The Effect of Ball Heading and Subclinical Concussion On the Neuromuscular Control Of The Lower Limb: A Systematic Review

Author:

Kakavas Georgios12ORCID,Giannakopoulos Ioannis2,Tsiokanos Athanasios2,Potoupnis Michael3,Tsaklis Panagiotis V.24ORCID

Affiliation:

1. Fysiotek Spine and Sports Lab Athens, Greece

2. Department of Physical Education and Sport Science, University of Thessaly, ErgoMech- Lab, Greece

3. Medical School, Aristotle University of Thessaloniki, Greece

4. Department of Molecular Medicine and Surgery, Growth and Metabolism, Karolinska Institute, Sweden

Abstract

Background Soccer is unique among sports because it is the only sport that involves purposeful use of the head to control, pass, or shoot the ball. Over the previous five years, a relationship between lower extremity (LE) injury and sports related concussion (SRC) has been established in various sporting populations. Athletes at the high school, collegiate, and professional levels have demonstrated a greater risk for sustaining a LE injury post SRC. The purpose of this systematic review was to examine the relationship of the SRC with the incidence of LE injuries. Methods Ten databases were searched with the following keywords: Lower limb, ball heading, neuromuscular control, concussion, MEDLINE, Ovid MEDLINE(R) Daily, and Ovid MEDLINE(R), EMBASE, and Scopus. The search was limited to English-language and peer-reviewed publications, until 15/12/2022. The PEDro scale was used for the assessment of the risk of bias among the included studies. All included papers were qualitatively analyzed. Results A total of 834 studies were identified and 10 articles (four concussion-MSK biomechanics, six concussion-MSK injury) were included in the qualitative analyses. Included papers ranged from low to high quality. Due to the heterogeneous nature of the included study designs, quantitative meta-analysis was unable to be performed. All four of the included concussion-MSK biomechanics studies demonstrated, to some degree, that worse cognitive performance was associated with lower extremity MSK biomechanical patterns suggestive of greater risk for MSK injury. Among the six injury related studies, two investigations failed to determine group differences in cognitive performance between subsequently injured and non-injured athletes. Conclusion More research is needed to better understand the relationship of SRC and lower extremity injuries and the extent to which they are related to concussions and/or repetitive neurotrauma after ball heading sustained in soccer. Level of Evidence 2

Publisher

International Journal of Sports Physical Therapy

Subject

Rehabilitation,Orthopedics and Sports Medicine,Physical Therapy, Sports Therapy and Rehabilitation

Reference50 articles.

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3. Neuroplasticity and anterior cruciate ligament injury;George Kakavas;Indian Journal of Orthopaedics,2020

4. An evidence-based discussion of heading the ball and concussions in high school soccer;R.D. Comstock;JAMA Pediatr,2015

5. Evidence of cognitive dysfunction after soccer playing with ball heading using a novel tablet-based approach;M.R. Zhang;PLoS One,2013

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