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Peek K, Ross A, Andersen TE, Meyer T, Dahlen S, Georgieva J, Williamson PR, Clarke M, Serner A. Heading in football: a systematic review of descriptors, definitions, and reporting methods used in heading incidence studies. SCI MED FOOTBALL 2024:1-18. [PMID: 38855969 DOI: 10.1080/24733938.2024.2362191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/27/2024] [Indexed: 06/11/2024]
Abstract
The primary objective of this systematic review was to describe the number and type of heading descriptors used in all published studies which report on heading incidence in football. The secondary objective was to detail the data collection and reporting methods used in the included studies to present heading incidence data. Eligible studies were identified through searches of five electronic databases: Ovid MEDLINE, CINAHL, EMBASE, SPORTDiscus, and Web of Science, using a combination of free-text keywords (inception to 12th September 2023). Manual searching of reference lists and retrieved systematic reviews was also performed. A descriptive overview and synthesis of the results is presented. From 1620 potentially eligible studies, 71 studies were included, with the following key findings: 1) only 61% of studies defined a header with even fewer (23%) providing an operational definition of a header within the methods; 2) important study and player demographic data including year and country were often not reported; 3) reported heading descriptors and their coding options varied greatly; 4) visual identification of headers was essential when inertial measurement units were used to collect heading incidence data; and 5) there was a lack of standardisation in the reporting methods used in heading incidence studies making comparison between studies challenging. To address these findings, the development of a standardised, internationally supported, operational definition of a header and related heading descriptors should be prioritised. Further recommendations include the development of minimum reporting criteria for heading incidence research.
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Affiliation(s)
- Kerry Peek
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Andrew Ross
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Physiotherapy Department, College of Sport, Health and Engineering, Victoria University, Melbourne, Australia
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, The Norwegian School of Sport Sciences, Oslo, Norway
- The Norwegian Football Association's Sports Medical Centre, Oslo, Norway
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
| | - Sara Dahlen
- Oslo Sports Trauma Research Center, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Julia Georgieva
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Paula R Williamson
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Mike Clarke
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Andreas Serner
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
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2
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Zuleger TM, Slutsky-Ganesh AB, Grooms DR, Yuan W, Barber Foss KD, Howell DR, Myer GD, Diekfuss JA. High magnitude exposure to repetitive head impacts alters female adolescent brain activity for lower extremity motor control. Brain Res 2024; 1828:148785. [PMID: 38272157 PMCID: PMC11110884 DOI: 10.1016/j.brainres.2024.148785] [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: 10/27/2023] [Revised: 01/14/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024]
Abstract
Contact and collision sport participation among adolescent athletes has raised concerns about the potential negative effects of cumulative repetitive head impacts (RHIs) on brain function. Impairments from RHIs and sports-related concussions (SRC) may propagate into lingering neuromuscular control. However, the neural mechanisms that link RHIs to altered motor control processes remain unknown. The purpose of this study was to isolate changes in neural activity for a lower extremity motor control task associated with the frequency and magnitude of RHI exposure. A cohort of fifteen high school female soccer players participated in a prospective longitudinal study and underwent pre- and post-season functional magnetic resonance imaging (fMRI). During fMRI, athletes completed simultaneous bilateral ankle, knee, and hip flexion/extension movements against resistance (bilateral leg press) to characterize neural activity associated with lower extremity motor control. RHI data were binned into continuous categories between 20 g - 120 g (defined by progressively greater intervals), with the number of impacts independently modeled within the fMRI analyses. Results revealed that differential exposure to high magnitude RHIs (≥90 g - < 110 g and ≥ 110 g) was associated with acute changes in neural activity for the bilateral leg press (broadly inclusive of motor, visual, and cognitive regions; all p < 0.05 & z > 3.1). Greater exposure to high magnitude RHIs may impair lower extremity motor control through maladaptive neural mechanisms. Future work is warranted to extend these mechanistic findings and examine the linkages between RHI exposure and neural activity as it relates to subsequent neuromuscular control deficits.
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Affiliation(s)
- Taylor M Zuleger
- Emory Sports Performance And Research Center (SPARC), Flowery Branch, GA, USA; Emory Sports Medicine Center, Atlanta, GA, USA; Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA; University of Cincinnati, Neuroscience Graduate Program, Cincinnati, OH, USA.
| | - Alexis B Slutsky-Ganesh
- Emory Sports Performance And Research Center (SPARC), Flowery Branch, GA, USA; Emory Sports Medicine Center, Atlanta, GA, USA; Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA; Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Dustin R Grooms
- Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens, OH, USA; Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA; Division of Physical Therapy, School of Rehabilitation and Communication Sciences, College of Health Science and Professions, Ohio University, Grover Center, Athens, OH, USA
| | - Weihong Yuan
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Kim D Barber Foss
- Emory Sports Performance And Research Center (SPARC), Flowery Branch, GA, USA; Emory Sports Medicine Center, Atlanta, GA, USA; Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
| | - David R Howell
- Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA; Department of Orthopaedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Gregory D Myer
- Emory Sports Performance And Research Center (SPARC), Flowery Branch, GA, USA; Emory Sports Medicine Center, Atlanta, GA, USA; Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA; Youth Physical Development Centre, Cardiff Metropolitan University, Wales, UK; The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
| | - Jed A Diekfuss
- Emory Sports Performance And Research Center (SPARC), Flowery Branch, GA, USA; Emory Sports Medicine Center, Atlanta, GA, USA; Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA.
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3
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Wahlquist VE, Glutting JJ, Kaminski TW. Examining the influence of the Get aHEAD Safely in Soccer™ program on head impact kinematics and neck strength in female youth soccer players. Res Sports Med 2024; 32:17-27. [PMID: 35611394 DOI: 10.1080/15438627.2022.2079982] [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: 11/29/2021] [Accepted: 04/28/2022] [Indexed: 10/18/2022]
Abstract
The objective was to examine the efficacy of the Get aHEAD Safely in Soccer™ intervention on head impact kinematics and neck strength in female youth soccer players. The control group (CG) consisted of 13 players (age: 11.0 ± 0.4 yrs), while the experimental group (EG) consisted of 14 players (age: 10.6 ± 0.5 yrs). Head impact kinematics included peak linear acceleration (PLA), peak rotational acceleration (PRA), and peak rotational velocity (PRV). Pre- and post-season measures included strength measures of neck/torso flexion (NF/TF) and extension (NE/TE). Data were analysed using a multilevel linear model and ANOVA techniques. No differences in PLA, PRA, or PRV were observed between groups. The EG showed significant improvement in NF strength while the CG showed significant improvement in NE strength. Both groups significantly improved in TF pre- to post-season. The foundational strength components of the Get aHEAD Safely in Soccer program appear to show a benefit in youth soccer players beginning to learn the skill of purposeful heading.
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Affiliation(s)
| | | | - Thomas W Kaminski
- Athletic Training Research Laboratory, University of Delaware, Newark, DE, USA
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Wahlquist VE, Buckley TA, Caccese JB, Glutting JJ, Royer TD, Kaminski TW. Quantitative Analysis of Ball-Head Impact Exposure in Youth Soccer Players. J Sports Sci Med 2023; 22:591-596. [PMID: 37711709 PMCID: PMC10499164 DOI: 10.52082/jssm.2023.591] [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: 06/27/2023] [Accepted: 08/24/2023] [Indexed: 09/16/2023]
Abstract
Since the implementation of the US Soccer heading guidelines released in 2015, little to no research on ball-head impact exposure in the United States youth soccer population has been conducted. The purpose was to compare ball-head impact exposure across sex and age in youth soccer players over a weekend tournament. Ten male and female games for each age group (Under-12 [U12], U13, and U14) were video recorded at a weekend tournament for a total of 60 games. Ball-head impact exposure for each game was then coded following a review of each recording. Male players were 2.8 times more likely to have ball-head impacts than female players, (p < 0.001) particularly in the U14 age group when compared to the U12 age group (p = 0.012). Overall 92.4% of players experienced 0-1 ball-head impacts per game with the remaining players experiencing 2+ ball-head impacts per game. Ball-head impact exposure levels are low in the youth players. Most youth soccer players do not head the soccer ball during match play and those that did, only headed the ball on average once per game. Overall, the difference in ball-head impact exposure per player was less than 1 between all the groups, which may have no clinical meaning.
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Affiliation(s)
| | - Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, USA
| | - Jaclyn B Caccese
- School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, USA
| | | | - Todd D Royer
- Department of Kinesiology and Applied Physiology, University of Delaware, USA
| | - Thomas W Kaminski
- Department of Kinesiology and Applied Physiology, University of Delaware, USA
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Sundaram V, Sundar V, Pearce AJ. Biomechanical characteristics of concussive and sub-concussive impacts in youth sports athletes: A systematic review and meta-analysis. J Sports Sci 2023:1-15. [PMID: 37393593 DOI: 10.1080/02640414.2023.2231317] [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: 02/02/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023]
Abstract
This study aimed to quantitatively investigate and report the biomechanical characteristics of concussive and sub-concussive impacts in youth sports. A systematic search was conducted in September 2022 to identify biomechanical impact studies in athletes ≤18 years of age. Twenty-six studies met the inclusion criteria for quantitative synthesis and analysis. DerSimonian Laird random effects model was used to pool data across the included studies. The pooled estimate of mean peak linear and rotational acceleration of concussive impacts in male youth athletes was 85.56 g (95% CI 69.34-101.79) and 4505.58 rad/s2 (95% CI 2870.28-6140.98), respectively. The pooled estimate of mean peak linear and rotational acceleration of sub-concussive impacts in youth athletes was 22.89 g (95% CI 20.69-25.08) and 1290.13 rad/s2 (95% CI 1050.71-1529.55), respectively. A male vs female analysis in sub-concussive impacts revealed higher linear and rotational acceleration in males and females, respectively. This is the first study to report on impact data in both sexes of youth athletes. Disparity in kinematic impact values suggests future research should aim for standardised measures to reduce heterogeneity in data. Despite this, the data reveals notable impact data that youth athletes are exposed to, suggesting modifications may be required to reduce long-term neurological risks.
