Abstract:
The activity most frequently associated with concussions in soccer is the act of heading the ball. Understanding the extent to which soccer heading can affect the brain and concerns over the cumulative effects of multiple concussions in sport have raised awareness among clinicians. PURPOSE: The purpose of this study was to assess the effects of an acute bout of purposeful heading in female soccer players with a history of concussion, on measures of balance and neuropsychological function. METHODS: A total of 24 college-aged soccer players with >4 years of competitive experience participated. Subjects were allocated to one of four groups: control (CON) and experimental group (EXP0) had no history of concussion, subjects with 1-2 previous concussions (EXP1), and those with 3 or more concussions (EXP2). Baseline session measurements included Concussion Symptom Checklist, ImPACT neuropsychological testing, and balance testing using the Balance Error Scoring System (BESS). For the soccer heading trials, subjects in EXP0, EXP1, and EXP2 were asked to head 20 soccer balls delivered from a JUGS soccer machine at a speed of 65 km/h at 80′. Subjects in the CON stood at the ready, but did not head the ball. Immediately upon concluding the heading session, subjects were re-tested on each of the baseline measurements. Group differences were assessed using repeated measures ANOVA techniques on each of the three dependent variables (concussion symptoms, ImPACT composite scores, and BESS scores) between sessions. RESULTS: Concussion-related symptoms were elevated in 3 of the 4 groups (exception CON) post-heading. There were no significant interactions or main effects for any of the ImPACT composite scores. There was however, a significant group by time interaction for the BESS (dual stance/firm condition), indicating that EXP2 had more errors post-heading than any of the other 3 groups. CONCLUSION: Balance deficits appeared following an acute bout of heading in a group of soccer players reporting 3 or more previous concussions. Perhaps those who have suffered multiple concussions in the past, should be carefully monitored during the course of a soccer match and use caution when heading the soccer ball. Although all groups demonstrated elevated concussion-like symptoms post-heading, the question remains as to how long these linger.