Blog

The findings, which represent the most comprehensive real-time study of soccer headers in adolescent athletes, were published in Journal of Biomechanical Engineering.

For some professional athletes, repetitive head strain during exercise – using your head as part of the game – is associated with negative long-term brain health, even in the absence of initial clinical symptoms. Despite awareness of the long-term consequences, short-term neurophysiological problems following repetitive head impacts, such as heading in football, are poorly understood in youth athletes. Some studies have identified potential problems throughout an entire sports season. This study examined the effects of repeated head impacts shortly after track exposure using a battery of six different tests to investigate a broader range of potential clinical implications.

In 2015, the U.S. Soccer Federation introduced limits on teenagers’ heading during practices: no more than 30 minutes of heading practice time and no more than 15 to 20 headers per week. The English Premier League has also adopted guidelines limiting the number of high-force headers to 10 in one training session per week. This laboratory study simulated these limits by performing 10 repeated football headers within one session with experienced teenage players. Based on their findings, researchers determined that this practice did not result in acute neurophysiological problems, as assessed by a comprehensive study. The study did not assess the safety of regular football heads over the course of a season or college career.

“Football is a sport where deliberately using your head to hit the ball is an integral part of the game, and parents, caregivers and coaches are understandably concerned about its long-term consequences,” said first study author Colin Huber , PhD, a postdoctoral researcher at Emory University who conducted this research at the Center for Injury Research and Prevention (CIRP) at CHOP. “We wanted to simulate these effects in a controlled laboratory environment and build on the work of previous studies to quantitatively assess the neurophysiological effects of repetitive football playing.”

In this study, 19 participants (17 men, 2 women) between 13 and 18 years old were assigned to a frontal head group (directing the ball back to where it came from), an oblique head group (pointing the ball to the right). ) or a kicking control group. These participants completed neurophysiological assessments immediately before, immediately after, and approximately 24 hours after completing 10 head or kick movements. These assessments include multiple eye movement tracking, pupil response, and balance testing.

The study ultimately found no neurophysiological problems in either group compared to the kicking control group, even when the six different assessments were taken into account. However, angled headers resulted in higher levels of angular head movements. Angular movements have been linked to concussions and other brain injuries, suggesting that players need to be properly trained to head the ball head-on to reduce the risk of injury.

“This study represents the most comprehensive investigation to date on the acute neurophysiological effects of football heading on youth and provides us with meaningful information about the safety of on-field heading,” said senior study author Kristy Arbogast, PhD, co-scientific director at CIRP and research director of the Minds Matter Concussion Program at CHOP. “We need to be clear that there may still be long-term consequences for repeated football playing over the course of an athletics career, but it appears that a small number of headers in a given session does not pose an immediate risk to well-trained young people. athletes.”

This study was supported by the National Institute of Neurologic Disorders and Stroke of the National Institutes of Health grant R01NS097549 and internal funds from CHOP.

The current study aimed to (1) quantify the physical and technical profile of substitutes, substitutes and players who completed the entire match, taking into account situational variables; (2) analyze the physical and technical performance difference between substitutes and players who substituted or completed the entire match at each playing position. Previous studies have mainly examined the physical performance of substitutes in football [5, 18,19,20,21]but only a few have examined the technical performance of replacements [5, 19]. In the current study, more comprehensive and detailed technical indicators were analyzed to investigate the impact of substitutes on technical performance. The results of the current study showed that substitutes performed better in terms of physical performance (Table 3), especially at high-intensity running and sprint distances, than players who were substituted or completed the entire match. The findings have shown the similarity with previous studies as the better physical performance of substitute players [5, 19]. Substitutions are generally used to reduce the impact of fatigue and maintain a high level of running performance for the entire team [34]. High-intensity running distances seem to be a particularly essential and useful indicator of physical performance in football [35], and the findings of the current study showed the significant difference in high-intensity running distance between substitutes and players who are substituted or complete the entire match. However, replacement players perform worse on the total distance than replaced players. Accordingly, playing time on the field is the most important factor that influences match intensity [36]. Replaced players mainly play on the field in the first half and would be replaced in the second half [5]. During the playing time of substituted players, the match intensity may therefore be higher than that of substitutes playing on the field, resulting in substitutes showing a lower total distance. Depending on playing positions, substitutes from all positions exhibit higher high-intensity distance and sprint distance than substitute players or players who complete the entire match. The finding is similar to the results regardless of positions. However, substitutes in the wide midfield show lower total distance than replaced players and players have completed the entire match. Coaches would introduce more defensive players to strengthen the defense if the team wins [4]. Modric, verse [37] It was found that wide midfielders’ total running distance decreased and sprint distance increased in the defensive phases, which is in line with the findings of this study.

