Postural Sway And Neuropsychological Test Performance Following An Acute Bout Of Soccer Heading

Journal of Athletic Training. -


McHugh, L. V., J. J. Glutting and T. W. Kaminski.



Context: Soccer is a contact sport and therefore the participants risk injury, including head injuries. Interestingly, the activity most frequently associated with concussions is the act of heading the ball. Objective: The purpose of this study was to determine if there are any changes in concussion symptoms, neuropsychological test performance, and balance after an acute bout of purposeful soccer heading in players with and without prior history of concussion. Design: A pretest-posttest groups design. Setting: Soccer heading analysis occurred in a climate-controlled athletic fieldhouse, while balance and neuropsychological testing (NP) took place in an athletic training research laboratory. Patients or Other Participants: A total of 28 elite level female soccer players (age = 19.6 + 0.96 years, mass = 60.4+ 5.3 kg, and height = 163.6 + 6.4 cm) participated in this project. Subjects were divided into 4 groups dependent on their concussion history: CONT = no concussion/simulated headers, EXP1 = no concussion/heading, EXP2 = 1-2 concussions/ heading, EXP3 = > 3 concussions/heading. Interventions: All subjects completed a baseline Concussion Symptom Checklist (CSC), a computerized neuropsychological test (ImPACT), and a series of balance tests using the Balance Error Scoring System (BESS) prior to performing the first soccer heading session (rotational or linear heading). During this session they performed 15 purposeful “headers” over a 15 minute time frame. Afterwards, the subject repeated the baseline tests described above. Following 7 days, subjects returned for another heading session (rotational or linear heading) utilizing similar test procedures. Main Outcome Measures: Group status served as the independent variable, while CSC score, BESS score, and the 5 ImPACT composite scores were the dependent measures. A one-way, repeated measures ANOVA was used to determine if differences existed between groups and test sessions. Results: Interestingly, post-heading (but not attributed to either linear or rotational heading) CSC scores on day 1 decreased regardless of group status as reflected in a significant (p=.025) time main effect (pre = 4.0±5.7 vs post = 3.8±7.3). There were no significant differences in BESS scores (errors) pre vs post heading in any of the groups (CONT 12.4±5.1 vs 12.0±7.2 linear & 9.7±5.9 rotational; EXP1 12.0±4.0 vs 13.2±6.1 linear & 17.2±58.7 rotational; EXP2 11.8±6.0 vs 14.2±9.0 linear & 11.2±6.3 rotational; EXP3 15.8±6.3 vs 16.5±7.6 linear & 16.0±7.4 rotational). There were no significant differences pre to post test in the composite scores of the ImPACT test. Conclusions: Using soccer balls projected at speeds similar to that seen in competitive soccer and headed by a group of highly skilled players does not appear to adversely affect variables commonly measured in head injured subjects. Additionally, those with a history of concussion do not appear to be affected any more than those without a history during this acute heading task. This project is funded by a grant from the University of Delaware Women’s Studies Program.

Links to full article: