessment Tool (SCAT)-based questionnaire study was performed at preseason (baseline) and from 48 hours to 3 months post-concussion. RESULTS We followed 959 players (389 women, 570 men) for 25 146 player game hours (9867 hours for women, 15 279 hours for men). Concussion incidence (n = 36 concussions during the season) was 1.19/1000 player game hours (females 1.22/1000 hours, males 1.18/1000 hours; P = .85). Twenty-seven percent of all players (8% of females, 40% of males) continued to play immediately after the concussion. When compared to male players, female players had worse initial symptom severity scores (median and IQR 30 (17-50.5) vs 11 (4-26.25), P = .02) on SCAT and longer return-to-play (P = .02). Risk factors for concussion were baseline symptoms and previous concussion. CONCLUSION In Swedish elite soccer, the concussion incidence was 1.19/1000 without gender differences. Most players recovered to play within 4 weeks post-injury. Almost one third of players continued to play at time of concussion. Female players had worse initial symptoms and longer return-to-play time than males, and a prolonged recovery beyond 3 months was only observed among female players.
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Affiliation(s)
- Fredrik Vedung
- Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden
| | - Sofie Hänni
- Department of Surgical Sciences, Anesthesiology, Uppsala University, Uppsala, Sweden
| | - Yelverton Tegner
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Jakob Johansson
- Department of Surgical Sciences, Anesthesiology, Uppsala University, Uppsala, Sweden
| | - Niklas Marklund
- Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala, Sweden.,Department of Clinical Sciences Lund, Neurosurgery, Skane University Hospital, Lund University, Lund, Sweden
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Beaudouin F, Aus der Fünten K, Tröß T, Reinsberger C, Meyer T. Match Situations Leading to Head Injuries in Professional Male Football (Soccer)-A Video-Based Analysis Over 12 Years. Clin J Sport Med 2020; 30 Suppl 1:S47-S52. [PMID: 32132477 DOI: 10.1097/jsm.0000000000000572] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To identify risk situations promoting head injuries in professional male football (soccer) and to investigate the impact of a rule change in 2006 punishing elbow-head contacts. DESIGN Analysis of video sequences of head events leading to head injury. PARTICIPANTS Professional football players of the first male German Bundesliga. MAIN OUTCOME MEASURES Observational criteria of head impacts on video recordings (players' actions preceding head injuries, foul play-referee's decision and assessment of rater, ball possession, on-pitch medical treatment, and consequences of head impact). RESULTS Three hundred thirty-four head injuries were reported in kicker Sportmagazin corresponding to an incidence rate of 2.25 (95% confidence interval 2.01-2.51) per 1000 player match hours. The injured player predominantly jumped (60%), headed the ball (36%), or ran forwards (20%); the noninjured players mainly jumped (64%), headed the ball (27%), or raised the elbow to the head (23%). Free ball situations (2 players challenge for the ball) caused most of the head injuries (81%). The players' action "raising the elbow" during a head injury seemed to be lower after the rule change. CONCLUSIONS Jumping for the ball with the intention of heading is the predominant action associated with head injury risk. Head injuries occur most often when players challenge for the ball in a header duel. As head injuries bear the potential risk of long-term health sequelae, the identification of situational circumstances is essential to develop preventative means in the future.