By focusing on technical performance, technical indicators in a broader range were analyzed and performance related to scoring, passing and defending was quantified (Table 1). Despite the importance of technical performance, little literature focuses on the technical activities of substitute players [1, 5, 19]. Bradley, Peñas [5] first analyzed the technical activities of substitutes, but found no significant difference in passing activities between substituted players and players who completed the entire match. The results of the current study show that substitutes mainly perform better in shooting activities and defensive activities, while they exhibit poorer passing activities, including passing, passing accuracy and long passes, than players who substituted or completed the entire match (Fig. 1). Existing literature mentions passing activities such as short passes; successful passes decrease from the first to second half of football matches, which can be affected by fatigue [38]. According to the theory, it is a good strategy for the coach to make substitutions on the field to counteract the decline in the team’s technical performance. Additionally, match status also impacts player performance as replacement players may attempt riskier passes and crosses due to the match status when they were introduced onto the pitch. [39]. Furthermore, research into substitution introduction patterns shows that coaches would introduce more players into attacking positions in the second half of the match [5]. Thus, substitutes would engage in riskier and more attacking activities when coaches aim to change the score line, causing the substitutes to employ lower passing accuracy but perform more attacking activities, including shots, shots on goal, key passes and breakthroughs.

One of the most compelling findings in time-motion analysis research is the significant differences between all playing positions in physical performance [6,7,8, 40,41,42] and technical performance [5, 24, 43, 44] of top footballers. Therefore, it is crucial to discuss the performance differences between players who are substituted, replaced and completed the entire match for each playing position. According to this research, substitute centre-backs have shown lower passing and organizational activities, while performing more defensive actions. To win the game, coaches usually send the defenders onto the field when their team is ahead [16, 17]. Thus, the tactical objective of substitute central defenders and full-backs is to defend the opponent’s attackers and protect the attacking third zone. Under the tactical objective, substitute defenders (center defenders and full-backs) would perform lower passing actions and higher defensive actions compared to players who substituted or completed the entire match. Furthermore, to strengthen the defensive level, attacking players may also have been introduced on the pitch in a defensive role, to hold the scoreline or waste time during the final stages of the match. [1]. These may be the reasons why attacking substitutes, such as forwards and wide midfielders, have shown more tackles, clearances and pass blocks than players who have been substituted or played out for the entire match.

On the other hand, the current research has shown that substitute strikers and wide midfielders demonstrate better passing and organization actions, such as passing, ball controls, crosses, short passes and long passes, than players who were substituted or completed the entire match. Players with attacking playing positions are usually introduced onto the field when their team is losing [1, 16, 17]. In general, replaced players are more likely to be considered underperforming if the team loses [17]and coaches introduce attacking substitutes to create more scoring opportunities and improve the performance of the entire team [5, 39]. The higher passing and organizational performance of attacking substitutes than those who have been substituted or completed the match are considered crucial factors for the success of the match. [5, 24, 39, 45]. Furthermore, substitute central midfielders in this study showed more scoring actions. Research into elite French football has shown that the increased number of goals scored by substitutes was a factor in distinguishing successful teams [46]. Therefore, substitute central midfielders can be introduced onto the pitch as another attacker to score a goal when their team is losing. These may be reasons why replacement central midfielders have a lower passing performance than replaced players and complete the entire match. Furthermore, a very interesting result from the current research is that substitute full-backs perform more shots, which is more likely the attacking playing style. Although coaches introduce some players with defensive positions, such as fullbacks, the introduced players may play in the attacking playing position in an attempt to create scoring opportunities. [19].

