Neuropsychological impairment as a consequence of football (soccer) play and football heading: a preliminary analysis and report on school students (13-16 years).
ABSTRACT Footballers run the risk of incurring mild head injury from a variety of sources, including the intentional use of the head to play the ball, known as heading. This paper presents a preliminary exploratory analysis of data collected to examine whether cumulative incidence of mild head injury, or cumulative heading frequency, are related to neuropsychological functioning in male adolescent footballers. In a quasi-experimental cross-sectional design, neuropsychological test scores of school team footballers were compared with those of similarly aged rugby players and noncontact sport players. Cumulative mild head injury incidence was estimated using self-reports, and cumulative heading was estimated using a combination of observation and self-reports. No participants had sustained a head injury within 3 months of testing. There was no relationship between head injury and neuropsychological performance, and there were no decrements in either the footballers or the rugby players in comparison with the noncontact sport players. Within the footballers, cumulative heading did not predict any of the neuropsychological test scores. These findings indicate the absence of neuropsychological impairment arising due to cumulative mild head injury incidence, or cumulative heading. Although these null findings may be reassuring to players, parents, and football organizers, we stress that they are preliminary. Further data is being collected from the same populations to provide more reliable effect estimates.
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ABSTRACT: Abstract Background: Soccer is currently the most popular and fastest-growing sport worldwide. Similar to many sports, soccer carries an inherent risk of injury, including concussion. Soccer is also unique in the use of 'heading'. The present paper provides a comprehensive review of the research examining the incidence, mechanisms, biomarkers of injury and neurocognitive outcomes of concussions and heading in soccer. Methods: Seven databases were searched for articles from 1806 to 24 May 2013. Articles obtained by the electronic search were reviewed for relevance, with 229 selected for review. Ultimately, 49 articles met criteria for inclusion in the present review. Results: Female soccer players have a higher incidence of concussions than males. The most frequent injury mechanism is player-to-player contact for both genders. Few studies examined the effects of concussion in soccer players; however, neurocognitive outcomes were similar to those reported in the larger sport concussion literature, while the effect of heading is less clear. Conclusion: Despite variation in research designs and study characteristics, the outcomes of concussions in soccer align with the greater concussion literature. This review makes recommendations for future research to increase standardization of research for improved understanding of concussions in soccer as well as the effects of heading.Brain Injury 01/2014; · 1.51 Impact Factor
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ABSTRACT: Purpose:To investigate the association of soccer heading with subclinical evidence of traumatic brain injury.Materials and Methods:With institutional review board approval and compliance with HIPAA guidelines, 37 amateur soccer players (mean age, 30.9 years; 75%  men, 25% [nine] women) gave written informed consent and completed a questionnaire to quantify heading in the prior 12 months and lifetime concussions. Diffusion-tensor magnetic resonance (MR) imaging at 3.0 T was performed (32 directions; b value, 800 sec/mm(2); 2 × 2 × 2-mm voxels). Cognitive function was measured by using a computerized battery of tests. Voxelwise linear regression (heading vs fractional anisotropy [FA]) was applied to identify significant regional associations. FA at each location and cognition were tested for a nonlinear relationship to heading by using an inverse logit model that incorporated demographic covariates and history of concussion.Results:Participants had headed 32-5400 times (median, 432 times) over the previous year. Heading was associated with lower FA at three locations in temporo-occipital white matter with a threshold that varied according to location (885-1550 headings per year) (P < .00001). Lower levels of FA were also associated with poorer memory scores (P < .00001), with a threshold of 1800 headings per year. Lifetime concussion history and demographic features were not significantly associated with either FA or cognitive performance.Conclusion:Heading is associated with abnormal white matter microstructure and with poorer neurocognitive performance. This relationship is not explained by a history of concussion.© RSNA, 2013.Radiology 06/2013; · 6.21 Impact Factor
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ABSTRACT: Development of a functional in-vivo head impact testing model would enhance the ability to elucidate mechanisms underlying individual responses to head impact in sports where a helmet is not worn. The objective of this paper is to describe a novel in-vivo method of assessing human head linear impact acceleration during the functional activity of soccer heading, using a repeated-measures design in a university research laboratory. 17 college-aged soccer players (age, 20.93 years (standard deviation (SD), 1.17 years); height, 170.39cm (SD, 10.15cm); mass, 71.50kg (SD, 9.89kg); head—neck mass, 5.90kg (SD, 0.83kg)) participated in this study. All participants read and signed a university Institutional-Review-Board-approved informed consent before participating.Proceedings of the Institution of Mechanical Engineers Part P Journal of Sports Engineering and Technology 09/2009; 223(3):117-123. · 0.53 Impact Factor