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Affiliation(s)
- Florian Beaudouin
- Institute of Sports and Preventive Medicine, Saarland University, FIFA-Medical Centre of Excellence, Saarbrücken, Germany; and
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, FIFA-Medical Centre of Excellence, Saarbrücken, Germany; and
| | - Tobias Tröß
- Institute of Sports and Preventive Medicine, Saarland University, FIFA-Medical Centre of Excellence, Saarbrücken, Germany; and
| | - Claus Reinsberger
- Institute of Sports Medicine, University of Paderborn, Paderborn, Germany
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, FIFA-Medical Centre of Excellence, Saarbrücken, Germany; and
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Terry DP, Wojtowicz M, Cook NE, Maxwell BA, Zafonte R, Seifert T, Silverberg ND, Berkner PD, Iverson GL. Factors Associated With Self-Reported Concussion History in Middle School Athletes. Clin J Sport Med 2020; 30 Suppl 1:S69-S74. [PMID: 32132480 DOI: 10.1097/jsm.0000000000000594] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Identifying personal characteristics associated with sustaining a concussion is of great interest, yet only a few have examined this in children. The purpose of this study was to examine the association between sex, neurodevelopmental disorders, health history, and lifetime history of self-reported concussion in 12- and 13-year-old athletes. DESIGN Cross-sectional study. SETTING Middle schools. PARTICIPANTS Participants were 1744 twelve- and thirteen-year-old student athletes who completed preseason Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) testing, including a self-report questionnaire about previous concussions, developmental diagnoses, and previous medical treatment. INDEPENDENT VARIABLES Age, sex, attention-deficit/hyperactivity disorder (ADHD), learning disabilities (LDs), and previous treatment for migraine. MAIN OUTCOME MEASURES Self-reported history of concussion. RESULTS A minority of athletes (13.7%) reported previous concussions (1 concussion, n = 181; 2 concussions, n = 41; and 3+ concussions, n = 17). A small proportion reported a history of ADHD (4.4%), LD (2.8%) or migraine treatment (4.0%). Higher rates of self-reported previous concussions were associated with male sex [16.9% vs 9.1%; χ(1) = 21.47, P < 0.001] and previous migraine treatment [31.9% vs 13.0%; χ(1) = 20.08, P < 0.001]. There were no differences in self-reported concussion history between 12- and 13-year olds (P = 0.18) and those with/without ADHD (P = 0.41) or LDs (P = 0.06). The overall logistic regression model was statistically significant [χ(5) = 42.01, P < 0.001] but explained only 4.3% of the variance. Previous treatment for migraine [P < 0.001, Exp(B) = 3.30] and male sex [P < 0.001, Exp(B) = 2.06] were independently associated with a self-reported concussion history, whereas age, LD, and ADHD were not (P's > 0.05). CONCLUSIONS Male sex and previous migraine treatment were associated with higher rates of self-reported previous concussions in both independent and multivariate models in middle school athletes, whereas age, ADHD, and LDs were not.
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Affiliation(s)
- Douglas P Terry
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts
- MassGeneral Hospital for Children Sport Concussion Program, Boston, Massachusetts
| | | | - Nathan E Cook
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
- MassGeneral Hospital for Children Sport Concussion Program, Boston, Massachusetts
| | - Bruce A Maxwell
- Department of Computer Science, Colby College, Waterville, Maine
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts
- MassGeneral Hospital for Children Sport Concussion Program, Boston, Massachusetts
| | - Tad Seifert
- Departments of Neurology and Sports Health, Norton Healthcare, Louisville, Kentucky
- Kentucky Boxing and Wrestling Commission, Frankfort, Kentucky
| | - Noah D Silverberg
- Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, BC, Canada
- Vancouver Coastal Health Research Institute Rehabilitation Research Program, Vancouver, BC, Canada; and
| | - Paul D Berkner
- Department of Biology and Health Services, Colby College, Waterville, Maine
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts
- MassGeneral Hospital for Children Sport Concussion Program, Boston, Massachusetts
