Bonke Elena M, Southard Julia, Buckley Thomas A, Reinsberger Claus, Koerte Inga K, Howell David R
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Ludwig-Maximilians-University, Germany; Graduate School of Systemic Neurosciences, Ludwig-Maximilians-University, Germany.
Department of Psychology and Neuroscience, Regis University, USA.
J Sci Med Sport. 2021 Mar;24(3):247-257. doi: 10.1016/j.jsams.2020.09.003. Epub 2020 Sep 9.
The purpose of our study was to investigate the association between repetitive head impact (RHI) exposure and postural control.
Systematic review.
PubMed, Embase and PsycInfo were searched using a self-developed search term including the keywords balance OR postural control AND repetitive OR sub-concussive head impacts. Twenty-one studies excluding non-peer reviewed studies, secondary studies, cross-sectional studies, animal studies, and studies investigating concussion were included for further analyses. We rated Level of Evidence and quality using the Centre for Evidence-Based Medicine tool, the Quality Assessment for the Systematic Review of Effectiveness, and the Sub-concussion Specific Tool.
All included studies were grouped into Category I and II studies. Category I included trials investigating the effects of controlled soccer heading on postural control (n=8) and Category II studies were cohort studies investigating on-the-field changes between preseason and postseason assessments on postural control measures (n=13). Findings were heterogeneous, with a tendency towards no effects of RHI on clinical postural control measures. Most laboratory studies in Category I used instrumented assessments whereas on-the-field studies in Category II used both instrumented and non-instrumented assessments.
Due to heterogeneous findings, future studies aiming to investigate the effects of RHI on different athlete populations are needed on other participant cohorts. Furthermore, the combination of objective clinical balance measures may be a promising approach to accurately measure how, and to what degree, postural control may be affected by RHI.
我们研究的目的是调查重复性头部撞击（RHI）暴露与姿势控制之间的关联。
系统评价。
使用自行制定的检索词在PubMed、Embase和PsycInfo数据库中进行检索，检索词包括关键词“平衡”或“姿势控制”以及“重复性”或“亚脑震荡性头部撞击”。纳入21项研究进行进一步分析，排除了非同行评审研究、二次研究、横断面研究、动物研究以及调查脑震荡的研究。我们使用循证医学中心工具、有效性系统评价质量评估工具和亚脑震荡特异性工具对证据水平和质量进行评级。
所有纳入研究被分为I类和II类研究。I类包括调查受控足球头球对姿势控制影响的试验（n = 8），II类研究是队列研究，调查季前赛和季后赛姿势控制测量的现场变化（n = 13）。研究结果存在异质性，RHI对临床姿势控制测量无影响的趋势。I类中的大多数实验室研究使用仪器评估，而II类中的现场研究同时使用仪器评估和非仪器评估。
由于研究结果存在异质性，未来需要在其他参与者队列中开展旨在调查RHI对不同运动员群体影响的研究。此外，客观临床平衡测量的组合可能是准确测量姿势控制如何以及在何种程度上受到RHI影响的一种有前景的方法。