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Affiliation(s)
- Vasanth Sundaram
- Department of Sports Biomechanics and Kinesiology, Tamil Nadu Physical Education and Sports University, Chennai, India
| | - Viswanath Sundar
- Physical Education and Sports Science, Visva-Bharati University, West Bengal, India
| | - Alan J Pearce
- College of Science, Health, and Engineering, La Trobe University, Bundoora, Melbourne, Australia
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6
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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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7
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Robinson EM, Sivakanthan S, Durfy S, Rivara FP, Chrisman S, Mac Donald CL. A Comparative Analysis of Depressive Symptoms Following Sports-Related Concussion in Youth Athletes Versus Their Age-Matched Non-concussed Counterparts. Cureus 2022; 14:e28549. [PMID: 36185860 PMCID: PMC9519058 DOI: 10.7759/cureus.28549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 11/05/2022] Open
Abstract
Background and objective Athletics is the leading cause of pediatric concussion, and depression is a major comorbidity associated with concussion in the pediatric population. Prior studies have described the risk of depression after concussion in high school-, collegiate-, and elite-level athletes, but there is scarce data on younger athletes. Interpretation of existing research on the association of depression with concussions in youth athletes is complicated by diverse study designs, varying measures of depression, differing timelines for symptom development, and a lack of control groups. Furthermore, limited research exists on sex-related differences in the development of depressive symptoms following sports-related concussions (SRC) in younger athletes. This study used the Seattle Pediatric Concussion Research Collaborative (SPCRC) Data Repository to compare depressive symptoms between youth athletes at one month post-SRC and non-concussed age-matched controls by using a standardized measure of depressive symptoms: the Patient Health Questionnaire-9 (PHQ-9). The secondary goal was to compare PHQ-9 scores between males and females for both concussed and non-concussed groups. Methods This study entailed a secondary analysis of data collected as part of the SPCRC Data Repository. We conducted a retrospective subgroup analysis of PHQ-9 scores at one month post-concussion for concussed youth athletes. We compared the PHQ9 scores of concussed youth athletes with PHQ-9 scores collected at the time of enrollment for non-concussed youth athletes. Results After random age-matching, a cohort of 266 patients (133 in the concussed group and 133 in the non-concussed control group) was included in the final analysis. The mean age was 13.8 years (range: 5-18 years). For the concussed group, a history of SRC was associated with a higher mean total PHQ-9 score at one month post-concussion compared with the control group at the time of enrollment (6.14 ±5.46 versus 1.53 ±1.81, respectively, p<0.0001). All nine subdomains of the PHQ-9 showed significantly higher scores in the concussion group compared with the control group (p<0.0001). Significantly higher scores were observed when comparing mean total PHQ-9 scores for male athletes in the concussion group with male athletes in the control group (7.03 ±5.72 versus 1.59 ±1.66, p<0.0001) and for female athletes in the concussion group compared with female controls (5.28 ±5.10 versus 1.49 ±1.92, p<0.0001). No significant differences were observed between sexes for total PHQ-9 scores or PHQ-9 subscores. Conclusion At one month post concussion, youth with SRC demonstrated higher levels of depressive symptoms as measured by PHQ-9 compared with age-matched typically developing controls. No significant differences were identified in total PHQ-9 scores and subscores between male and female participants for either the concussion or control group. This study suggests that clinicians need to be vigilant and monitor for symptoms of depression in young athletes for at least one month post-concussion.
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Kuo C, Patton D, Rooks T, Tierney G, McIntosh A, Lynall R, Esquivel A, Daniel R, Kaminski T, Mihalik J, Dau N, Urban J. On-Field Deployment and Validation for Wearable Devices. Ann Biomed Eng 2022; 50:1372-1388. [PMID: 35960418 DOI: 10.1007/s10439-022-03001-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 06/24/2022] [Indexed: 11/01/2022]
Abstract
Wearable sensors are an important tool in the study of head acceleration events and head impact injuries in sporting and military activities. Recent advances in sensor technology have improved our understanding of head kinematics during on-field activities; however, proper utilization and interpretation of data from wearable devices requires careful implementation of best practices. The objective of this paper is to summarize minimum requirements and best practices for on-field deployment of wearable devices for the measurement of head acceleration events in vivo to ensure data evaluated are representative of real events and limitations are accurately defined. Best practices covered in this document include the definition of a verified head acceleration event, data windowing, video verification, advanced post-processing techniques, and on-field logistics, as determined through review of the literature and expert opinion. Careful use of best practices, with accurate acknowledgement of limitations, will allow research teams to ensure data evaluated is representative of real events, will improve the robustness of head acceleration event exposure studies, and generally improve the quality and validity of research into head impact injuries.
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Affiliation(s)
- Calvin Kuo
- The University of British Columbia, Vancouver, Canada
| | - Declan Patton
- Children's Hospital of Philadelphia, Philadelphia, USA
| | - Tyler Rooks
- United States Army Aeromedical Research Laboratory, Fort Rucker, USA
| | | | - Andrew McIntosh
- McIntosh Consultancy and Research, Sydney, Australia.,Monash University Accident Research Centre Monash University, Melbourne, Australia.,School of Engineering Edith Cowan University, Perth, Australia
| | | | | | - Ray Daniel
- United States Army Aeromedical Research Laboratory, Fort Rucker, USA
| | | | - Jason Mihalik
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Nate Dau
- Biocore, LLC, Charlottesville, USA
| | - Jillian Urban
- Wake Forest University School of Medicine, 575 Patterson Ave, Suite 530, Winston-Salem, NC, 27101, USA.
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Bertocci G, Smalley C, Brown N, Dsouza R, Hilt B, Thompson A, Bertocci K, McKinsey K, Cory D, Pierce MC. Head biomechanics of video recorded falls involving children in a childcare setting. Sci Rep 2022; 12:8617. [PMID: 35597795 PMCID: PMC9124183 DOI: 10.1038/s41598-022-12489-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/11/2022] [Indexed: 12/04/2022] Open
Abstract
The objective of this study was to characterize head biomechanics of video-recorded falls involving young children in a licensed childcare setting. Children 12 to < 36 months of age were observed using video monitoring during daily activities in a childcare setting (in classrooms and outdoor playground) to capture fall events. Sensors (SIM G) incorporated into headbands worn by the children were used to obtain head accelerations and velocities during falls. The SIM G device was activated when linear acceleration was ≥ 12 g. 174 video-recorded falls activated the SIM G device; these falls involved 31 children (mean age = 21.6 months ± 5.6 SD). Fall heights ranged from 0.1 to 1.2 m. Across falls, max linear head acceleration was 50.2 g, max rotational head acceleration was 5388 rad/s2, max linear head velocity was 3.8 m/s and max rotational head velocity was 21.6 rad/s. Falls with head impact had significantly higher biomechanical measures. There was no correlation between head acceleration and fall height. No serious injuries resulted from falls—only 1 child had a minor injury. In conclusion, wearable sensors enabled characterization of head biomechanics during video-recorded falls involving young children in a childcare setting. Falls in this setting did not result in serious injury.
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Affiliation(s)
- Gina Bertocci
- Department of Bioengineering, University of Louisville, Louisville, KY, USA.
| | - Craig Smalley
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Nathan Brown
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Raymond Dsouza
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Bret Hilt
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Angela Thompson
- Engineering Fundamentals Department, University of Louisville, Louisville, KY, USA
| | - Karen Bertocci
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Keyonna McKinsey
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Danielle Cory
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Mary Clyde Pierce
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
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Basinas I, McElvenny DM, Pearce N, Gallo V, Cherrie JW. A Systematic Review of Head Impacts and Acceleration Associated with Soccer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095488. [PMID: 35564889 PMCID: PMC9100160 DOI: 10.3390/ijerph19095488] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/06/2022] [Accepted: 04/26/2022] [Indexed: 02/04/2023]
Abstract
Epidemiological studies of the neurological health of former professional soccer players are being undertaken to identify whether heading the ball is a risk factor for disease or premature death. A quantitative estimate of exposure to repeated sub-concussive head impacts would provide an opportunity to investigate possible exposure-response relationships. However, it is unclear how to formulate an appropriate exposure metric within the context of epidemiological studies. We have carried out a systematic review of the scientific literature to identify the factors that determine the magnitude of head impact acceleration during experiments and from observations during playing or training for soccer, up to the end of November 2021. Data were extracted from 33 experimental and 27 observational studies from male and female amateur players including both adults and children. There was a high correlation between peak linear and angular accelerations in the observational studies (p < 0.001) although the correlation was lower for the experimental data. We chose to rely on an analysis of maximum or peak linear acceleration for this review. Differences in measurement methodology were identified as important determinants of measured acceleration, and we concluded that only data from accelerometers fixed to the head provided reliable information about the magnitude of head acceleration from soccer-related impacts. Exposures differed between men and women and between children and adults, with women on average experiencing higher acceleration but less frequent impacts. Playing position appears to have some influence on the number of heading impacts but less so on the magnitude of the head acceleration. Head-to-head collisions result in high levels of exposure and thus probably risk causing a concussion. We concluded, in the absence of evidence to the contrary, that estimates of the cumulative number of heading impacts over a playing career should be used as the main exposure metric in epidemiological studies of professional players.