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Cheng J, Ammerman B, Santiago K, Jivanelli B, Lin E, Casey E, Ling D. Sex-Based Differences in the Incidence of Sports-Related Concussion: Systematic Review and Meta-analysis. Sports Health 2019; 11:486-491. [PMID: 31567052 DOI: 10.1177/1941738119877186] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
CONTEXT The incidence of sports-related concussion in females has been increasing in recent years. OBJECTIVE To conduct a meta-analysis on sex-based differences in concussion incidence in various sports and to determine the effects of study design (retrospective vs prospective), setting (competition vs practice), and population (university and above vs high school and below) via a meta-regression. DATA SOURCES PubMed (Medline), EMBASE, and Cochrane Library databases were searched from January 2000 to January 2018. STUDY SELECTION Studies reporting sports-related concussion incidence data for both males and females (age ≥10 years) were included. STUDY DESIGN Systematic review with meta-analysis and meta-regression. LEVEL OF EVIDENCE Level 4. METHODS The rate ratio was calculated as the concussion rate in females/males. Data were pooled using the DerSimonian-Laird random-effects model. RESULTS Thirty-eight studies met the eligibility criteria and were included in the meta-analysis. Soccer and basketball demonstrated significantly higher incidence of concussions in females compared with males (rate ratio [95% CI], 1.76 [1.43-2.16] and 1.99 [1.56-2.54], respectively; P < 0.01). Sex-based differences in concussion incidence rates for baseball/softball, ice hockey, lacrosse, swimming/diving, and track and field were not statistically significant. In the meta-regression analysis, there were no significant effects on the rate ratio when evaluating study design, setting, and population. CONCLUSION Concussion incidence rates were significantly higher in females than in males for soccer and basketball.
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Affiliation(s)
- Jennifer Cheng
- Department of Physiatry, Hospital for Special Surgery, New York, New York
| | - Brittany Ammerman
- Department of Primary Care Sports Medicine, Hospital for Special Surgery, New York, New York
| | - Kristen Santiago
- Department of Physiatry, Hospital for Special Surgery, New York, New York
| | - Bridget Jivanelli
- Kim Barrett Memorial Library, Hospital for Special Surgery, New York, New York.,HSS Education Institute, Hospital for Special Surgery, New York, New York
| | - Emerald Lin
- Department of Physiatry, Hospital for Special Surgery, New York, New York
| | - Ellen Casey
- Department of Physiatry, Hospital for Special Surgery, New York, New York
| | - Daphne Ling
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York.,Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York
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Salhab HA, Fares MY, Khachfe HH, Fares J. Musculoskeletal lower limb injuries in Major League Baseball. Phys Ther Sport 2019; 39:38-43. [DOI: 10.1016/j.ptsp.2019.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 05/11/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022]
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Armstrong N, Rotundo M, Aubrey J, Tarzi C, Cusimano MD. Characteristics of potential concussive events in three elite football tournaments. Inj Prev 2019; 26:334-338. [PMID: 31331934 PMCID: PMC7418614 DOI: 10.1136/injuryprev-2019-043242] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/20/2019] [Accepted: 06/20/2019] [Indexed: 11/21/2022]
Abstract
Objective Identify patterns in the nature and characteristics of potential concussive events (PCEs) in football. Methods This study analysed the incidence and characteristics of PCEs that occurred during the 2014 and 2018 Fédération Internationale de Football Association World Cups, and the 2016 UEFA Euro Cup. PCEs were defined as direct head collision incidents resulting in the athlete being unable to immediately resume play for at least 5 sec following impact. Results A total of 218 incidents were identified in 179 matches (1.22 per match, 36.91 per 1000 hours of exposure). The most common mechanism of PCE was elbow-to-head (28.7%, n=68). The frontal region was the most frequently affected location of impact with 22.8% (n=54). Conclusion Our study defined the identification, prevalence and nature of PCEs in professional international soccer tournaments. Our findings indicate the different contexts and mechanisms of head contact and contact to different regions of the head can be associated with varying signs of concussion. The results highlight targets for future injury prevention strategies.