Overall, substitutes can indeed improve the physical and technical performance of the team. The current study has confirmed previous findings as substitutes are introduced to change the scoring line or reduce the influence of fatigue [1, 4, 5, 16, 17, 19, 39, 47]. By taking into account the situational variables, the current study analyzed a wider range of technical variables and quantified the technical performance of substitutes in different playing positions. Furthermore, the match location influences most technical performance indicators, which show higher scoring and passing performance, while defensive performance is lower. The findings verified home field advantage and confirmed previous research [26, 31].

However, some limitations need to be further studied in subsequent research. Sports psychology literature shows that substitutes may perform worse when introduced into the match as starters due to the psychological strain [48]. It is important to investigate the performance difference of substitutes between the substitution situations and the starter situation. Furthermore, the timing of substitutes introduced onto the field also influences performance, as the match status determines the tactical purpose of substitutions. [5, 16, 17]. In the current study, the match data was analyzed for only one year and the substitution option was changed in 2020. To better investigate the influence of substitutes on match performance, it is important for future research to analyze match data over a larger number of seasons.

The article, which was published in Exercise and Sports Science Reviewsinvestigates how a group of plant compounds that accumulate in the retina, known as macular pigments, work to improve eye health and functional vision.

Previous studies conducted by UGA researchers Billy R. Hammond and Lisa Renzi-Hammond have shown that eating foods such as dark leafy greens or yellow and orange vegetables, which contain high levels of the plant compounds lutein and zeaxanthin, improve eye and brain health. improves.

“Much research on macular lutein and zeaxanthin has focused on health benefits, but from a functional perspective, higher concentrations of these plant pigments improve many aspects of visual and cognitive ability. In this article we discuss their ability to improve vision in far distance or visual range,” said lead author Jack Harth, a doctoral candidate at UGA’s College of Public Health.

Visual range, or how well someone can see a target clearly over a distance, is critical for elite athletes in virtually every sport.

The reason why objects become harder to see and appear fainter the further away they are from our eyes is partly due to the effects of blue light.

“From a midfielder’s perspective, as the ball goes into the air, it will be seen against a backdrop of a clear blue sky, or against a gray background if it is a cloudy day. Either way, the goal is obscured by atmospheric interference.” in that path of light,” Harth said.

Many athletes already take steps to reduce the impact of blue light by wearing black or blue blocker sunglasses, but eating more foods rich in lutein and zeaxanthin can enhance the eye’s natural ability to deal with blue light exposure. to improve, said Harth.

When a person absorbs lutein and zeaxanthin, the compounds collect as yellow pigments in the retina and act as a filter to block blue light from entering the eye.

Previous research into pilot vision was conducted in the 1980s, and Hammond and Renzi-Hammond have more recently investigated how macular pigment density, or the amount of yellow pigment built up in the retina, is related with a number of factors. of eye health measures and functional vision tests.

“In a long series of studies, we have shown that increasing amounts of lutein and zeaxanthin in the retina and brain reduce glare and discomfort and improve chromatic contrast and visual-motor reaction time, and replenishing these compounds facilitates executive functions like solving problems.” and memory. All of these tasks are particularly important for athletes,” said corresponding author Billy R. Hammond, professor of psychology in the Behavior and Brain Sciences Program at UGA’s Franklin College of Arts and Sciences.

This article, Harth said, brings the research into these links between macular pigment and functional vision up to date and questions what the evidence suggests about optimizing athletic performance.

“We are at a point where we can say that we have seen visual range differences in pilots that match the differences found in the modeling, and now we have also seen it in laboratory testing, and a future goal would be to to actually take people outside and to measure their ability to see contrast over distance through true blue haze and in outdoor environments,” Harth said.