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Affiliation(s)
- Ioannis Basinas
- Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK; (I.B.); (D.M.M.)
- Division of Population Health, Health Services Research & Primary Care, Centre for Occupational and Environmental Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Damien M. McElvenny
- Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK; (I.B.); (D.M.M.)
- Division of Population Health, Health Services Research & Primary Care, Centre for Occupational and Environmental Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Neil Pearce
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Valentina Gallo
- Campus Fryslân, University of Groningen, 8911 CE Leeuwarden, The Netherlands;
| | - John W. Cherrie
- Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK; (I.B.); (D.M.M.)
- Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Edinburgh EH14 4AS, UK
- Correspondence:
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11
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Characterization of Head Impact Exposure in Women's Collegiate Soccer. J Appl Biomech 2021; 38:2-11. [PMID: 34911036 DOI: 10.1123/jab.2020-0304] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 08/25/2021] [Accepted: 09/29/2021] [Indexed: 11/18/2022]
Abstract
Soccer players are regularly exposed to head impacts by intentionally heading the ball. Evidence suggests repetitive subconcussive head impacts may affect the brain, and females may be more vulnerable to brain injury than males. This study aimed to characterize head impact exposure among National Collegiate Athletic Association women's soccer players using a previously validated mouthpiece-based sensor. Sixteen players were instrumented during 72 practices and 24 games. Head impact rate and rate of risk-weighted cumulative exposure were compared across session type and player position. Head kinematics were compared across session type, impact type, player position, impact location, and ball delivery method. Players experienced a mean (95% confidence interval) head impact rate of 0.468 (0.289 to 0.647) head impacts per hour, and exposure rates varied by session type and player position. Headers accounted for 89% of head impacts and were associated with higher linear accelerations and rotational accelerations than nonheader impacts. Headers in which the ball was delivered by a long kick had greater peak kinematics (all P < .001) than headers in which the ball was delivered by any other method. Results provide increased understanding of head impact frequency and magnitude in women's collegiate soccer and may help inform efforts to prevent brain injury.
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12
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Gallagher VT, Murthy P, Stocks J, Vesci B, Mjaanes J, Chen Y, Breiter HC, LaBella C, Herrold AA, Reilly JL. Eye Movements Detect Differential Change after Participation in Male Collegiate Collision versus Non-Collision Sports. Neurotrauma Rep 2021; 2:440-452. [PMID: 34901940 PMCID: PMC8655805 DOI: 10.1089/neur.2021.0030] [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] [Indexed: 11/13/2022] Open
Abstract
Although neuroimaging studies of collision (COLL) sport athletes demonstrate alterations in brain structure and function from pre- to post-season, reliable tools to detect behavioral/cognitive change relevant to functional networks associated with participation in collision sports are lacking. This study evaluated the use of eye-movement testing to detect change in cognitive and sensorimotor processing among male club collegiate athletes after one season of participation in collision sports of variable exposure. We predicted that COLL (High Dose [hockey], n = 8; Low Dose [rugby], n = 9) would demonstrate longer reaction times (antisaccade and memory-guided saccade [MGS] latencies), increased inhibitory errors (antisaccade error rate), and poorer spatial working memory (MGS spatial accuracy) at post-season, relative to pre-season, whereas non-collision collegiate athletes (NON-COLL; n = 17) would remain stable. We also predicted that whereas eye-movement performance would detect pre- to post-season change, ImPACT (Immediate Post-Concussion Assessment and Cognitive Test) performance would remain stable. Our data showed that NON-COLL had shorter (improved performance) post- versus pre-season antisaccade and MGS latencies, whereas COLL groups showed stable, longer, or attenuated reduction in latency (ps ≤ 0.001). Groups did not differ in antisaccade error rate. On the MGS task, NON-COLL demonstrated improved spatial accuracy over time, whereas COLL groups showed reduced spatial accuracy (p < 0.05, uncorrected). No differential change was observed on ImPACT. This study provides preliminary evidence for eye-movement testing as a sensitive marker of subtle changes in attentional control and working memory resulting from participation in sports with varying levels of subconcussive exposure.
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Affiliation(s)
| | - Prianka Murthy
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jane Stocks
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brian Vesci
- Department of Sports Medicine, Northwestern University, Evanston, Illinois, USA
| | - Jeffrey Mjaanes
- Department of Sports Medicine, Northwestern University, Evanston, Illinois, USA
| | - Yufen Chen
- Center for Translational Imaging, Northwestern University, Evanston, Illinois, USA
| | - Hans C Breiter
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Cynthia LaBella
- Division of Orthopedics and Sports Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Amy A Herrold
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - James L Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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13
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Head Impact Research Using Inertial Sensors in Sport: A Systematic Review of Methods, Demographics, and Factors Contributing to Exposure. Sports Med 2021; 52:481-504. [PMID: 34677820 DOI: 10.1007/s40279-021-01574-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The number and magnitude of head impacts have been assessed in-vivo using inertial sensors to characterise the exposure in various sports and to help understand their potential relationship to concussion. OBJECTIVES We aimed to provide a comprehensive review of the field of in-vivo sensor acceleration event research in sports via the summary of data collection and processing methods, population demographics and factors contributing to an athlete's exposure to sensor acceleration events. METHODS The systematic search resulted in 185 cohort or cross-sectional studies that recorded sensor acceleration events in-vivo during sport participation. RESULTS Approximately 5800 participants were studied in 20 sports using 18 devices that included instrumented helmets, headbands, skin patches, mouthguards and earplugs. Female and youth participants were under-represented and ambiguous results were reported for these populations. The number and magnitude of sensor acceleration events were affected by a variety of contributing factors, suggesting sport-specific analyses are needed. For collision sports, being male, being older, and playing in a game (as opposed to a practice), all contributed to being exposed to more sensor acceleration events. DISCUSSION Several issues were identified across the various sensor technologies, and efforts should focus on harmonising research methods and improving the accuracy of kinematic measurements and impact classification. While the research is more mature for high-school and collegiate male American football players, it is still in its early stages in many other sports and for female and youth populations. The information reported in the summarised work has improved our understanding of the exposure to sport-related head impacts and has enabled the development of prevention strategies, such as rule changes. CONCLUSIONS Head impact research can help improve our understanding of the acute and chronic effects of head impacts on neurological impairments and brain injury. The field is still growing in many sports, but technological improvements and standardisation of processes are needed.
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14
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Wright F, Docherty PD, Williams E, Greybe D, Arora H, Kabaliuk N. An in-silico study of the effect of non-linear skin dynamics on skin-mounted accelerometer inference of skull motion. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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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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16
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Brooks JS, Allison W, Harriss A, Bian K, Mao H, Dickey JP. Purposeful Heading Performed by Female Youth Soccer Players Leads to Strain Development in Deep Brain Structures. Neurotrauma Rep 2021; 2:354-362. [PMID: 34901935 PMCID: PMC8655815 DOI: 10.1089/neur.2021.0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Head impacts in soccer have been associated with both short- and long-term neurological consequences. Youth players' brains are especially vulnerable given that their brains are still developing, and females are at an increased risk of traumatic brain injury (TBI) compared to males. Approximately 90% of head impacts in soccer occur from purposeful heading. Accordingly, this study assessed the relationship between kinematic variables and brain strain during purposeful headers in female youth soccer players. A convenience sample of 36 youth female soccer players (13.4 [0.9] years of age) from three elite youth soccer teams wore wireless sensors to quantify head impact magnitudes during games. Purposeful heading events were categorized by game scenario (e.g., throw-in, goal kick) for 60 regular season games (20 games per team). A total of 434 purposeful headers were identified. Finite element model simulations were performed to calculate average peak maximum principal strain (APMPS) in the corpus callosum, thalamus, and brainstem on a subset of 110 representative head impacts. Rotational velocity was strongly associated with APMPS in these three regions of the brain (r = 0.83-0.87). Linear acceleration was weakly associated with APMPS (r = 0.13-0.31). Game scenario did not predict APMPS during soccer games (p > 0.05). Results demonstrated considerable APMPS in the corpus callosum (mean = 0.102) and thalamus (mean = 0.083). In addition, the results support the notion that rotational velocity is a better predictor of brain strain than linear acceleration and may be a potential indicator of changes to the brain.
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Affiliation(s)
- Jeffrey S. Brooks
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Wayne Allison
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Alexandra Harriss
- Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Kewei Bian
- Department of Mechanical and Materials Engineering, Faculty of Engineering, Western University, London, Ontario, Canada
| | - Haojie Mao
- Department of Mechanical and Materials Engineering, Faculty of Engineering, Western University, London, Ontario, Canada
- School of Biomedical Engineering, Western University, London, Ontario, Canada
| | - James P. Dickey
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Biomedical Engineering, Western University, London, Ontario, Canada
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17
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McCunn R, Beaudouin F, Stewart K, Meyer T, MacLean J. Heading in Football: Incidence, Biomechanical Characteristics and the Association with Acute Cognitive Function-A Three-Part Systematic Review. Sports Med 2021; 51:2147-2163. [PMID: 34129222 DOI: 10.1007/s40279-021-01492-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is growing concern surrounding the role of repetitive sub-concussive head impacts, such as football heading, on brain health. OBJECTIVES Three questions were addressed while only considering studies that observed heading exposure directly: (1) how frequently does heading occur within football training and matches, (2) what are the biomechanical characteristics of heading, and (3) is cognitive function affected by heading? METHODS This review followed the steps described in the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Electronic databases including MEDLINE and SPORTDiscus were searched from the earliest entry to July 2020. Studies that reported independently quantified heading exposure, biomechanical characteristics of heading or the relationship between heading and cognitive function were included. Data were extracted and used to populate summary tables with reference to each research question. RESULTS Heading incidence ranged between one to nine headers per player per match. The number of headers observed in small-sided games during training varied depending on the exact format used but generally speaking ranged between zero to one per player per game. The three most commonly reported biomechanical variables were head acceleration, head rotational velocity and overall movement kinematics during the heading action. Average head acceleration ranged from approximately four to 50 g. Nine out of 12 included studies did not observe a negative impact on cognitive test performance following exposure to heading and while three did, these negative effects were limited to specific outcome measures: reaction time and memory function. CONCLUSION The current weight of evidence summarised herein does not support the notion that heading is deleterious to cognitive performance in the short term; however, this conclusion is tentative due to methodological shortcomings in the existing evidence base.