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Affiliation(s)
| | - Mario Rotundo
- Neurosurgery, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Jason Aubrey
- Neurosurgery, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Michael D Cusimano
- Neurosurgery, St. Michael's Hospital, Toronto, Ontario, Canada .,Neurosurgery, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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EPIDEMIOLOGY of NECK INJURIES ACCOMPANYING SPORT CONCUSSIONS in YOUTH OVER a 13-YEAR PERIOD IN a COMMUNITY-BASED HEALTHCARE SYSTEM. Int J Sports Phys Ther 2019; 14:334-344. [PMID: 31681492 DOI: 10.26603/ijspt20190334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The same trauma that produces concussion may also produce neck injury. The signs of concussion and neck injury are similar, and symptoms after acceleration-deceleration trauma to the head-neck complex do not accurately discriminate between them. Research on the epidemiology of neck injury among sport-concussed youth is sparse. Purpose The purpose of this study was to investigate the epidemiology of diagnosed neck injury in non-sport-related concussion (Non-SRC) versus sport-related concussion (SRC) in youth by age, sex, and sport. Study design Cross-sectional epidemiologic study. Methods De-identified data from community-based electronic health records over 13 years were extracted to analyze rates and characteristics of neck injuries among non-SRCs and SRCs in youth aged five to 21. Neck injury diagnosis prevalence rates and odds ratios were calculated to estimate risk of neck injury among concussed youth, comparing non-SRCs to SRCs by age and sex. Results Sixteen thousand, eight hundred eighty-five concussion records were extracted, of which 3,040 SRCs and 2,775 non-SRCs in youth aged five to 21 were identified by cross-filtering sport-related keywords (e.g., football, basketball, soccer, running, swimming, batting, horseback riding, skiing, etc.) with all ICD-9 and ICD-10 concussion codes. The prevalence of neck injuries diagnosed among SRCs (7.2%) was significantly different than the prevalence of neck injuries diagnosed among non-SRCs (12.1%, p < 0.000). Neck injury diagnoses were significantly more prevalent in females overall (p < 0.000) and among non-SRCs (p < 0.000). The prevalence of neck injury diagnoses was not significantly higher in concussed females versus concussed males with SRC (p = 0.164).Among youth aged five to 21 exposed to concussions, non-SRCs were more likely to be accompanied by a neck injury diagnosis than SRCs (OR 1.66; 95% CI 1.39 to 1.98; p < 0.000). Similarly, female-to-male neck injury proportion ratios were significantly higher in females in non-SRCs compared to SRCs (IPR 1.90, 95% CI 1.60 to 2.25, p < 0.000).Sports with highest prevalence of concussion differ from sports with highest prevalence of concussion-related neck injury in both sexes. Conclusions The overall prevalence of diagnosed neck injuries in youth was higher in non-SRCs compared to SRCs (12.1 vs. 7.2%, p < 0.001), with the highest prevalence at age 14 in both sexes. The risk of neck injury diagnosis accompanying concussion was significantly higher in females compared to males (6.1% difference; p < 0.000).
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Quintero LM, Moore JW, Yeager MG, Rowsey K, Olmi DJ, Britton-Slater J, Harper ML, Zezenski LE. Reducing risk of head injury in youth soccer: An extension of behavioral skills training for heading. J Appl Behav Anal 2019; 53:237-248. [PMID: 30924148 DOI: 10.1002/jaba.557] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 02/11/2019] [Indexed: 11/09/2022]
Abstract
Recently, concerns regarding sport-related concussions have increased within the research literature, the media, and popular culture. One potential source of soccer-related concussions involves the purposeful striking of the ball with one's head (i.e., heading). There is currently limited research on an effective teaching method to improve safe heading technique. In the current study, Behavior Skills Training (BST) was evaluated as a method to teach correct heading techniques to youth soccer players. BST increased the percentage of correct steps for each player based on a task analysis of heading. Based on social validity questionnaires administered to players and the coach, BST was rated as an acceptable form of training. After the final training session, experienced coaches rated each player as having improved from baseline to training.