But before you start eating kale in hopes of improving your game, he warns that everyone is different. That could mean that the way our bodies absorb and use lutein and zeaxanthin varies, and it may take a while before you notice any improvement, if at all.

Still, the evidence of the overall health benefits of consuming more lutein and zeaxanthin is reason enough to add more color to your diet, the authors say.

“We have data from modeling and empirical studies showing that higher macular pigment in your retina will improve your ability to see over distance. The application for athletes is clear,” Harth said.

Prevalence and normalization of stress urinary incontinence in female strength athletes.

Mahoney K, Heidel RE, and Olewinski LJ Good luck Cond2023 [epub ahead of print].

Full text freely available

Take home message

Seven in ten female strength training athletes report stress urinary incontinence (SUI) in some aspect of their lives. However, fewer than 2 in 10 athletes talk to their doctor or seek treatment for SUI.

Background

Very intensive physical activity can increase the risk of SUI, an involuntary loss of urine due to increased intra-abdominal pressure. Up to 2 in 5 women may experience SUI throughout their lives, which can negatively impact an individual’s quality of life. Pelvic floor training can treat SUI. Although female strength training athletes may be at greater risk for SUI, it remains unclear how many of these athletes experience SUI and seek treatment, as well as how they would prefer to learn about SUI.

Study aim

The researchers conducted a cross-sectional study to assess female strength training athletes’ understanding and normalization of SUI, including how often female strength training athletes sought treatment for SUI.

Methods

The researchers developed a new study, which was expertly reviewed, to share on various social media platforms. The survey asked respondents about demographic information, risk factors for SUI, experience with SUI, favorite sources of information about SUI, and whether the respondent had sought treatment for SUI. Respondents to the survey were women over the age of 18 who considered powerlifting, weightlifting or strongman as their main activity.

Results

Of the 425 respondents, 69% reported experiencing SUI in some aspects of their lives. Of the athletes who experienced SUI, 61% reported that they first experienced SUI after starting their sport. About two-thirds of athletes thought SUI was a normal part of their sport. Only 17% of respondents reported talking to their doctor about SUI, and 9% sought treatment. Nearly 30% of respondents reported seeking advice about SUI from videos and articles on the internet, 23% spoke to friends and 13% spoke to their coach about SUI.

Viewpoints

Overall, the results of this study indicated that SUI is common among female strength training athletes, and most consider it a normal part of their sport. However, very few athletes turn to healthcare to address their SUI. It would be interesting to see this study replicated by asking athletes to complete the survey during competitions, as it is unclear whether women with SUI are more likely to complete the online survey. So the online survey may overestimate how many women have SUI, but the answers about engaging the health care system and where they seek advice are still likely to be informative.

Clinical implications

Clinicians who work with athletes who are at high risk for developing SUI should educate athletes about effective treatments. It can also be helpful to educate strength and conditioning coaches about SUI and available treatments.

Questions for discussion

How do you talk to your athletes about SUI? Have you noticed that other athletes have high SUI rates?

Written by Kyle Harris
Reviewed by Jeffrey Driban

related posts

Check the lights before you check that urine!
Throw away your strips for better urine density results
Altered hydration status may impact concussion assessment
Cheers! The more you exercise, the more you should drink

Published in the Journal for Science and Medicine in Sports,the world’s first study tracked and evaluated the long-term impact of concussion and subsequent injury risk in 1455 sub-elite junior Australian football players.

This builds on previous UniSA research which found that sub-elite Australian Rules footballers returning from injury are approximately 1.5 times more likely to suffer injury compared to players without injury.

By tracking injuries over a period of seven seasons, researchers found that football players who suffered a concussion were also about 1.5 times more likely to be injured again in the future, compared to players who were never injured. This increased risk was the same as in players returning from upper and lower limb injuries.

The finding comes ahead of the Australian Senate report on concussions and follows the AFL’s announcement of a $25 million study into the long-term effects of concussions and head impacts.