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Affiliation(s)
- Robert McCunn
- Heart of Midlothian Football Club, Tynecastle Park , Edinburgh, EH11 2NL, UK.
| | - Florian Beaudouin
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Katy Stewart
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Hampden Sports Clinic, Glasgow, UK
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - John MacLean
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Hampden Sports Clinic, Glasgow, UK
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18
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Huber CM, Patton DA, Jain D, Master CL, Margulies SS, McDonald CC, Arbogast KB. Variations in Head Impact Rates in Male and Female High School Soccer. Med Sci Sports Exerc 2021; 53:1245-1251. [PMID: 33986230 PMCID: PMC8122001 DOI: 10.1249/mss.0000000000002567] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Repetitive head impacts in soccer have been linked to short-term neurophysiological deficits, and female soccer players have higher concussion rates than males. These findings have inspired investigation into gender differences in head impact exposure and how head impact rate contributes to the cumulative effect of head impact exposure on neurological outcomes. Various periods of exposure have been used to calculate head impact rates, including head impacts per season, game, and player-hour. PURPOSE The aim of this study was to apply different methodological approaches to quantify and compare head impact rates by gender for two seasons of high school varsity soccer. METHODS Video review was used to confirm all events recorded by a headband-mounted impact sensor and calculate playing time for all players. Impact rates were calculated per athlete exposure (presence and participation) and per player-hour (scheduled game time, individual play time, and absolute time). RESULTS Impact rates per athlete exposure ranged from 2.5 to 3.2 for males and from 1.4 to 1.6 for females, and impact rates per player-hour ranged from 2.7 to 3.8 for males and from 1.0 to 1.6 for females. The exposure calculation method significantly affected head impact rates; however, regardless of approach, the head impact rate for males was higher, up to threefold, than for females. Individual head impact exposure varied substantially within a team with one in five players experiencing no impacts. CONCLUSIONS Overall, the gender differences found in this study indicate that males experience higher head impact exposure compared with females. Future studies are needed to understand potential clinical implications of variability in head impact exposure and reconcile higher female concussion rates with the reduced head impact rates presented herein.
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Affiliation(s)
- Colin M Huber
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA,Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Declan A. Patton
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Divya Jain
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA,Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Christina L. Master
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA,Sports Medicine and Performance Center, Children’s Hospital of Philadelphia, Philadelphia, PA,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Susan S. Margulies
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA
| | - Catherine C. McDonald
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA,School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Kristy B. Arbogast
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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19
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Abstract
Recent public concern over the short- and long-term effects of repetitive head impacts (RHI) associated with purposeful heading in soccer has led researchers to study a multitude of variables related to this important aspect of the game. Of particular interests are the effects of soccer heading in the youth population (≤ 13 years old) whose brains are undergoing rapid development. We conducted a review on youth soccer heading that includes purposeful heading frequency, head impact biomechanics, head injuries, clinical outcomes, and modifying factors. We have concluded that youth soccer players head the ball at a low frequency that typically increases with age and with a finding that boys head the ball more often than girls do. Interestingly, although girls head the ball less frequently than boys do, they tend to sustain higher head impact magnitudes. Head injuries are more likely to occur in girls versus boys and during games because of contact with another player. Clinical outcome measures of concussion are often utilized to study the effects of soccer heading, in both field and laboratory environments. Immediately following soccer heading, youth often report having a headache and demonstrate some deficits in balance measures. Modifying factors that may benefit soccer players participating in purposeful heading activities include stronger neck musculature, wearing headgear, and the use of mouthguards. Research involving youth soccer players needs to be expanded and funded appropriately to better understand the consequences of RHI in both the short and long term.
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20
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Caccese JB, Bodt BA, Iverson GL, Kaminski TW, Bryk K, Oldham J, Broglio SP, McCrea M, McAllister T, Buckley TA. Estimated Age of First Exposure to Contact Sports and Neurocognitive, Psychological, and Physical Outcomes in Healthy NCAA Collegiate Athletes: A Cohort Study. Sports Med 2021; 50:1377-1392. [PMID: 32002824 DOI: 10.1007/s40279-020-01261-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Collegiate football players who started playing tackle football before age 12 years did not show worse neuropsychological test performance than those who started playing tackle football after age 12 years. It is unknown if beginning other contact sports, such as lacrosse, at a younger age is associated with worse neurocognitive performance, greater psychological distress, or worse postural stability in collegiate student athletes. OBJECTIVE The purpose of this study was to examine the association between estimated age of first exposure (eAFE) to repetitive head impacts (RHI) and these outcome measures in collegiate student athletes. METHODS 1891 female and 4448 male collision/contact (i.e., football, ice hockey, lacrosse, wrestling, soccer) and non-contact (i.e., golf, rifle, rowing/crew, swimming, tennis) sport athletes completed baseline testing, including the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Brief Symptom Inventory 18 (BSI-18), and Balance Error Scoring System (BESS). RESULTS For women, the eAFE-by-sport interaction was associated with ImPACT Verbal Memory and Visual Memory, whereby earlier eAFE to contact sports was associated with higher composite scores (B = - 0.397, B = - 0.485, respectively). For men, the eAFE-by-sport interaction was associated with BSI-18 Depression and Global Severity Index and symptom severity scores, whereby earlier eAFE to football was associated with lower psychological distress and symptom severity [Depression, Exp(B) = 1.057; Global Severity Index, Exp(B) = 1.047; Symptom Severity, Exp(B) = 1.046]. Parameter estimates were small suggesting these results may have minimal practical relevance. CONCLUSION Findings suggest that RHI during early adolescence is unrelated to brain health as measured by these specific outcome measures in collegiate student athletes.
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Affiliation(s)
- Jaclyn B Caccese
- School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, 453 W 10th Ave, Columbus, OH, 43210, USA
| | - Barry A Bodt
- College of Health Sciences, University of Delaware, 540 S. College Ave, Newark, DE, 19713, USA
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Spaulding Research Institute, MassGeneral Hospital for Children Sports Concussion Program and Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, USA.,Center for Health and Rehabilitation Research, 79/96 Thirteenth Street, Charlestown, MA, 20129, USA
| | - Thomas W Kaminski
- Interdisciplinary Biomechanics and Movement Science Program, Department of Kinesiology and Applied Physiology, University of Delaware, 541 S. College Ave, Newark, DE, 19716, USA
| | - Kelsey Bryk
- Interdisciplinary Biomechanics and Movement Science Program, Department of Kinesiology and Applied Physiology, University of Delaware, 100 Discovery Blvd, Newark, DE, 19713, USA
| | - Jessie Oldham
- The Micheli Center for Sports Injury Prevention, Boston Children's Hospital, 9 Hope Ave, Waltham, MA, 02453, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, 401 Washtenaw Ave, Ann Arbor, MI, 48104, USA
| | - Michael McCrea
- Department of Neurosurgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Thomas McAllister
- Indiana University School of Medicine, Goodman Hall, 355 W. 16th St., Suite 4800, Indianapolis, IN, 46202, USA
| | - Thomas A Buckley
- Interdisciplinary Biomechanics and Movement Science Program, Department of Kinesiology and Applied Physiology, University of Delaware, 100 Discovery Blvd, Newark, DE, 19713, USA.
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21
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Bonn MM, Harriss AB, Thompson JWG, Dickey JP. Performing more than 20 purposeful gameplay headers in a soccer season may alter autonomic function in female youth soccer players. Res Sports Med 2021; 29:440-448. [PMID: 33596738 DOI: 10.1080/15438627.2021.1888098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study evaluated the effects of cumulative purposeful soccer heading on autonomic nervous system function in 22 female youth soccer players (13.3 ± 0.9 years). A 10 minute electrocardiogram recording was collected at baseline and following the 20 game season (post-season) to calculate measures of heart rate variability (HRV), including standard deviation of the normal-normal intervals, total power, high frequency (HF), low frequency (LF), LF:HF, normalized HF and normalized LF. Participants were categorized into low- (<20 headers per season; n = 13) and high- (>20 headers per season; n = 9) exposure groups. Mann-Whitney U tests demonstrated no significant differences between groups for any HRV metric. However, the increased normalized LF power (low exposure 8.67 and high exposure -31.17, respectively; r = 0.35) and LF:HF power (-6.39 and 15.80, respectively; r = 0.35), between groups had moderate practical significance. Therefore, female youth players who perform more than 20 purposeful headers during a soccer season may exhibit altered autonomic function.
