Symptoms from repeated intentional and unintentional head impact in soccer players

Walter F. Stewart, Namhee Kim, Chloe S. Ifrah, Richard B. Lipton, Tamar A. Bachrach, Molly E. Zimmerman, Mimi Kim, Michael L. Lipton

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)901-908
Number of pages8
JournalNeurology
Volume88
Issue number9
DOIs
StatePublished - Feb 28 2017

Fingerprint

Soccer
Head
Odds Ratio
Confidence Intervals
Craniocerebral Trauma
Logistic Models

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Symptoms from repeated intentional and unintentional head impact in soccer players. / Stewart, Walter F.; Kim, Namhee; Ifrah, Chloe S.; Lipton, Richard B.; Bachrach, Tamar A.; Zimmerman, Molly E.; Kim, Mimi; Lipton, Michael L.

In: Neurology, Vol. 88, No. 9, 28.02.2017, p. 901-908.

Research output: Contribution to journalArticle

Stewart, Walter F. ; Kim, Namhee ; Ifrah, Chloe S. ; Lipton, Richard B. ; Bachrach, Tamar A. ; Zimmerman, Molly E. ; Kim, Mimi ; Lipton, Michael L. / Symptoms from repeated intentional and unintentional head impact in soccer players. In: Neurology. 2017 ; Vol. 88, No. 9. pp. 901-908.
@article{cda084bd6557465c8d3140810299c355,
title = "Symptoms from repeated intentional and unintentional head impact in soccer players",
abstract = "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.",
author = "Stewart, {Walter F.} and Namhee Kim and Ifrah, {Chloe S.} and Lipton, {Richard B.} and Bachrach, {Tamar A.} and Zimmerman, {Molly E.} and Mimi Kim and Lipton, {Michael L.}",
year = "2017",
month = "2",
day = "28",
doi = "10.1212/WNL.0000000000003657",
language = "English (US)",
volume = "88",
pages = "901--908",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Symptoms from repeated intentional and unintentional head impact in soccer players

AU - Stewart, Walter F.

AU - Kim, Namhee

AU - Ifrah, Chloe S.

AU - Lipton, Richard B.

AU - Bachrach, Tamar A.

AU - Zimmerman, Molly E.

AU - Kim, Mimi

AU - Lipton, Michael L.

PY - 2017/2/28

Y1 - 2017/2/28

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85014117226&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014117226&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000003657

DO - 10.1212/WNL.0000000000003657

M3 - Article

C2 - 28148633

AN - SCOPUS:85014117226

VL - 88

SP - 901

EP - 908

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 9

ER -