Association football injuries to the brain. A preliminary report.

Tysvaer, A; Storli, O. V.

doi:10.1136/bjsm.15.3.163

Cited by 77 publications

(42 citation statements)

References 14 publications

(15 reference statements)

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“…37 Top-level male soccer athletes are estimated to experience an average of 6.6 impacts per game, or 2000 head balls during games across their careers. 38 The amount of head-ball exposure during practices is unknown in this group. More recent research, however, has shown that collegiate female soccer athletes received a similar number of head balls during games (7 per game) and 3.5 headers during practice sessions.…”

Section: Discussionmentioning

confidence: 99%

Football Players' Head-Impact Exposure After Limiting of Full-Contact Practices

Broglio

Williams

O’Connor

et al. 2016

Journal of Athletic Training

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Context: Sporting organizations limit full-contact football practices to reduce concussion risk and based on speculation that repeated head impacts may result in long-term neurodegeneration.Objective: To directly compare head-impact exposure in high school football players before and after a statewide restriction on full-contact practices.Design: Cross-sectional study. Setting: High school football field.Patients or Other Participants: Participants were varsity football athletes from a single high school. Before the rule change, 26 athletes (age ¼ 16.2 6 0.8 years, height ¼ 179.6 6 6.4 cm, weight ¼ 81.9 6 13.1 kg) participated. After the rule change, 24 athletes (age ¼ 15.9 6 0.8 years, height ¼ 178.3 6 6.5 cm, weight ¼ 76.2 6 11.6 kg) participated. Nine athletes participated in both years of the investigation.Main Outcome Measure(s): Head-impact exposure was monitored using the Head Impact Telemetry System while the athletes participated in football games and practices in the seasons before and after the rule change. Head-impact frequency, location, and magnitude (ie, linear acceleration, rotational acceleration, and Head Impact Telemetry severity profile [HITsp], respectively) were measured.Results: A total of 15 398 impacts (592 impacts per player per season) were captured before the rule change and 8269 impacts (345 impacts per player per season) after the change. An average 42% decline in impact exposure occurred across all players, with practice-exposure declines occurring among linemen (46% decline); receivers, cornerbacks, and safeties (41% decline); and tight ends, running backs (including fullbacks), and linebackers (39% decline). Impact magnitudes remained largely unchanged between the years.Conclusions: A rule change limiting full-contact high school football practices appears to have been effective in reducing head-impact exposure across all players, with the largest reduction occurring among linemen. This finding is likely associated with the rule modification, particularly because the coaching staff and offensive scheme remained consistent, yet how this reduction influences concussion risk and long-term cognitive health remains unknown.Key Words: concussions, traumatic brain injuries, protective equipment Key PointsWhen full-contact high school practices were restricted to no more than 2 days per week, head impacts declined by 42%. The decline varied by player position; linemen experienced the largest reduction. The coaching staff and offensive scheme remained unchanged, so the rule change is likely responsible for the decline in head impacts. R epetitive concussive and nonconcussive head impacts are speculated to result in long-term neurodegenerative disease. 1 The proposed model suggests that each impact results in the deposition of phosphorylated s protein in the depths of the cerebral sulci that accumulates over time, causing impaired cognitive functioning. Many conclusions have been drawn from observational data, and American football has attracted the most attention, leading sporting organiz...

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Section: Discussionmentioning

confidence: 99%

Football Players' Head-Impact Exposure After Limiting of Full-Contact Practices

Broglio

Williams

O’Connor

et al. 2016

Journal of Athletic Training

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“…Frequently heading a soccer ball has been discussed as a source of subconcussive head impact in soccer (Koerte et al 2012(Koerte et al , 2015bLipton and Kim 2013;Jordan et al 1996). On average, professional soccer players perform 6-12 headings per game, resulting in thousands of headings over a player's career (Ekblom 1986;Rutherford et al 2009;Straume-Naesheim et al 2005;Tysvaer and Storli 1981). Because there is often no clinical manifestation, subconcussive head impacts are often thought to be harmless.…”