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Affiliation(s)
- Marquise M Bonn
- Health and Rehabilitation Sciences, Western University, London, Canada
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22
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Gallagher VT, Murthy P, Stocks J, Vesci B, Colegrove D, Mjaanes J, Chen Y, Breiter H, LaBella C, Herrold AA, Reilly JL. Differential Change in Oculomotor Performance among Female Collegiate Soccer Players versus Non-Contact Athletes from Pre- to Post-Season. Neurotrauma Rep 2020; 1:169-180. [PMID: 33274345 PMCID: PMC7703496 DOI: 10.1089/neur.2020.0051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Sensitive and reliable tools are needed to evaluate potential behavioral and cognitive changes following head impact exposure in contact and collision sport participation. We evaluated change in oculomotor testing performance among female, varsity, collegiate athletes following variable exposure to head impacts across a season. Female, collegiate, contact sport (soccer, CONT) and non-contact sport (NON-CONT) athletes were assessed pre-season and post-season. Soccer athletes were grouped according to total season game headers into low dose (≤40 headers; CONT-Low Dose) or high dose (>40 headers; CONT-High Dose) groups. Performance on pro-saccade (reflexive visual response), anti-saccade (executive inhibition), and memory-guided saccade (MGS, spatial working memory) computer-based laboratory tasks were assessed. Primary saccade measures included latency/reaction time, inhibition error rate (anti-saccade only), and spatial accuracy (MGS only). NON-CONT (n = 20), CONT-Low Dose (n = 17), and CONT-High Dose (n = 7) groups significantly differed on pre-season versus post-season latency on tasks with executive functioning demands (anti-saccade and MGS, p ≤ 0.001). Specifically, NON-CONT and CONT-Low Dose demonstrated shorter (i.e., faster) anti-saccade (1.84% and 2.68%, respectively) and MGS (5.74% and 2.76%, respectively) latencies from pre-season to post-season, whereas CONT-High Dose showed 1.40% average longer anti-saccade, and 0.74% shorter MGS, latencies. NON-CONT and CONT-Low Dose demonstrated reduced (i.e., improved) inhibition error rate on the anti-saccade task at post-season versus pre-season, whereas CONT-High Dose demonstrated relative stability (p = 0.021). The results of this study suggest differential exposure to subconcussive head impacts in collegiate female athletes is associated with differential change in reaction time and inhibitory control performances on executive saccadic oculomotor testing.
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Affiliation(s)
- Virginia T Gallagher
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Prianka Murthy
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jane Stocks
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brian Vesci
- Department of Sports Medicine, Northwestern University, Evanston, Illinois, USA
| | - Danielle Colegrove
- Department of Sports Medicine, Northwestern University, Evanston, Illinois, USA
| | - Jeffrey Mjaanes
- Department of Sports Medicine, Northwestern University, Evanston, Illinois, USA
| | - Yufen Chen
- Center for Translational Imaging, Northwestern University, Chicago, Illinois, USA
| | - Hans Breiter
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Cynthia LaBella
- Division of Orthopedics and Sports Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Amy A Herrold
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Edward Hines, Jr. VA Hospital, Hines, Illinois, USA
| | - James L Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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23
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Characterization of On-Field Head Impact Exposure in Youth Soccer. J Appl Biomech 2020; 37:36-42. [PMID: 33152691 DOI: 10.1123/jab.2020-0071] [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] [Received: 03/11/2020] [Revised: 08/19/2020] [Accepted: 08/27/2020] [Indexed: 11/18/2022]
Abstract
The objective of this research was to characterize head impacts with a validated mouthpiece sensor in competitive youth female soccer players during a single season with a validated mouthpiece sensor. Participants included 14 youth female soccer athletes across 2 club-level teams at different age levels (team 1, ages 12-13 y; team 2, ages 14-15 y). Head impact and time-synchronized video data were collected for 66 practices and games. Video data were reviewed to characterize the type and frequency of contact experienced by each athlete. A total of 2216 contact scenarios were observed; heading the ball (n = 681, 30.7%) was most common. Other observed contact scenarios included collisions, dives, falls, and unintentional ball contact. Team 1 experienced a higher rate of headers per player per hour of play than team 2, while team 2 experienced a higher rate of collisions and dives. A total of 935 video-verified contact scenarios were concurrent with recorded head kinematics. While headers resulted in a maximum linear acceleration of 56.1g, the less frequent head-to-head collisions (n = 6) resulted in a maximum of 113.5g. The results of this study improve the understanding of head impact exposure in youth female soccer players and inform head impact exposure reduction in youth soccer.
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24
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Clinical Changes in Cervical Neuromuscular Control Following Subconcussive Impacts. J Sport Rehabil 2020; 30:467-474. [PMID: 33075749 DOI: 10.1123/jsr.2020-0228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/09/2020] [Accepted: 08/09/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Increased injury rates following concussive injury have been attributed to decreased neuromuscular coordination frequently documented following a concussion. However, altered integration between the vestibular system and oculomotor pathways following impacts at subconcussive thresholds implicate all sports-related impacts not just those at a concussive threshold in future musculoskeletal injury. While, several studies have explored the utility of vestibular and oculomotor clinical testing to detect altered neuromuscular control and then correlated those alterations to future injury risk, no research has explored the use of cervical clinical tests in the same capacity. OUTCOME MEASURES Cervical joint position error test, Neck Disability Index and head acceleration. INTERVENTIONS Soccer headers, fatigue protocol, soccer headers + fatigue. OBJECTIVE To explore the clinical utility of a novel clinical approach to measuring changes in cervical neuromuscular control following subconcussive impacts in a controlled lab environment. PARTICIPANTS 40 current female colligate club soccer athletes were recruited. Inclusion criteria included between the age of 18 and 25 and a minimum of 4-year soccer heading experience. SETTING Laboratory. Design: A repeated-measures design with 4 groups was utilized to test the hypothesis. RESULTS A 65%, 54%, and 49% increased error was observed following the soccer heading, fatigue only, and soccer heading + fatigue interventions, respectively. Meanwhile, the controls saw a 6% decrease in neck position error. Concussion: While, cervical joint position error testing was sensitive to decreased neuromuscular coordination following soccer heading, it was not specific enough to rule out an exercise effect in the absence of subconcussive impacts. Further research is warranted to explore the clinical utility and specificity of cervical joint position error testing to measured alterations in supraspinal processing following subconcussive impacts, and how these alterations may lead to decreased coordination and movement of the body during sports-related task.
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25
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Caccese JB, Santos FV, Yamaguchi F, Jeka JJ. Sensory Reweighting for Upright Stance in Soccer Players: A Comparison of High and Low Exposure to Soccer Heading. J Neurotrauma 2020; 37:2656-2663. [PMID: 32571175 DOI: 10.1089/neu.2020.7001] [Citation(s) in RCA: 8] [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
The purpose of this study was to compare sensory reweighting for upright stance between soccer players who report higher soccer heading exposure to those who report lower soccer heading exposure. Thirty participants completed a self-reported questionnaire to estimate the number of soccer headers experienced over the previous year and were divided into "low exposure" and "high exposure" groups based on their responses. Sensory reweighting for upright stance was assessed by simultaneously perturbing visual, vestibular, and proprioceptive systems. The visual stimulus was a sinusoidal translation of the visual scene at 0.2 Hz, the vestibular stimulus was ±1mA binaural monopolar galvanic vestibular stimulation (GVS) at 0.36 Hz, and the proprioceptive stimulus was Achilles tendon vibration at 0.28 Hz. The visual stimulus was presented at two amplitudes (0.2 m, 0.8 m). Center of mass (COM) gain/phase to each modality, total power, 95% area and velocity were compared between low exposure (N = 15, six males, 21.5 ± 1.9 years, 27.7 ± 31.6 headers) and high exposure groups (N = 15, 10 males, 22.1 ± 3.5years, 734.9 ± 877.7 headers). Without vibration, COM 95% area (F = 5.861, p = 0.022*, partial η2 = 0.173), velocity (F = 14.198, p = 0.001, partial η2 = 0.336), and total power (F = 13.491, p = 0.001, partial η2 = 0.325) for the "high exposure" group were higher than for the "low exposure" group, and postural sway lagged the vestibular stimulus in the "high exposure" group rather than leading it as in the "low exposure" group (F = 4.765, p = 0.038, partial η2 = 0.145). There were no differences in sensory reweighting and no differences in COM gain/phase between groups. These findings lend empirical evidence to a detrimental effect of soccer heading exposure on balance control during upright stance.
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Affiliation(s)
- Jaclyn B Caccese
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | | | - Felipe Yamaguchi
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
| | - John J Jeka
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
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Amitay N, Zlotnik Y, Coreanu T, Zeller L, Abu-Salameh I, Novack V, Ifergane G. Soccer heading and subclinical neuropsychiatric symptomatology in professional soccer players. Neurology 2020; 95:e1776-e1783. [DOI: 10.1212/wnl.0000000000010244] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/17/2020] [Indexed: 12/17/2022] Open
Abstract
ObjectivesTo evaluate the association between postconcussive symptomatology and heading in professional soccer players, overcoming the bias of self-reported exposure, we evaluated several clinical neuropsychiatric symptoms using questionnaires after a thorough objective follow-up of players’ heading exposure throughout an entire season.MethodsWe collected heading data for all Israeli Premier League players for an entire season using a web-based platform for performance analysis, which enabled us to quantify the exact number of headers per player. Players filled out questionnaires regarding postconcussion symptoms, depression, anxiety, and sleep disorders. We tested the association between the number of headers and each outcome using a negative binomial regression corrected for the hours played.ResultsA total of 159 players were included, of whom 79 were considered in the high heading exposure group (49%), defined as more than median number of headings (1.34 per game hour). Among players without any past head injury, those with higher heading exposure were less likely to have postconcussion symptoms compared with players with low heading exposure (relative risk [RR] per heading per hour 0.94, 95% confidence interval [CI] 0.912–0.963). Players with high heading exposure had fewer depression symptoms (RR 0.98, 95% CI 0.961–0.997), anxiety (RR 0.98, 95% CI 0.958–0.997), and sleep disorders (RR 0.98, 95% CI 0.961–0.996).ConclusionProfessional soccer players with high heading rate do not display higher postconcussive symptomatology severity. Symptoms among players with low heading exposure might be explained by low resilience, possibly associated with an inferior heading technique. Alternatively, it can reflect heading-avoidant behavior.
