From the Department of Neurology (N.A., Y.Z., I.A.-S., G.I.), Clinical Research Center (T.C., V.N.), and Department of Internal Medicine C (L.Z.), Soroka University Medical Center, Beer-Sheva, Israel.
Neurology. 2020 Sep 29;95(13):e1776-e1783. doi: 10.1212/WNL.0000000000010244. Epub 2020 Jul 10.
To evaluate the association between postconcussive symptomatology and heading in professional soccer players, overcoming the bias of self-reported exposure, we evaluated several clinical neuropsychiatric symptoms using questionnaires after a thorough objective follow-up of players' heading exposure throughout an entire season.
We collected heading data for all Israeli Premier League players for an entire season using a web-based platform for performance analysis, which enabled us to quantify the exact number of headers per player. Players filled out questionnaires regarding postconcussion symptoms, depression, anxiety, and sleep disorders. We tested the association between the number of headers and each outcome using a negative binomial regression corrected for the hours played.
A total of 159 players were included, of whom 79 were considered in the high heading exposure group (49%), defined as more than median number of headings (1.34 per game hour). Among players without any past head injury, those with higher heading exposure were less likely to have postconcussion symptoms compared with players with low heading exposure (relative risk [RR] per heading per hour 0.94, 95% confidence interval [CI] 0.912-0.963). Players with high heading exposure had fewer depression symptoms (RR 0.98, 95% CI 0.961-0.997), anxiety (RR 0.98, 95% CI 0.958-0.997), and sleep disorders (RR 0.98, 95% CI 0.961-0.996).
Professional soccer players with high heading rate do not display higher postconcussive symptomatology severity. Symptoms among players with low heading exposure might be explained by low resilience, possibly associated with an inferior heading technique. Alternatively, it can reflect heading-avoidant behavior.
评估脑震荡后症状与职业足球运动员头顶球之间的关联，为了克服自我报告暴露的偏差，我们在整个赛季对球员头顶球暴露情况进行了彻底的客观随访后，使用问卷评估了几种临床神经精神症状。
我们使用基于网络的绩效分析平台收集了整个赛季以色列超级联赛所有球员的头顶球数据，这使我们能够量化每个球员的头顶球次数。球员填写了关于脑震荡后症状、抑郁、焦虑和睡眠障碍的问卷。我们使用负二项回归模型，根据比赛时间对每个结果与头顶球次数的关系进行了校正。
共纳入 159 名球员，其中 79 名球员被认为处于高头顶球暴露组（49%），定义为头顶球次数超过中位数（每比赛小时 1.34 次）。在没有任何既往头部受伤的球员中，与低头顶球暴露组相比，高头顶球暴露组发生脑震荡后症状的可能性较低（每头顶球小时的相对风险 [RR]为 0.94，95%置信区间 [CI]为 0.912-0.963）。高头顶球暴露组的抑郁症状（RR 0.98，95%CI 0.961-0.997）、焦虑症状（RR 0.98，95%CI 0.958-0.997）和睡眠障碍（RR 0.98，95%CI 0.961-0.996）较少。
头顶球率较高的职业足球运动员并未表现出更高的脑震荡后症状严重程度。低头顶球暴露组球员的症状可能归因于低弹性，可能与较差的头顶球技术有关。或者，这可能反映了避免头顶球的行为。
