Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
Said Business School, University of Oxford, Oxford, UK.
Am J Sports Med. 2019 Aug;47(10):2287-2293. doi: 10.1177/0363546519859542. Epub 2019 Jul 15.
The incidence and effect of sports-related concussions (SRCs) within the global sport of professional soccer is poorly described.
To comparatively examine the effects of SRC on athletes in Major League Soccer (MLS) and the English Premier League (EPL) in terms of incidence, return to play (RTP), performance, and career longevity.
Cohort study; Level of evidence, 3.
Contracts, transactions, injury reports, and performance statistics from 2008 to 2017 were obtained and cross-referenced across 6 publicly available websites detailing MLS and EPL data, including official league publications. For each league, players who sustained a concussion were compared with the 2008-2017 uninjured player pool. RTP and games missed were analyzed and compared. Career length was analyzed with Kaplan-Meier survival curves. Player performance changes were evaluated before and after concussion.
Of the 1784 eligible MLS and 2001 eligible EPL players evaluated over the 10-year period, the incidence of publicly reported concussions per 1000 athlete-exposures was 20.22 and 18.68, respectively ( = .53). The incidence of reported concussions steadily increased in both leagues. MLS players missed a mean 7.3 games after concussion (37.0 days missed); EPL players missed a mean 0.6 games after concussion (10.9 days missed) ( < .0001, < .0001). Statistical performance in terms of games started, assists, shots on goal, and total shots after concussion was significantly reduced at all nongoalie positions for players in the EPL; however, MLS nongoalie positions with concussion had no significant decreases in these categories. Goalies in both leagues had no significant change in performance or games started. The probability of playing a full season after concussion was not significantly decreased when compared with the uninjured pool in both leagues.
This study established the SRC incidence among elite soccer players in 2 international professional leagues and identified major RTP and performance differences between EPL and MLS players. While career longevity was unaffected, the approach to managing concussion as in MLS may better promote player safety and preserve on-field performance.
全球职业足球运动中，与运动相关的脑震荡（SRC）的发生率和影响情况描述不足。
比较美国职业足球大联盟（MLS）和英格兰足球超级联赛（EPL）中 SRC 对运动员的影响，比较发病率、重返赛场（RTP）、表现和职业寿命。
队列研究；证据水平，3 级。
从 2008 年至 2017 年，获取合同、交易、伤病报告和表现统计数据，并在 6 个可公开获取的网站上交叉引用，这些网站详细说明了 MLS 和 EPL 的数据，包括官方联赛出版物。对于每个联赛，将遭受脑震荡的运动员与 2008-2017 年未受伤的运动员池进行比较。分析和比较 RTP 和错过的比赛。用 Kaplan-Meier 生存曲线分析职业寿命。评估脑震荡前后球员表现的变化。
在 10 年期间，对 1784 名符合 MLS 条件和 2001 名符合 EPL 条件的合格运动员进行评估，报告的脑震荡发病率分别为每 1000 名运动员暴露 20.22 和 18.68（=0.53）。两个联赛的报告脑震荡发病率均稳步上升。MLS 运动员脑震荡后平均缺阵 7.3 场比赛（缺阵 37.0 天）；EPL 运动员脑震荡后平均缺阵 0.6 场比赛（缺阵 10.9 天）（<0.0001，<0.0001）。EPL 非守门员位置的运动员在首发比赛、助攻、射门和总射门次数等方面的表现明显下降，但 MLS 非守门员位置的脑震荡运动员在这些类别中没有明显的下降。两个联赛的守门员在表现或首发比赛方面均无显著变化。与未受伤的运动员相比，脑震荡后完成整个赛季的概率在两个联赛中均无显著降低。
本研究确定了两个国际职业联赛中精英足球运动员 SRC 的发病率，并确定了 EPL 和 MLS 运动员之间 RTP 和表现的主要差异。虽然职业寿命未受影响，但 MLS 管理脑震荡的方法可能更有利于保障运动员的安全和保持场上表现。
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