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Comparison of head impact measurements via an instrumented mouthguard and an anthropometric testing device. SPORTS ENGINEERING 2020. [DOI: 10.1007/s12283-020-00324-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractThe purpose of this study was to determine and compare the efficacy of head impact measurements via an electronic sensor framework, embedded within a mouthguard, against an anthropometric testing device. Development of the former is in response to the growing issue of head impacts and concussion in rugby union. Testing was conducted in a vehicle safety laboratory using a standard impact protocol utilising the headforms of anthropometric testing devices. The headforms were subjected to controlled front and side impacts. For each impact, the linear acceleration and rotational velocity was measured over a 104-ms interval at a frequency of 1 kHz. The magnitude of peak linear acceleration and peak rotational velocity was determined from the measured time-series traces and statistically compared. The peak linear acceleration and rotational velocity had intraclass correlation coefficients of 0.95 and 0.99, respectively. The root-mean-square error between the measurement systems was 4.3 g with a standard deviation of 3.5 g for peak linear acceleration and 0.7 rad/s with a standard deviation of 0.4 rad/s for rotational velocity. Bland and Altman analysis indicated a systematic bias of 2.5 g and − 0.5 rad/s and limits of agreement (1.96 × standard deviation) of ± 13.1 g and ± 1.25 rad/s for the instrumented mouthguard. These results provide the basis on which the instrumented mouthguard can be further developed for deployment and application within professional rugby, with a view to accurately and reliably quantify head collision dynamics.
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Beaudouin F, Gioftsidou A, Larsen MN, Lemmink K, Drust B, Modena R, Espinola JR, Meiu M, Vouillamoz M, Meyer T. The UEFA Heading Study: Heading incidence in children's and youth' football (soccer) in eight European countries. Scand J Med Sci Sports 2020; 30:1506-1517. [PMID: 32335945 DOI: 10.1111/sms.13694] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 04/15/2020] [Accepted: 04/20/2020] [Indexed: 12/28/2022]
Abstract
To assess the real-life magnitude of the heading incidence in children's and youth' football in eight European countries with different "football cultures," a cross-sectional observational design, in which one match per team in 480 different teams from eight European countries (2017/18-2018/19), was recorded by video. One training session was recorded in 312 teams. Clubs with Under-10, Under-12 (female/male/mixed), and Under-16 female and male teams were eligible to participate. Heading frequencies and types were analyzed. Results are presented as headers per match/training and per team. Incidence rates (IR) per 1000 match/training hours were calculated. Under-10 teams carried out the lowest average number of headers per match (8.8), followed by Under-16 female (17.7), Under-12 (18.4), and Under-16 male (35.5). Total number of headers per match and team varied between countries. 80% of the total number of headers were single intentional headers, 12% heading duels, 3% unintentional headers by getting hit, and 5% others (trends apparent in all age groups). Three head injuries occurred during match play corresponding to an IR of 0.70 (95% CI, 0.23-2.16). The lowest number of headers per training and team was found in Under-10 (21.3), followed by Under-16 females (34.1), Under-12 (35.8), and Under-16 males (45.0). In conclusion, this large-scale study presents novel data about the number and type of headers in youth' football throughout Europe. A more precise understanding of the heading incidence, specifically in young players, is mandatory for the debate of restrictions on heading in youth football.
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Affiliation(s)
- Florian Beaudouin
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Asimenia Gioftsidou
- Department of Physical Education and Sport Sciences, Democritus University of Thrace, Komotini, Greece
| | - Malte Nejst Larsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Koen Lemmink
- Center of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Barry Drust
- Sport and Exercise Sciences, John Moores University, Liverpool, UK
| | - Roberto Modena
- CeRiSM Research Center Sport Mountain and Health, University of Verona, Verona, Italy
| | | | - Mihai Meiu
- Romanian Football Federation, Bucharest, Romania
| | - Marc Vouillamoz
- Union des Associations Européennes de Football (UEFA), Nyon, Switzerland
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
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29
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Harriss A, Johnson AM, Thompson JWG, Walton DM, Dickey JP. Cumulative soccer heading amplifies the effects of brain activity observed during concurrent moderate exercise and continuous performance task in female youth soccer players. JOURNAL OF CONCUSSION 2020. [DOI: 10.1177/2059700220912654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Alexandra Harriss
- Health and Rehabilitation Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Andrew M Johnson
- School of Health Studies, The University of Western Ontario, London, Ontario, Canada
| | | | - David M Walton
- Health and Rehabilitation Sciences, The University of Western Ontario, London, Ontario, Canada
- School of Health Studies, The University of Western Ontario, London, Ontario, Canada
- School of Physical Therapy, The University of Western Ontario, London, Ontario, Canada
| | - James P Dickey
- School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
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30
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Sandmo SB, Filipcik P, Cente M, Hanes J, Andersen TE, Straume-Naesheim TM, Bahr R. Neurofilament light and tau in serum after head-impact exposure in soccer. Brain Inj 2020; 34:602-609. [DOI: 10.1080/02699052.2020.1725129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Stian Bahr Sandmo
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Peter Filipcik
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Martin Cente
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Jozef Hanes
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Truls Martin Straume-Naesheim
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Orthopedic Surgery, Akershus University Hospital, Lørenskog, Norway
- Department of Orthopedic Surgery, Haugesund Rheumatism Hospital, Haugesund, Norway
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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Jadischke R, Zendler J, Lovis E, Elliott A, Goulet GC. Quantitative and qualitative analysis of head and body impacts in American 7v7 non-tackle football. BMJ Open Sport Exerc Med 2020; 6:e000638. [PMID: 32095268 PMCID: PMC7011012 DOI: 10.1136/bmjsem-2019-000638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives Non-tackle American football is growing in popularity, and it has been proposed as a safer alternative for young athletes interested in American football. Little is known about the nature of head contact in the sport, which is necessary to inform the extent to which protective headgear is warranted. The objective of this study was to identify the location, types and frequency of head and body contacts in competitive 7v7 non-tackle American football. Methods Video analysis was used to document the type, frequency and mechanism of contacts across a series of under 12, under 14 and high school non-tackle tournament games. A subset of impacts was quantitatively analysed via 3-D model-based image matching to calculate the preimpact and postimpact speed of players’ heads and the change in resultant translational and rotational velocities. Results The incidence rate of head contact was found to be low (3.5 contacts per 1000 athlete-plays). Seventy-five per cent of head contacts were caused by a head-to-ground impact. No head-to-head contacts were identified. Most contacts occurred to the rear upper (occiput) or side upper (temporal/parietal) regions. Head-to-ground impact was associated with a maximum preimpact velocity of 5.9±2.2 m/s and a change in velocity of 3.0±1.1 m/s. Conclusion Non-tackle football appears to represent a lower contact alternative to tackle football. The distribution of head impact locations, mechanisms and energies found in the present study is different than what has been previously reported for tackle football. The existing tackle football standards are not appropriate to be applied to the sport of non-tackle football, and sport-specific head protection and headgear certification standards must be determined.
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Affiliation(s)
| | - Jessica Zendler
- Xenith, Detroit, Michigan, USA.,School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
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Kaminski TW, Weinstein S, Wahlquist VE. A comprehensive prospective examination of purposeful heading in American interscholastic and collegiate soccer players. SCI MED FOOTBALL 2019. [DOI: 10.1080/24733938.2019.1696470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Thomas W. Kaminski
- Department of Kinesiology and Applied Physiology, Athletic Training Research Lab, University of Delaware, Newark, DE, USA
| | - Sarah Weinstein
- Family Medicine, Crozer Chester Medical Center, Springfield, PA, USA
| | - Victoria E. Wahlquist
- Department of Kinesiology and Applied Physiology, Athletic Training Research Lab, University of Delaware, Newark, DE, USA
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An Evaluation of Heart Rate Variability in Female Youth Soccer Players Following Soccer Heading: A Pilot Study. Sports (Basel) 2019; 7:sports7110229. [PMID: 31689916 PMCID: PMC6915463 DOI: 10.3390/sports7110229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 11/22/2022] Open
Abstract
Most head impacts in soccer occur from purposeful heading; however, the link between heading and neurological impairment is unknown. Previous work suggests concussion may result in an uncoupling between the autonomic nervous system and cardiovascular system. Accordingly, heart rate variability (HRV) may be a sensitive measure to provide meaningful information regarding repetitive heading in soccer. The purpose of this pilot study assesses the feasibility of measuring HRV to evaluate autonomic function following soccer heading. Sixteen youth female participants underwent heart rate monitoring during a heading and footing condition. Participants completed a five minute resting supine trial at the start and end of each testing session. Standard 450 g soccer balls were projected at 6 m/s towards participants. Participants performed five headers, for the header condition, and five footers for the footer condition. The HRV for resting supine trials, pre- and post-header and footer conditions were assessed for both time and frequency domains. HRV effect sizes were small when comparing conditions, except absolute low frequency (d = 0.61) and standard deviation of the normal-normal (NN) intervals (d = 0.63). Participant retention and adherence were high, without adverse events. Findings suggest HRV is a feasible measure for evaluating the effects of heading on autonomic function.