Section: Tmt a Trailmaking Test A Tmt B Trailmaking Test Bmentioning

confidence: 98%

Cortical thinning in former professional soccer players

Koerte

Mayinger

Muehlmann

et al. 2015

Brain Imaging and Behavior

127

113

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Soccer is the most popular sport in the world. Soccer players are at high risk for repetitive subconcussive head impact when heading the ball. Whether this leads to long-term alterations of the brain's structure associated with cognitive decline remains unknown. The aim of this study was to evaluate cortical thickness in former professional soccer players using high-resolution structural MR imaging. Fifteen former male professional soccer players (mean age 49.3 [SD 5.1] years) underwent high-resolution structural 3 T MR imaging, as well as cognitive testing. Fifteen male, age-matched former professional non-contact sport athletes (mean age 49.6 [SD 6.4] years) served as controls. Group analyses of cortical thickness were performed using voxel-based statistics. Soccer players demonstrated greater cortical thinning with increasing age compared to controls in the right inferolateral-parietal, temporal, and occipital cortex. Cortical thinning was associated with lower cognitive performance as well as with estimated exposure to repetitive subconcussive head impact. Neurocognitive evaluation revealed decreased memory performance in the soccer players compared to controls. The association of cortical thinning and decreased cognitive performance, as well as exposure to repetitive subconcussive head impact, further supports the hypothesis that repetitive subconcussive head impact may play a role in early cognitive decline in soccer players. Future studies are needed to elucidate the time course of changes in cortical thickness as well as their association with impaired cognitive function and possible underlying neurodegenerative process.

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“…The estimated cumulative linear (6192g) and rotational (415,036.8 rad/sec 2 ) accelerations were far below those recorded in our high school football cohort. Similarly, elite soccer athletes have been reported to sustain an average of 6.6 head balls per game (Tsyvaer and Storli, 1981). This results in approximately 264 head balls during a 40-game regular season.…”

Section: Football Head Impactsmentioning

confidence: 99%

Cumulative Head Impact Burden in High School Football

Broglio

Eckner

Martini

et al. 2011

Journal of Neurotrauma

198

182

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Impacts to the head are common in collision sports such as football. Emerging research has begun to elucidate concussion tolerance levels, but sub-concussive impacts that do not result in clinical signs or symptoms of concussion are much more common, and are speculated to lead to alterations in cerebral structure and function later in life. We investigated the cumulative number of head impacts and their associated acceleration burden in 95 high school football players across four seasons of play using the Head Impact Telemetry System (HITS). The 4-year investigation resulted in 101,994 impacts collected across 190 practice sessions and 50 games. The number of impacts per 14-week season varied by playing position and starting status, with the average player sustaining 652 impacts. Linemen sustained the highest number of impacts per season (868); followed by tight ends, running backs, and linebackers (619); then quarterbacks (467); and receivers, cornerbacks, and safeties (372). Post-impact accelerations of the head also varied by playing position and starting status, with a seasonal linear acceleration burden of 16,746.1g, while the rotational acceleration and HIT severity profile burdens were 1,090,697.7 rad/sec 2 and 10,021, respectively. The adolescent athletes in this study clearly sustained a large number of impacts to the head, with an impressive associated acceleration burden as a direct result of football participation. These findings raise concern about the relationship between sub-concussive head impacts incurred during football participation and late-life cerebral pathogenesis, and justify consideration of ways to best minimize impacts and mitigate cognitive declines.

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Association football injuries to the brain. A preliminary report.

Cited by 77 publications

References 14 publications

Football Players' Head-Impact Exposure After Limiting of Full-Contact Practices

Football Players' Head-Impact Exposure After Limiting of Full-Contact Practices

Cortical thinning in former professional soccer players

Cumulative Head Impact Burden in High School Football

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