Heading in Football: Incidence, Biomechanical Characteristics and the Association with Acute Cognitive Function—A Three-Part Systematic Review

McCunn, Robert; Beaudouin, Florian; Stewart, Katy; Meyer, Tim; Maclean, John

doi:10.1007/s40279-021-01492-z

Cited by 23 publications

(33 citation statements)

References 83 publications

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“…examined twelve studies that conducted on-field research with youth and collegiate soccer players. 31 Most studies focused on games as the optimal setting to record heading activity, leaving a paucity of practice data even though practice usually represent a larger percentage of heading exposure as players age. 4 Additionally, 8 of the 12 field studies focused on youth athletes, indicating a need to further investigate header biomechanics in older players, including university/collegiate athletes.…”

Section: Introductionmentioning

confidence: 99%

Head Impact Exposure and Biomechanics in University Varsity Women’s Soccer

et al. 2022

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Soccer is a unique sport where players purposefully and voluntarily use their unprotected heads to manipulate the direction of the ball. There are limited soccer head impact exposure data to further study brain injury risks. The objective of the current study was to combine validated mouthpiece sensors with comprehensive video analysis methods to characterize head impact exposure and biomechanics in university varsity women’s soccer. Thirteen female soccer athletes were instrumented with mouthpiece sensors to record on-field head impacts during practices, scrimmages, and games. Multi-angle video was obtained and reviewed for all on-field activity to verify mouthpiece impacts and identify contact scenarios. We recorded 1307 video-identified intentional heading impacts and 1011 video-verified sensor impacts. On average, athletes experienced 1.83 impacts per athlete-exposure, with higher exposure in practices than games/scrimmages. Median and 95th percentile peak linear and peak angular accelerations were 10.0, 22.2 g, and 765, 2296 rad/s 2 , respectively. Long kicks, top of the head impacts and jumping headers resulted in the highest impact kinematics. Our results demonstrate the importance of investigating and monitoring head impact exposure during soccer practices, as well as the opportunity to limit high-kinematics impact exposure through heading technique training and reducing certain contact scenarios.

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Section: Introductionmentioning

confidence: 99%

Head Impact Exposure and Biomechanics in University Varsity Women’s Soccer

et al. 2022

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“…While heading has always been an integral part of football, there is growing uncertainty surrounding the role repeated head impacts from football heading has on brain health [ 1 ]. A recent cohort study reported that Scottish male professional football players ( n = 7676) were more likely (hazard ratio 3.66; 95% confidence interval [CI] 2.88–4.65; p < 0.001) to be identified with a neurodegenerative disease when compared with matched controls ( n = 23,028) from the general population [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of the FIFA 11 + with Added Neck Exercises on Maximal Isometric Neck Strength and Peak Head Impact Magnitude During Heading: A Pilot Study

et al. 2021

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Background Higher neck strength has been postulated to reduce head impact magnitude during purposeful heading in football. Objectives This pilot trial explored the effect of a neck exercise programme on (1) neck strength and (2) head impact magnitude during heading in male and female adolescent football players. Methods Boys and girls (aged 12–17 years) were randomised by team to the intervention (5 weeks of supervised neuromuscular neck exercises integrated into part 2 of the FIFA 11 + , completed three times per week) or the control group (usual part 2 of the FIFA 11 + , no neck exercises). Outcomes included isometric neck strength and head impact magnitude (peak linear acceleration and peak angular velocity) during standardised heading from a throw-in (at baseline and 6 weeks) plus completion of an evaluation survey by intervention players and coaches. Results In total, 52 players ( n = 31 intervention; n = 21 control) completed the study. Mixed-model analysis of variance (ANOVA) revealed significant differences in neck strength variables ( p < 0.001), peak linear acceleration ( p = 0.04) and peak angular velocity ( p = 0.04) between the intervention and control groups over time. Intervention players demonstrated increases in mean composite neck strength (53.8% intervention vs 15.6% control) as well as decreases in mean peak linear head acceleration during heading (− 11.8% vs − 5.0%) from baseline to follow-up. Reduction in peak angular velocity was more pronounced in girls (− 27.7%) than boys (− 11.5%) in the intervention group. The addition of neck exercises into part 2 of the FIFA 11 + was feasible and accepted by players and coaches. Conclusion On average, players who completed neck exercises demonstrated an increase in isometric neck strength and a decrease in head impact magnitude during heading. These exercises were easily incorporated into usual training. Australian New Zealand Clinical Trials Registry (no: ACTRN12619001375145). Supplementary Information The online version contains supplementary material available at 10.1007/s40279-021-01564-0.

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“…Indeed, a systematic review has highlighted the lack of studies evaluating the long-term effect of heading on cognitive performance. 27 A further study assessing the effect of soccer heading on diffusion tension images and cognitive function found no significant difference in terms of microstructural features and cognitive performance between non-athlete participants unexposed to heading and amateur soccer players with high exposure. 28 However, the players enrolled in this study were, again, of relatively young age (25.5±7.2), which could limit its long-term relevance.…”

Section: Introductionmentioning

confidence: 93%

“…However, this study did not have a follow-up period, and soccer players were relatively young (average age of 24.6±4.5 years), meaning that any cumulative effects of heading across a player’s career. Indeed, a systematic review has highlighted the lack of studies evaluating the long-term effect of heading on cognitive performance 27. A further study assessing the effect of soccer heading on diffusion tension images and cognitive function found no significant difference in terms of microstructural features and cognitive performance between non-athlete participants unexposed to heading and amateur soccer players with high exposure 28.…”

Section: Introductionmentioning

confidence: 99%

Cerebral and cognitive modifications in retired professional soccer players: TC-FOOT protocol, a transverse analytical study

et al. 2022

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IntroductionSoccer is the most popular sport in the world. This contact sport carries the risk of exposure to repeated head impacts in the form of subconcussions, defined as minimal brain injuries following head impact, with no symptom of concussion. While it has been suggested that exposure to repetitive subconcussive events can result in long-term neurophysiological modifications, and the later development of chronic traumatic encephalopathy, the consequences of these repeated impacts remain controversial and largely unexplored in the context of soccer players.Methods and analysisThis is a prospective, single-centre, exposure/non-exposure, transverse study assessing the MRI and neuropsychological abnormalities in professional retired soccer players exposed to subconcussive impacts, compared with high-level athletes not exposed to head impacts. The primary outcome corresponds to the results of MRI by advanced MRI techniques (diffusion tensor, cerebral perfusion, functional MRI, cerebral volumetry and cortical thickness, spectroscopy, susceptibility imaging). Secondary outcomes are the results of the neuropsychological tests: number of errors and time to complete tests. We hypothesise that repeated subconcussive impacts could lead to morphological lesions and impact on soccer players’ cognitive skills in the long term.Ethics and disseminationEthics approval has been obtained and the study was approved by the Comité de Protection des Personnes (CPP) No 2021-A01169-32. Study findings will be disseminated by publication in a high-impact international journal. Results will be presented at national and international imaging meetings.Trial registration numberNCT04903015.

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Heading in Football: Incidence, Biomechanical Characteristics and the Association with Acute Cognitive Function—A Three-Part Systematic Review

Cited by 23 publications

References 83 publications

Head Impact Exposure and Biomechanics in University Varsity Women’s Soccer

Head Impact Exposure and Biomechanics in University Varsity Women’s Soccer

The Effect of the FIFA 11 + with Added Neck Exercises on Maximal Isometric Neck Strength and Peak Head Impact Magnitude During Heading: A Pilot Study

Cerebral and cognitive modifications in retired professional soccer players: TC-FOOT protocol, a transverse analytical study

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