In the AFL, concussions are one of the most common injuries, with an average of six concussions per 1000 hours of play, affecting approximately 70 to 80 male players annually.

In elite junior football, as well as AFL and AFLW, concussion guidelines state that the earliest a player can return to play after concussion is 12 days after the injury, after following gradual progression through a return-to-play -program.

Lead researcher Dr. UniSA’s Hunter Bennett says the significant and increased risk of injury following concussion may indicate that some players may need a longer recovery time to recover better before returning to play.

“The current recommendation of 12 days after concussion may not be sufficient to allow full recovery in elite football players under the age of 18,” says Dr Bennett.

It may also indicate that the physical attributes affected by concussion need to be more thoroughly assessed before an athlete is cleared to return to sport.

“Concussion is a common injury in Australian football and can lead to limitations in balance, coordination, reaction time and decision-making – and these limitations can increase the risk of other injuries if an athlete returns to play before full recovery.”

A recent consensus statement on concussions in sports also indicates that children and teens may take up to four weeks to recover from a sports-related concussion.

“Concussion is a unique injury that occurs without damage to muscle tissue but affects aspects of motor control,” says Dr. Bennett.

“Recurring injuries can have a significant impact on team success, player health and career longevity.

“In elite sport, there is a possibility that young athletes may exaggerate their willingness to return to sport after injury because they worry that missing matches could exclude them from senior drafting or competition.

“Knowing that athletes are at greater risk of re-injury after a concussion suggests that we need unique and careful rehabilitation strategies to monitor when an athlete has fully recovered and is ready to return to play.”

Researchers say future research should aim to identify optimal rehabilitation and injury prevention strategies for athletes who suffer from concussions.

Exercise-induced heat illness: policy adoption and influence on contextual factors reported by athletic administrators

Scarneo-Miller SE, Adams WM, Coleman KA, Lopez RM. Sports Health. Mar 5, 2023: 19417381231155107. doi: 10.1177/19417381231155107. E-publishing prior to printing. PMID: 36872595.

https://journals.sagepub.com/doi/10.1177/19417381231155107

Take home message

Most high school athletic administrators reported having a written heat illness policy in place, but they were often missing key components. The presence of an athletic trainer helped create a written policy that included more components.

Background

Sports administrators play an important role in policy acceptance. Policy measures such as addressing acute heat illness are critical as improper management can lead to poor outcomes. Unfortunately, we know little about the factors that promote and hinder the implementation of heat illness policies.

Study aim

The authors surveyed high school athletic administrators in the United States to describe the adoption of exertional heat illness policies and to examine factors that influence the adoption of these policies.

Methods

During the 2018-2019 academic school year, the research team emailed nearly 7,000 athletic administrators inviting them to complete a questionnaire asking about 1) demographics, 2) exercise-related illness policies, 3) monitoring and modification of written policy, and 4) enablers and barriers to policy development. The researchers used the precautionary adoption process model to assess an athletics administrator’s willingness to adopt policies. The adoption model is based on 8 phases, from not being aware to maintaining a written policy for more than 6 months.

Results

Of 466 athletics administrators (~48 years old, 82% male, 77% worked in the field for more than 15 years), 78% reported having a written policy on the prevention and treatment of exertional heat illness. Only 6% adopted all eleven essential elements of an exertional heat illness policy. Almost half of the managers indicated that they adopted fewer than 5 essential elements.

Older athletics administrators, those who had previously dealt with heat illness, or those with an athletic trainer on their staff were more likely to have a written policy. Additionally, state mandates and having a medical professional were the most commonly cited facilitators for adopting policies on exertional illness prevention and use of a rectal thermometer. Similarly, the most commonly reported barrier to comprehensive heat illness management was the lack of a full-time athletic trainer (11). Administrators also recognized budget constraints that limited the use of a cold water immersion pool (23%), and the top barriers to using a rectal thermometer were discomfort using the thermometer (32%), parent/guardian resistance (30 %), resistance from parents/guardians (30%). coaches (30%) and liability issues (27%).