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34
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Sandmo SB, Andersen TE, Koerte IK, Bahr R. Head impact exposure in youth football-Are current interventions hitting the target? Scand J Med Sci Sports 2019; 30:193-198. [PMID: 31584703 PMCID: PMC6916205 DOI: 10.1111/sms.13562] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/27/2019] [Accepted: 10/01/2019] [Indexed: 12/20/2022]
Abstract
Restrictions on heading in youth football have been implemented in some countries to limit head impact exposure. However, current interventions remain poorly guided by evidence. Our objective was to quantify heading exposure in youth football, assessing the effects of sex and age. Football matches played during an international youth football tournament with no heading restrictions were directly observed, including players from both sexes (11-19 years). The elite senior level was included for comparison, using video analysis. All heading events were registered, classified, and assigned to individual players. Heading rates were calculated for each sex and age group. We observed a total of 267 matches, corresponding to 4011 player hours (1927 player hours for females, 2083 player hours for males). Males headed more frequently than females (2.7 vs 1.8 headers/player hour; P < .001). Heading rates increased with age (ANOVA, P < .001), approaching the elite senior level for players 16 years and older. There was substantial variation within teams for all age and sex groups, with the widest range (1-18 headers) observed for girls aged 19. Girls younger than 12 years had the lowest exposure, with an average of <2 players per team heading the ball, each with 1-2 headers. In conclusion, age and sex influence head impact exposure in youth football, and warrants careful consideration when introducing injury prevention measures. Males are more frequently exposed than females, heading rates increase with age, and there is substantial variation between players. Heading is a rare event in the youngest age groups, especially among females.
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Affiliation(s)
- Stian Bahr Sandmo
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Inga Katharina Koerte
- Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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35
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Kaminski TW, Chiampas GT, Putukian M, Kirkendall D, Fokas J, Kontos AP. Purposeful heading in U.S. youth soccer players: results from the U.S. soccer online heading survey – epidemiological evidence. SCI MED FOOTBALL 2019. [DOI: 10.1080/24733938.2019.1677937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Thomas W. Kaminski
- Department of Kinesiology & Applied Physiology, Human Performance Laboratory, University of Delaware, Newark, DE, USA
| | - George T Chiampas
- Emergency Medicine and Orthopaedic Surgery, Chief Medical Officer – U.S. Soccer, Northwestern University, Feinberg School of Medicine, Fuquay-Varina, NC, USA
| | - Margot Putukian
- Director of Athletic Medicine, Princeton University, Princeton, NJ, USA
| | - Donald Kirkendall
- James Urbaniak Sport Sciences Institute, Duke Health, Durham, North Carolina
| | - Jennifer Fokas
- College of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Anthony P. Kontos
- UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
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36
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Development, Validation and Pilot Field Deployment of a Custom Mouthpiece for Head Impact Measurement. Ann Biomed Eng 2019; 47:2109-2121. [PMID: 31297724 DOI: 10.1007/s10439-019-02313-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 06/22/2019] [Indexed: 10/26/2022]
Abstract
The objective of this study was to develop a mouthpiece sensor with improved head kinematic measurement for use in non-helmeted and helmeted sports through laboratory validation and pilot field deployment in female youth soccer. For laboratory validation, data from the mouthpiece sensor was compared to standard sensors mounted in a headform at the center of gravity as the headform was struck with a swinging pendulum. Linear regression between peak kinematics measured from the mouthpiece and headform showed strong correlation, with r2 values of 0.95 (slope = 1.02) for linear acceleration, 1.00 (slope = 1.00) for angular velocity, and 0.97 (slope = 0.96) for angular acceleration. In field deployment, mouthpiece data were collected from four female youth soccer players and time-synchronized with film. Film-verified events (n = 915) were observed over 9 practices and 5 games, and 632 were matched to a corresponding mouthpiece event. This resulted in an overall sensitivity of 69.2% and a positive predictive value of 80.3%. This validation and pilot field deployment data demonstrates that the mouthpiece provides highly accurate measurement of on-field head impact data that can be used to further study the effects of impact exposure in both helmeted and non-helmeted sports.
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37
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Nevins D, Hildenbrand K, Vasavada A, Kensrud J, Smith L. In-Game Head Impact Exposure of Male and Female High School Soccer Players. ACTA ACUST UNITED AC 2019. [DOI: 10.3928/19425864-20180802-02] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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38
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Harriss A, Johnson AM, Walton DM, Dickey JP. Head impact magnitudes that occur from purposeful soccer heading depend on the game scenario and head impact location. Musculoskelet Sci Pract 2019; 40:53-57. [PMID: 30708266 DOI: 10.1016/j.msksp.2019.01.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/07/2019] [Accepted: 01/21/2019] [Indexed: 01/12/2023]
Abstract
PURPOSE This study quantified the linear and angular kinematics that result from purposeful heading during youth soccer games, and the influence of game scenario and head impact location on these magnitudes. METHOD This observational study recruited thirty-six female soccer players (13.4 ± 0.9 years old) from three elite youth soccer teams (U13, U14, U15) and followed for an entire soccer season. Players wore wireless sensors during each game to quantify head impact magnitudes. A total of 60 regular season games (20 games per team) were video recorded, and purposeful heading events were categorized by game scenario (e.g. throw in), and head impact location (e.g. front of head). RESULTS Game scenario had a statistically significant effect on the linear head acceleration, and rotational head velocity, that resulted from purposeful headers. Rotational velocity from purposeful headers varied significantly between head impact locations, with impacts to the top of the head (improper technique) resulting in larger peak rotational velocities than impacts to the front of the head (proper technique); this was also the case for the linear acceleration for punts. CONCLUSION Our findings suggest that the magnitude for both linear and angular head impact kinematics depend on the game scenario and head impact location. Headers performed with the top of the head (improper technique) result in larger rotational velocities compared to the front of the head (proper technique). Accordingly, youth players should be educated on how to execute proper heading technique to reduce head impact accelerations.
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Affiliation(s)
- Alexandra Harriss
- Health and Rehabilitation Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Andrew M Johnson
- Health and Rehabilitation Sciences, The University of Western Ontario, London, Ontario, Canada; School of Health Studies, The University of Western Ontario, London, Ontario, Canada
| | - David M Walton
- School of Health Studies, The University of Western Ontario, London, Ontario, Canada; School of Physical Therapy, The University of Western Ontario, London, Ontario, Canada
| | - James P Dickey
- School of Kinesiology, The University of Western Ontario, London, Ontario, Canada.
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39
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Miller LE, Pinkerton EK, Fabian KC, Wu LC, Espeland MA, Lamond LC, Miles CM, Camarillo DB, Stitzel JD, Urban JE. Characterizing head impact exposure in youth female soccer with a custom-instrumented mouthpiece. Res Sports Med 2019; 28:55-71. [DOI: 10.1080/15438627.2019.1590833] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Logan E. Miller
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston Salem, NC, USA
| | - Elizabeth K. Pinkerton
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Katie C. Fabian
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lyndia C. Wu
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Mark A. Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lindsey C. Lamond
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Christopher M. Miles
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Joel D. Stitzel
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston Salem, NC, USA
| | - Jillian E. Urban
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Winston Salem, NC, USA
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40
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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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41
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Rodrigues AC, Lima MDM, de Souza LC, Furtado C, Marques CE, Gonçalves L, Lima MV, Lasmar RP, Caramelli P. No Evidence of Association Between Soccer Heading and Cognitive Performance in Professional Soccer Players: Cross-Sectional Results. Front Neurol 2019; 10:209. [PMID: 30915024 PMCID: PMC6422927 DOI: 10.3389/fneur.2019.00209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 02/18/2019] [Indexed: 12/29/2022] Open
Abstract
Although the scientific community has focused on the effects of concussions in contact sports, the role of subconcussive impacts, as it can occur during soccer heading, has recently gained attention, considering that it may represent an additional mechanism of cumulative brain injury. The aim of this study is to investigate the effects of soccer heading on cognitive functioning in active professional soccer players. Male soccer players (n = 44), from two soccer teams that play in the Brazilian A Series Championship, and non-athletes (n = 47), comparable in age and education, were submitted to cognitive assessment, consisting of computerized and conventional neuropsychological testing (Neupsilin battery). In the computerized cognitive assessment, soccer players performed better than controls on reaction time measures in general motor coordination, executive functioning and memory tests, and on accuracy measures in executive functioning tests. There were no significant differences between groups on the Neupsilin battery. A comparison between two sub-groups of soccer players, based on the self-reported number of headings, did not show significant differences on tests performance. No significant correlations were found between an estimate of exposure to heading during professional soccer career and cognitive performance. Our data demonstrate no evidence of cognitive impairment in soccer players, compared to non-athletes, and no association between heading exposure and performance on neuropsychological tests. Longitudinal investigations, including neuroimaging assessment, will help to clarify whether soccer heading may be associated with brain injury and cognitive dysfunction.
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Affiliation(s)
- Ana Carolina Rodrigues
- Pró-Reitoria de Graduação, Reitoria da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mariana Drummond Martins Lima
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leonardo Cruz de Souza
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Celso Furtado
- Departamento Médico do América Futebol Clube, Belo Horizonte, Brazil
| | | | - Lucas Gonçalves
- Departamento de Análise de Desempenho do Clube Atlético Mineiro, Belo Horizonte, Brazil
| | | | - Rodrigo Pace Lasmar
- Departamento Médico do Clube Atlético Mineiro, Belo Horizonte, Brazil.,Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Paulo Caramelli
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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42
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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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43
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Abstract
OBJECTIVE To examine variation in head impact exposure (HIE) by age and sex in youth soccer. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS Youth soccer athletes (11-14 years old) in local clubs. EXPOSURES Age and sex. OUTCOME MEASURES Head impact exposure measured using adhesive-mounted accelerometers during 1 month of soccer. RESULTS Forty-six youth athletes (54% female) participated. No athlete reported a concussion during the study. More males than females had at least 1 head impact ≥15 g (P = 0.02). Of those who sustained a head impact above the 15-g threshold (57%), females sustained HIE of greater magnitude than males (median 47.4 g vs 33.3 g, P = 0.04). Eighty-five percent of athletes on U14 teams had at least 1 head impact ≥15 g compared with 15% of athletes on U12 teams (P < 0.001). Poisson regression stratified by sex and controlling for team-suggested age effects were significant only for females (P = 0.02). There was significant variation in HIE by team. There were no decrements in concussion symptoms, health-related quality of life, or neuropsychological testing after 1 month of soccer play. CONCLUSIONS There is significant variation in HIE in youth soccer, which seems to be influenced by age and sex. Further studies are needed to better understand potential significance for injury prevention.