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Kerr ZY, Campbell KR, Fraser MA, Currie DW, Pierpoint LA, Kaminski TW, Mihalik JP. Head Impact Locations in U.S. High School Boys' and Girls' Soccer Concussions, 2012/13-2015/16. J Neurotrauma 2019; 36:2073-2082. [PMID: 29092652 DOI: 10.1089/neu.2017.5319] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This study describes concussions and concussion-related outcomes sustained by high school soccer players by head impact location, sex, and injury mechanism. Data were obtained for the 2012/13-2015/16 school years from the National High School Sports-Related Injury Surveillance System, High School RIO™. This Internet-based sports injury surveillance system captures data reported by athletic trainers from an annual average of 162 U.S. high schools. Data were analyzed to describe circumstances of soccer concussion (e.g., symptomology, symptom resolution, and return-to-play time) by impact location (i.e., front- [face included], back-, side-, and top-of-the-head) and sex. Most concussions were from front-of-the-head impacts (boys, 30.5%; girls, 34.0%). Overall, 4.1 ± 2.2 and 4.6 ± 2.3 symptoms were reported in boys and girls, respectively. In boys, symptom frequency was not associated with head impact location (p = 0.66); an association was found in girls (p = 0.02), with the highest symptom frequency reported in top-of-the-head impacts (5.4 ± 2.2). Head impact location was not associated with symptom resolution time (boys, p = 0.21; girls, p = 0.19) or return-to-play time (boys, p = 0.18; girls, p = 0.07). Heading was associated with 28.0% and 26.5% of concussions in boys and girls, respectively. Most player-player contact concussions during heading occurred from side-of-the-head impacts (boys, 49.4%; girls, 43.2%); most heading-related ball contact concussions occurred from front-of-the-head (boys, 41.4%; girls, 42.6%) and top-of-the-head (boys, 34.5%; girls, 36.9%) impacts. Head impact location was generally independent of symptom resolution time, return-to-play time, and recurrence among high school soccer concussions. However, impact location may be associated with reported symptom frequency. Further, many of these clinical concussion descriptors were associated with sex.
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Affiliation(s)
- Zachary Y Kerr
- 1 Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina.,2 Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, North Carolina
| | - Kody R Campbell
- 2 Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, North Carolina.,3 Human Movement Science Curriculum, University of North Carolina, Chapel Hill, North Carolina
| | - Melissa A Fraser
- 4 Department of Health and Human Performance, Texas State University, San Marcos, Texas
| | - Dustin W Currie
- 5 Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado
| | - Lauren A Pierpoint
- 5 Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado
| | - Thomas W Kaminski
- 6 Department of Kinesiology & Applied Physiology, University of Delaware, Newark, Deleware
| | - Jason P Mihalik
- 1 Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina.,2 Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina, Chapel Hill, North Carolina
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Putukian M, Echemendia RJ, Chiampas G, Dvorak J, Mandelbaum B, Lemak LJ, Kirkendall D. Head Injury in Soccer: From Science to the Field; summary of the head injury summit held in April 2017 in New York City, New York. Br J Sports Med 2019; 53:1332. [DOI: 10.1136/bjsports-2018-100232] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2019] [Indexed: 12/15/2022]
Abstract
There has been an increased focus and awareness of head injury and sport-related concussion (SRC) across all sports from the medical and scientific communities, sports organisations, legislators, the media and the general population. Soccer, in particular, has been a focus of attention due to the popularity of the game, the frequency of SRC and the hypothesised effects of repetitive heading of the ball. Major League Soccer, US Soccer and the National Women’s Soccer League jointly hosted a conference entitled, ‘Head Injury in Soccer: From Science to the Field’, on 21–22 April 2017 in New York City, New York. The mission of this conference was to identify, discuss and disseminate evidence-based science related to the findings and conclusions of the fifth International Conference on Concussion in Sport held by the Concussion in Sport Group and apply them to the sport of soccer. In addition, we reviewed information regarding the epidemiology and mechanism of head injuries in soccer at all levels of play, data regarding the biomechanics and effects of repetitive head impacts and other soccer-specific considerations. We discussed how to release the information raised during the summit to key stakeholders including athletes, parents, coaches and healthcare providers. We identified future areas for research and collaboration to enhance the health and safety of soccer (football) players.
