Systematic review and meta-analysis of the effects of football heading

Kontos, Anthony P.; Braithwaite, Rock; Chrisman, Sara P D; McAllister-Deitrick, Jamie; Symington, Larissa; Reeves, Valerie L.; Collins, Michael W.

doi:10.1136/bjsports-2016-096276

Cited by 68 publications

(60 citation statements)

References 48 publications

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“…Football is the only sport, in which players purposefully use the head to play the ball. 1 In recent years, short-and long-term consequences of playing football and the effect of heading on brain structure and function have been debated in professional football, [1][2][3][4][5][6][7][8] but more specifically in youth players. [9][10][11][12][13][14] In detail, four systematic reviews on the effects of football heading found no overall effect for heading on adverse outcomes; the consequences of repetitive heading to be unclear and various methodological shortcomings limit the evidence for persistent effects on brain structure/function.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11][12][13][14] In detail, four systematic reviews on the effects of football heading found no overall effect for heading on adverse outcomes; the consequences of repetitive heading to be unclear and various methodological shortcomings limit the evidence for persistent effects on brain structure/function. 3,4,6,8 The consensus statement of the head injury summit described that acute or chronic neurocognitive effects from heading are elusive, also due to different research methodologies. 5 Other research on retired football players and heading may suggest that changes are reversible or that heading may not be as harmful as commonly thought.…”

Section: Introductionmentioning

confidence: 99%

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The UEFA Heading Study: Heading incidence in children’s and youth’ football (soccer) in eight European countries

Beaudouin

Gioftsidou

Larsen

et al. 2020

Scandinavian Med Sci Sports

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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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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The UEFA Heading Study: Heading incidence in children’s and youth’ football (soccer) in eight European countries

Beaudouin

Gioftsidou

Larsen

et al. 2020

Scandinavian Med Sci Sports

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“…The first studies on the topic were conducted in the early 1990s by Tysvaer and Lochen (1991), who found mild to severe neuropsychologic deficits in former soccer players compared to a control group, with a higher prevalence of impairment in "typical headers". However, more recently, two systematic reviews on the topic involving mostly active soccer players found no convincing evidence for this association (Kontos et al, 2017;Tarnutzer, Straumann, Brugger, & Feddermann-Demont, 2017). Interestingly, both meta-analyses noted that studies involving more senior or retired athletes were more likely to report adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Ageing in Top-Level Female Soccer Players Compared to a Normative Sample from the General Population: A Cross-sectional Study

Prien

Besuden

Junge

et al. 2020

J Int Neuropsychol Soc

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Objective: There is an ongoing debate on the potential negative effect of contact sport participation on long-term neurocognitive performance due to inherent exposure to concussive and subconcussive head impacts. The aim of the present study was to investigate whether cognitive ageing is exacerbated in elite soccer players compared to the general population. Method: Neurocognitive performance in 6 domains was compared between 240 elite soccer players and a normative sample from the general population (n = 585) using the computerised test battery CNS Vital Signs. We used two-way factorial ANOVA to analyse the interaction between age groups (15–19, 20–29, 30–39, 40–49 years) and study population (female soccer players vs. norm sample) in their effects on neurocognitive performance. Results: We found no significant interaction effect of age group and study population in five of six test domains. For processing speed, the effect of age was more pronounced in female soccer players (F = 16.89, p = .002). Further, there was a clear main effect of study population on neurocognitive performance with generally better scores in soccer players. Conclusions: Elite female soccer players generally performed better than the norm sample on tests of cognitive function, and further, cognitive ageing effects were similar in elite soccer players and controls in all but one domain. A lifespan approach may facilitate insightful future research regarding questions related to long-term neurocognitive health in contact sport athletes.

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“…Der kürzlich veröffentlichte systematische Review von Maher et al (2014) bestätig-te den bisherigen Stand der Forschung, dass der Einfluss des Kopfballspiels auf kognitive Fähigkeiten der Fußballspieler unklar ist [36]. Eine weitere Metaanalyse aus dem Jahre 2016 bestätigte zusätzlich, dass aktuell keine ungünstigen Folgen durch das Kopfballspiel nachzuweisen sind [31]. Speziell die schwache Methodik der vorliegenden Studien zu diesem Thema ist von Tarnutzer et al (2016) geschlussfolgert worden, wobei speziell der Nachweis, dass bestimmte klinisch-kognitive oder radiologisch-strukturelle Veränderungen am Gehirn nur sehr schwach mit dem Kopfballspiel und seiner Frequenz und Intensität in Zusammenhang gebracht werden können [54].…”

Section: Kopfballspiel Und Folgen Für Die Spielerunclassified

Prävention von Gehirnerschütterungen im Juniorenfußball – Ist eine Abschaffung des Kopfballspiels notwendig?

Krutsch¹,

Krutsch²,

Jansen³

et al. 2017

Sportverletz Sportschaden

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Football, the most popular sports worldwide, is associated with a high number of injuries. Head and brain injuries in football are less frequent, but may result in severe long-term damage. The mechanisms of these injuries in football are multifactorial, and the ball is rarely the main cause of a head injury. Short-term, medium-term and long-term consequences of headings in football are insufficiently examined, and there are hardly any case reports about severe episodes. Heading has been banned in US junior football since November 2015, which is understandable considering the higher risk for head injuries in popular American sports such as ice hockey or American football and people's fear associated with this risk. However, the decision to ban heading in football is not based on scientific results, and different experiences have been made in European football. Therefore, this decision should not simply be transferred to Europe. In fact, other injury prevention strategies for head injuries in junior football are necessary, such as the adaptation of ball sizes, which has already been implemented. It is not necessary to change match rules in the form of a general ban on heading in football. Further scientific studies are needed for standardisation in football worldwide.

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Systematic review and meta-analysis of the effects of football heading

Abstract: We provide the first meta-analytical review of football heading effects aggregated from multiple studies and extended findings from a recent systematic review of the effects of football heading. Our analysis indicates no overall effect for heading a football on adverse outcomes.

Cited by 68 publications

References 48 publications

The UEFA Heading Study: Heading incidence in children’s and youth’ football (soccer) in eight European countries

The UEFA Heading Study: Heading incidence in children’s and youth’ football (soccer) in eight European countries

Cognitive Ageing in Top-Level Female Soccer Players Compared to a Normative Sample from the General Population: A Cross-sectional Study

Prävention von Gehirnerschütterungen im Juniorenfußball – Ist eine Abschaffung des Kopfballspiels notwendig?

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