Viewpoints

Nearly 80% of athletics administrators surveyed reported that they had a written policy on exertional heat illness. Few integrated or were aware of all the necessary components to meet best clinical practices. The authors found that access to athletic training services was associated with better adoption of exercise health policies. This finding is consistent with it being an athletic trainer who would implement such a policy. It’s worth recognizing that only 7% of administrators contacted completed the survey. Therefore, these results may not accurately reflect what is happening in high schools across the country. One possibility is that people more interested in policy or heat illness completed the survey. So these results may show us the best-case scenario for written policies (78%) that include all components (6%) – which is a worrying sign.

Clinical implications

Encouraging state mandates and schools to hire athletic trainers can ensure that there are written policies to address heat illness. Clinicians may also want to consider strategies to educate coaches and parents/guardians about the reasons for this policy, such as rectal thermometers and cold water plunge pools.

Questions for discussion

Are you having trouble adding rectal temperature to your exercise heat illness protocol? Do you communicate with your athletics administrator regarding the approval, implementation and annual review/practice of your emergency policy?

related posts

1. Management of exertional heat stroke still leaves something to be desired
2. A little more education about heat stroke due to exertion could go a long way
3. Clinical Pearl: prevention and treatment of exertional heat stroke
4. Tag us! What do coaches know about heat stroke during exertion and the role of the athletic trainer?
5. Follow guidelines to prevent exertional heat illness? Let’s reconsider these guidelines

Written by Jane McDevitt
Reviewed by Jeffrey Driban

Prevalence of urinary incontinence and other pelvic floor-related symptoms in female professional dancers

Take home message

Background

Study aim

Methods

The authors developed an anonymous online questionnaire on several topics, including demographics, back and hip pain, dance training and cross-training, menstruation, pelvic health, oral contraceptive use, and bowel movements. The authors shared the survey via email and social media posts. The study assessed urinary incontinence using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. Their target group consisted of professional dancers of at least 18 years old who trained or performed at least 25 hours a week.

Results

Viewpoints

Clinical implications

Questions for discussion

related posts

Activity affected urinary incontinence; Let’s talk about it!

Written by Alexandra Bossi
Reviewed by Jeffrey Driban

Diet and training go hand in hand if you want to achieve the best results. Most athletes know this, and many of them monitor their energy intake and training closely. However, a new study from the Department of Public Health at Aarhus University shows that the bodies of female athletes are negatively affected when the athletes consume too little energy through their diet compared to their training volume, explains PhD student Mikkel Oxfeldt. He and Associate Professor Mette Hansen are behind the research.

“We know that both top female athletes and active women sometimes, consciously or unconsciously, do not have an energy intake that matches their energy expenditure during training. The research shows that insufficient energy intake can have a negative effect on the ability of the muscles to respond to After just ten days of low energy intake, we started to see changes in the hormonal system, such as a decrease in metabolic hormone , followed by a decrease in metabolism.’

The research shows that it is important for women to be careful not to reduce their energy intake too much. In fact, they should actually increase their energy intake as they increase their training volume, says Mikkel Oxfeldt:

“If you don’t get enough energy from your diet, your body starts to slow down processes that require a lot of energy, much like a cell phone going into battery-saving mode. We know from previous studies that this can lead to menstruation. However, our results show that other processes in the body, such as the build-up of new muscle proteins, are also affected.”

We must confront the one-sided focus on weight

Thirty fit women aged between 18 and 30 took part in the study, which is part of the Novo Nordic-funded Team Denmark network called ‘competition preparation and training optimization’. All women started the study immediately after the start of their period and followed a highly controlled exercise and diet regimen for three weeks.

