Sullivan Georgia R, Lin Eugenia A, Hoffer Alexander, Richardson Meghan, Chhabra Anikar
Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA.
Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Orthop J Sports Med. 2024 Dec 3;12(12):23259671241303180. doi: 10.1177/23259671241303180. eCollection 2024 Dec.
Because of growing concerns regarding repeated head trauma, in 2016, the United States Soccer Federation (USSF) banned headers for athletes aged ≤10 years and limited athletes aged 11 to 13 years to practicing headers for 30 minutes per week.
To assess whether the USSF header policy was associated with fewer soccer-related concussions after the 2015 season.
Descriptive epidemiology study.
A retrospective cohort from the National Electronic Injury Surveillance System database was assessed. Age, sex, and injury type were extracted for all soccer-related emergency department visits between January 1, 2012, and December 31, 2023. Univariate and multiple regression analyses were used to assess concussions as a percentage of all soccer-related injuries based on sex, age group (6-9, 10-13, and 14-17 years), and year. The following time frames were assessed: 2012-2015, 2016-2019, and 2020-2023.
The proportion of concussions decreased from 8.2% of all soccer-related injuries in 2012-2015 to 6.1% in 2020-2023 ( < .01). The relative risk reduction for soccer-related concussions presenting to an emergency department in 2020-2023 compared with 2012-2015 was 25.6%. Overall, the proportion of concussions among 10- to 13-year-old and 14- to 17-year-old players was higher than for 6- to 9-year-old players (6.6% and 8.9% vs 4.9%, respectively; < .01). Despite having a lower frequency of soccer-related injuries overall, female players had a greater proportion of concussions than male players (9.6% vs 6.2% of all soccer-related injuries; < .01). In the multiple regression analysis, injuries that occurred in 2020-2023 were associated with lower odds of concussion compared with 2012-2015 (odds ratio [OR], 0.75 [95% CI, 0.69-0.81]). Compared with 6- to 9-year-old and male players, the 10- to 13-year-old (OR, 1.30 [95% CI, 1.16-1.45]), 14- to 17-year-old (OR, 1.79 [95% CI, 1.61-1.99]), and female players (OR, 1.53 [95% CI, 1.43-1.63]) were associated with higher odds of concussion.
A 25.6% reduction in the relative risk of presenting to the emergency department with a soccer-related concussion was found when comparing 2020-2023 (after USSF header policy implementation) with 2012-2015 (before policy implementation). The USSF youth soccer header policy may improve player safety by reducing head impacts in the pediatric population.
由于对反复头部创伤的担忧日益增加，2016年，美国足球联合会（USSF）禁止10岁及以下的运动员进行头球，并将11至13岁的运动员每周头球练习时间限制为30分钟。
评估USSF的头球政策在2015赛季后是否与足球相关脑震荡减少有关。
描述性流行病学研究。
评估了来自国家电子伤害监测系统数据库的回顾性队列。提取了2012年1月1日至2023年12月31日期间所有与足球相关的急诊科就诊患者的年龄、性别和损伤类型。单因素和多因素回归分析用于评估脑震荡占所有与足球相关损伤的百分比，分析基于性别、年龄组（6 - 9岁、10 - 13岁和14 - 17岁）和年份。评估了以下时间段：2012 - 2015年、2016 - 2019年和2020 - 2023年。
脑震荡的比例从2012 - 2015年所有与足球相关损伤的8.2%降至2020 - 2023年的6.1%（P <.01）。与2012 - 2015年相比，2020 - 2023年因足球相关脑震荡到急诊科就诊的相对风险降低了25.6%。总体而言，10至13岁和14至17岁球员的脑震荡比例高于6至9岁球员（分别为6.6%和8.9%，而6至9岁球员为4.9%；P <.01）。尽管总体上与足球相关的损伤频率较低，但女性球员的脑震荡比例高于男性球员（占所有与足球相关损伤的9.6%对6.2%；P <.01）。在多因素回归分析中，与2012 - 2015年相比，2020 - 2023年发生的损伤与脑震荡几率较低相关（优势比[OR]，0.75[95%置信区间，0.69 - 0.81]）。与6至9岁和男性球员相比，10至13岁（OR，1.30[95%置信区间，1.16 - 1.45]）、14至17岁（OR，1.79[95%置信区间，1.61 - 1.99]）和女性球员（OR，1.53[95%置信区间，1.43 - 1.63]）发生脑震荡的几率较高。
将2020 - 2023年（USSF头球政策实施后）与2012 - 2015年（政策实施前）进行比较，发现因足球相关脑震荡到急诊科就诊的相对风险降低了25.6%。USSF青少年足球头球政策可能通过减少儿科人群的头部撞击来提高球员安全性。
