足球运动员反复有意和无意头部撞击所产生的症状。
Symptoms from repeated intentional and unintentional head impact in soccer players.
作者信息
Stewart Walter F, Kim Namhee, Ifrah Chloe S, Lipton Richard B, Bachrach Tamar A, Zimmerman Molly E, Kim Mimi, Lipton Michael L
机构信息
From Sutter Health Research (W.F.S.), Walnut Creek, CA; The Gruss Magnetic Resonance Research Center (N.K., C.S.I., T.A.B., M.L.L.), the Departments of Radiology (N.K., C.S.I., T.A.B., M.L.L.), Neurology (R.B.L., M.E.Z.), Epidemiology and Population Health (R.B.L., M.K.), and Psychiatry and Behavioral Sciences (M.L.L.), and The Dominick P. Purpura Department of Neuroscience (M.L.L.), Albert Einstein College of Medicine and Montefiore Medical Center; and Fordham University (M.E.Z.), Bronx, NY.
出版信息
Neurology. 2017 Feb 28;88(9):901-908. doi: 10.1212/WNL.0000000000003657. Epub 2017 Feb 1.
OBJECTIVE
To determine the rate and differential contribution of heading vs unintentional head impacts (e.g., head to head, goal post) to CNS symptoms in adult amateur soccer players.
METHODS
Amateur soccer players completed baseline and serial on-line 2-week recall questionnaires (HeadCount) and reported (1) soccer practice and games, (2) heading and unintentional soccer head trauma, and (3) frequency and severity (mild to very severe) of CNS symptoms. For analysis, CNS symptoms were affirmed if one or more moderate, severe, or very severe episodes were reported in a 2-week period. Repeated measures logistic regression was used to assess if 2-week heading exposure (i.e., 4 quartiles) or unintentional head impacts (i.e., 0, 1, 2+) were associated with CNS symptoms.
RESULTS
A total of 222 soccer players (79% male) completed 470 HeadCount questionnaires. Mean (median) heading/2 weeks was 44 (18) for men and 27 (9.5) for women. One or more unintentional head impacts were reported by 37% of men and 43% of women. Heading-related symptoms were reported in 20% (93 out of 470) of the HeadCounts. Heading in the highest quartile was significantly associated with CNS symptoms (odds ratio [OR] 3.17, 95% confidence interval [CI] 1.57-6.37) when controlling for unintentional exposure. Those with 2+ unintentional exposures were at increased risk for CNS symptoms (OR 6.09, 95% CI 3.33-11.17) as were those with a single exposure (OR 2.98, 95% CI 1.69-5.26) when controlling for heading.
CONCLUSIONS
Intentional (i.e., heading) and unintentional head impacts are each independently associated with moderate to very severe CNS symptoms.
目的
确定成年业余足球运动员中头球撞击与无意头部撞击（如头对头、撞球门柱）对中枢神经系统症状的发生率及不同贡献。
方法
业余足球运动员完成基线及连续的为期2周的在线回顾调查问卷（HeadCount），并报告（1）足球训练和比赛情况，（2）头球及无意的足球头部创伤情况，以及（3）中枢神经系统症状的发生频率和严重程度（从轻度到非常严重）。在分析时，如果在2周内报告了一次或多次中度、重度或非常严重的发作，则认定存在中枢神经系统症状。采用重复测量逻辑回归分析来评估2周内的头球暴露情况（即4个四分位数）或无意头部撞击情况（即0次、1次、2次及以上）是否与中枢神经系统症状相关。
结果
共有222名足球运动员（79%为男性）完成了470份HeadCount调查问卷。男性平均（中位数）每2周头球次数为44次（18次），女性为27次（9.5次）。37%的男性和43%的女性报告有一次或多次无意头部撞击。在470份调查问卷中，有20%（470份中的93份）报告了与头球相关的症状。在控制无意暴露因素后，处于最高四分位数的头球暴露与中枢神经系统症状显著相关（优势比[OR]为3.17，95%置信区间[CI]为1.57 - 6.37）。在控制头球暴露因素后，有2次及以上无意暴露的人发生中枢神经系统症状的风险增加（OR为6.09，95%CI为3.33 - 11.17），单次无意暴露的人也是如此（OR为2.98，95%CI为1.69 - 5.26）。
结论
有意（即头球）和无意头部撞击均各自独立地与中度至非常严重的中枢神经系统症状相关。
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