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Beaudouin F, der Fünten KA, Tröß T, Reinsberger C, Meyer T. Time Trends of Head Injuries Over Multiple Seasons in Professional Male Football (Soccer). Sports Med Int Open 2019; 3:E6-E11. [PMID: 30697588 PMCID: PMC6349547 DOI: 10.1055/a-0808-2551] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 10/26/2018] [Accepted: 11/13/2018] [Indexed: 11/25/2022] Open
Abstract
The present study aimed to investigate time trends of head injuries and their injury mechanisms since a rule change as monitoring may help to identify causes of head injuries and may advance head injury prevention efforts. Based on continuously recorded data from the German football magazine “kicker Sportmagazin
®
” as well as other media sources, a database of head injuries in the 1
st
German male Bundesliga was generated comprising 11 seasons (2006/07–2016/17). Injury mechanisms were analysed from video recordings. Injury incidence rates (IR) and 95% confidence intervals (95% CI) were calculated. Time trends were analysed via linear regression. Two hundred thirty-eight match head injuries occurred (IR 1.77/1000 match hours, 95% CI 1.56–2.01). There were no significant seasonal changes, expressed as annual average year-on-year change, in IRs over the 11-year period for total head injuries (p=0.693), facial/head fractures (p=0.455), lacerations/abrasions (p=0.162), and head contusions (p=0.106). The annual average year-on-year increase for concussion was 6.4% (p=0.004). Five head injury mechanisms were identified. There were no seasonal changes in injury mechanisms over the study period. The concussion subcategory increased slightly over the seasons, which may either be a result of increasing match dynamics or raised awareness among team physicians and players.
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Affiliation(s)
- Florian Beaudouin
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tobias Tröß
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Claus Reinsberger
- Institute of Sports Medicine, University of Paderborn, Paderborn, Germany
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
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Merritt VC, Padgett CR, Jak AJ. A systematic review of sex differences in concussion outcome: What do we know? Clin Neuropsychol 2019; 33:1016-1043. [PMID: 30618335 DOI: 10.1080/13854046.2018.1508616] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: The purpose of this review was to examine sex differences in concussion, or mild traumatic brain injury (mTBI) outcome, updating previous critical reviews of the literature. Method: Within adult human studies, we reviewed a wide range of concussion outcome variables: prevalence of concussion, injury characteristics, postconcussion symptom trajectories and psychiatric distress, neuropsychological performance, and neuroimaging findings. Sports-related concussion, civilian, and military samples were included in the review. Results: Given the robust concussion literature, there is a relative paucity of research addressing sex differences following concussion. The majority of available studies focused on sports-related concussion, with fewer studies targeting other civilian causes of concussion or military-related concussion in females. Prevalence of concussion was generally reported to be higher in females than males. Although symptom reporting largely showed a pattern for females to report greater overall symptoms than males, examining individual symptoms or symptom clusters resulted in mixed findings between the sexes. Neuropsychological studies generally showed females performing more poorly than males on measures of visual memory following concussion, though this finding was not consistently reported. Conclusion: Research examining sex differences in humans following concussion, in general, is in its infancy, and exploration of sex differences in studies outside of the sports concussion domain is particularly nascent. Given the increased prevalence of concussion and potential higher symptom reporting among women, ongoing research is necessary to better understand the role of biological sex on outcome following concussion. Understanding sex differences has important implications for assessment, management, and treatment of concussion.
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Affiliation(s)
| | - Christine R Padgett
- b School of Medicine (Psychology), University of Tasmania , Hobart , TAS , Australia
| | - Amy J Jak
- a VA San Diego Healthcare System , San Diego , CA , USA.,c University of California San Diego (UCSD) School of Medicine, Department of Psychiatry , La Jolla , CA , USA
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