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44
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Mainwaring L, Ferdinand Pennock KM, Mylabathula S, Alavie BZ. Subconcussive head impacts in sport: A systematic review of the evidence. Int J Psychophysiol 2018; 132:39-54. [DOI: 10.1016/j.ijpsycho.2018.01.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 01/10/2018] [Accepted: 01/11/2018] [Indexed: 12/18/2022]
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45
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Harriss A, Johnson AM, Walton DM, Dickey JP. The number of purposeful headers female youth soccer players experience during games depends on player age but not player position. SCI MED FOOTBALL 2018. [DOI: 10.1080/24733938.2018.1506591] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Alexandra Harriss
- School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
- Health and Rehabilitation Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Andrew M. Johnson
- School of Health Studies, The University of Western Ontario, London, Ontario, Canada
| | - David M. Walton
- School of Physical Therapy, The University of Western Ontario, London, Ontario, Canada
- Health and Rehabilitation Sciences, The University of Western Ontario, London, Ontario, Canada
| | - James P. Dickey
- School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
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46
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Eckner JT, O'Connor KL, Broglio SP, Ashton-Miller JA. Comparison of Head Impact Exposure Between Male and Female High School Ice Hockey Athletes. Am J Sports Med 2018; 46:2253-2262. [PMID: 29856659 DOI: 10.1177/0363546518777244] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Concussion incidence rates are higher among female than male athletes in sports played by both sexes. Biomechanical factors may play a role in observed sex-based differences in concussion incidence. PURPOSE To compare head impact counts and magnitudes during sports participation between male and female high school ice hockey athletes. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Over 2 seasons, a total of 21 male and 19 female ice hockey athletes from a single high school were instrumented with impact-sensing adhesive skin patches worn over the mastoid process while participating in games and practices. The impact sensors recorded the number, magnitude (peak linear acceleration [PLA, g] and peak angular acceleration [PAA, rad/s2] of the head; Head Impact Telemetry severity profile [HITsp]), and location of impacts sustained during each instrumented session. Head impact counts, magnitudes, and locations were compared between the sexes. RESULTS Males experienced more head impacts than females during games (mean ± SD: 7.7 ± 3.0 vs 5.3 ± 2.0, P < .001) as well as practices (4.3 ± 1.6 vs 3.8 ± 1.1, P = .002). Mean impact magnitudes were greater for females for PLA (18.8 g ± 1.7 g vs 17.1 g ± 1.6 g, P < .001) and HITsp (19.7 ± 1.5 vs 17.7 ± 1.4, P < .001), while mean PAA was greater for males (3057.6 ± 2.0 rad/s2 vs 2778.3 ± 2.7 rad/s2, P < .001). Female athletes experienced higher PLA, PAA, and HITsp magnitudes for the top 10%, 5%, and 1% of impacts (all P < .050). Males experienced more impacts to the front (34.3%) and back (31.7%) of the head, while females experienced more impacts to the side (43.1%) and top (4.1%) (χ2 = 295.70, df = 3, P < .001). CONCLUSION While male high school ice hockey athletes experienced more head impacts than females, impact magnitudes tended to be higher for females.
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Affiliation(s)
- James T Eckner
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Steven P Broglio
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - James A Ashton-Miller
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, USA
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47
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King DA, Hume PA, Gissane C, Kieser DC, Clark TN. Head impact exposure from match participation in women’s rugby league over one season of domestic competition. J Sci Med Sport 2018; 21:139-146. [DOI: 10.1016/j.jsams.2017.10.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 06/29/2017] [Accepted: 10/17/2017] [Indexed: 10/18/2022]
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48
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Lamond LC, Caccese JB, Buckley TA, Glutting J, Kaminski TW. Linear Acceleration in Direct Head Contact Across Impact Type, Player Position, and Playing Scenario in Collegiate Women's Soccer Players. J Athl Train 2018; 53:115-121. [PMID: 29373056 DOI: 10.4085/1062-6050-90-17] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Heading, an integral component of soccer, exposes athletes to a large number of head impacts over a career. The literature has begun to indicate that cumulative exposure may lead to long-term functional and psychological deficits. Quantifying an athlete's exposure over a season is a first step in understanding cumulative exposure. OBJECTIVE To measure the frequency and magnitude of direct head impacts in collegiate women's soccer players across impact type, player position, and game or practice scenario. DESIGN Cross-sectional study. SETTING National Collegiate Athletic Association Division I institution. PATIENTS OR OTHER PARTICIPANTS Twenty-three collegiate women's soccer athletes. MAIN OUTCOME MEASURE(S) Athletes wore Smart Impact Monitor accelerometers during all games and practices. Impacts were classified during visual, on-field monitoring of athletic events. All direct head impacts that exceeded the 10 g threshold were included in the final data analysis. The dependent variable was linear acceleration, and the fixed effects were (1) type of impact: clear, pass, shot, unintentional deflection, or head-to-head contact; (2) field position: goalkeeper, defense, forward, or midfielder; (3) playing scenario: game or practice. RESULTS Shots (32.94 g ± 12.91 g, n = 38; P = .02) and clears (31.09 g ± 13.43 g, n = 101; P = .008) resulted in higher mean linear accelerations than passes (26.11 g ± 15.48 g, n = 451). Head-to-head impacts (51.26 g ± 36.61 g, n = 13; P < .001) and unintentional deflections (37.40 g ± 34.41 g, n = 24; P = .002) resulted in higher mean linear accelerations than purposeful headers (ie, shots, clears, and passes). No differences were seen in linear acceleration across player position or playing scenario. CONCLUSIONS Nonheader impacts, including head-to-head impacts and unintentional deflections, resulted in higher mean linear accelerations than purposeful headers, including shots, clears, and passes, but occurred infrequently on the field. Therefore, these unanticipated impacts may not add substantially to an athlete's cumulative exposure, which is a function of both frequency and magnitude of impact.
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Affiliation(s)
- Lindsey C Lamond
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark
| | - Jaclyn B Caccese
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark
| | - Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark
| | | | - Thomas W Kaminski
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark
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49
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Harriss A, Walton DM, Dickey JP. Direct player observation is needed to accurately quantify heading frequency in youth soccer. Res Sports Med 2018; 26:191-198. [DOI: 10.1080/15438627.2018.1431534] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - David M. Walton
- School of Physical Therapy, Western University, Elborn College, London, ON, Canada
| | - James P. Dickey
- School of Kinesiology, Western University, London, ON, Canada
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50
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Caccese JB, Buckley TA, Tierney RT, Rose WC, Glutting JJ, Kaminski TW. Sex and age differences in head acceleration during purposeful soccer heading. Res Sports Med 2017; 26:64-74. [PMID: 29067816 DOI: 10.1080/15438627.2017.1393756] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Differences in head-neck segment mass, purposeful heading technique, and cervical strength and stiffness may contribute to differences in head accelerations across sex and age. The purpose of this study was to compare head acceleration across sex and age (youth [12-14 years old], high school and collegiate) during purposeful soccer heading. One-hundred soccer players (42 male, 58 female, 17.1 ± 3.5 years, 168.5 ± 20.3 cm, 61.5 ± 13.7 kg) completed 12 controlled soccer headers at an initial ball velocity of 11.2 m/s. Linear and rotational accelerations were measured using a triaxial accelerometer and gyroscope and were transformed to the head centre-of-mass. A MANOVA revealed a significant multivariate main effect for sex (Pillai's Trace = .165, F(2,91) = 11.868, p < .001), but not for age (Pillai's Trace = .033, F(4,182) = 0.646, p = .630). Peak linear and rotational accelerations were higher in females (40.9 ± 13.3 g; 3279 ± 1065 rad/s2) than males (27.6 ± 8.5 g, 2219 ± 823 rad/s2). These data suggest that under controlled soccer heading conditions, females may be exposed to higher head accelerations than males.
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Affiliation(s)
- Jaclyn B Caccese
- a Department of Kinesiology and Applied Physiology , University of Delaware , Newark , DE , USA.,b Biomechanics and Movement Science Interdisciplinary Program , University of Delaware , Newark , DE , USA
| | - Thomas A Buckley
- a Department of Kinesiology and Applied Physiology , University of Delaware , Newark , DE , USA.,b Biomechanics and Movement Science Interdisciplinary Program , University of Delaware , Newark , DE , USA
| | - Ryan T Tierney
- c Department of Kinesiology , Temple University , Philadelphia , PA , USA
| | - William C Rose
- a Department of Kinesiology and Applied Physiology , University of Delaware , Newark , DE , USA.,b Biomechanics and Movement Science Interdisciplinary Program , University of Delaware , Newark , DE , USA
| | | | - Thomas W Kaminski
- a Department of Kinesiology and Applied Physiology , University of Delaware , Newark , DE , USA.,b Biomechanics and Movement Science Interdisciplinary Program , University of Delaware , Newark , DE , USA
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