“Under the supervision of the researchers, the participants performed individual training programs aimed at increasing muscle mass, strength and overall fitness. We also provided the women’s meals. By monitoring their training regimen and their diet, we were able to see how much energy they expended and what they ate during the study,” says Mikkel Oxfeldt and continues:

“This is the first time such a well-controlled study has been conducted in this area, with both the diet and exercise of a group of fit women regulated to this extent. During the study, all participants drank double-labeled water. “, which is enriched with trace material. When we combine this tracer technique with the retrieval and subsequent analysis of muscle tissue samples, we can gain detailed insight into the response of the muscles to the experimental protocol,” explains Mikkel Oxfeldt.

Mikkel and the research group believe that it is necessary to confront the idea that weight loss leads to medals, when in fact weight loss can negatively impact a number of body systems, including the muscles.

“In recent years we have heard about public weigh-ins within some elite sports. They are part of promoting a culture where some women are constantly trying to lose weight. However, our results show that this focus on weight loss can have negative consequences on the short and possibly long term for women, both in relation to their health and training results. The research will hopefully give athletes and coaches a more nuanced picture of possible side effects.”

In collaboration with colleagues from the University of Copenhagen and the University of Southern Denmark, the researchers behind the study are now investigating how physical performance, the immune system and metabolism are affected by insufficient energy intake. They hope to one day be able to determine whether there is a difference between the way women’s and men’s bodies respond to insufficient energy intake.

Does headgear prevent sports-related concussions? A systematic review and meta-analysis of randomized controlled trials involving 6311 players and 173,383 exposure hours.

Al Attar WSA, Mahmoud H, Alfadel A, Faude O. Sports health. May 19, 2023: 19417381231174461. doi: 10.1177/19417381231174461. E-publishing prior to printing. PMID: 37204092.

Full text not freely available

Take home message

Headgear worn by young football or rugby players cannot reduce the incidence of sports-related concussions.

Background

Protective headgear reduces the risk of facial and dental injuries; However, there is inconsistent research supporting the rate at which they prevent sports-related concussions.

Study aim

In this systematic review, the authors identified and summarized findings from three randomized control trials evaluating whether headgear effectively reduces the incidence of sports-related concussions.

Methods

The authors systematically searched five databases to identify randomized control trials that evaluated the extent to which headgear prevented sports-related concussions. All control groups wore no headgear. The authors recorded exposure hours and number of players to calculate injury rates and document compliance.

Results

The 3 studies had an ‘average’ to ‘good’ methodological quality on the PEDro scale. The primary outcome assessed in each study was the rate of sports-related concussions per group (headgear vs. no headgear/control). The aggregated results include 6,311 players and 173,383 exposure hours. The authors found that headgear did not prevent concussions in football or rugby. Compliance was variable between studies (99.6%, 46% and not measured in one study).

Viewpoints

The authors of this systematic review concluded that the risk of sports-related concussion was virtually identical in the group with or without headgear. It should be noted that the rugby trials exclusively involved young men. While the football trials involved women, the study focused on 14- to 16-year-olds. Therefore, it is unclear how headgear performs among older athletes and female rugby players. The authors also found that compliance was quite variable. One football study had high adherence, while one rugby study had low adherence. It would be useful to understand whether differences in compliance are related to different strategies to promote compliance, differences in sport, or personal preferences for headgear styles. Understanding what worked in football but not in rugby could help identify strategies to promote good compliance.

Clinical implications

Medical professionals should not promote the wearing of headgear for football and rugby athletes to prevent concussion. Instead, medical professionals should promote concussion education on what can prevent a concussion, such as proper form (e.g., keeping head up while dribbling/being aware of surroundings) and proper tackling technique in rugby (e.g., not using head). .

Questions for discussion

Do you encourage headgear in sports such as football and rugby? Does this systematic review change your position? Why or why not?

related posts

1. Headgear can reduce concussion risk in high school lacrosse
2. Aftermarket helmet add-ons don’t add up
3. Women are not only at increased risk for concussions, but also for more severe concussions
4. A Closer Look at Concussions 2016-2020: Increasing Prevalence and Gender Differences

Written by Jane McDevitt
Reviewed by Jeffrey Driban