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

# 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...

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Main Authors: Georgios Kakavas, Ioannis Giannakopoulos Sr., Athanasios Tsiokanos, Michael Potoupnis, Panagiotis V. Tsaklis
Format: Article
Language:English
Published: North American Sports Medicine Institute 2023-10-01
Series:International Journal of Sports Physical Therapy
Online Access:https://doi.org/10.26603/001c.87922
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author Georgios Kakavas
Ioannis Giannakopoulos Sr.
Athanasios Tsiokanos
Michael Potoupnis
Panagiotis V. Tsaklis
author_facet Georgios Kakavas
Ioannis Giannakopoulos Sr.
Athanasios Tsiokanos
Michael Potoupnis
Panagiotis V. Tsaklis
author_sort Georgios Kakavas
collection DOAJ
description # 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
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spelling doaj-art-cbc169522972494cbf28fd9b303f03ac2025-02-11T20:30:08ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962023-10-01185The Effect of Ball Heading and Subclinical Concussion On the Neuromuscular Control Of The Lower Limb: A Systematic ReviewGeorgios KakavasIoannis Giannakopoulos Sr.Athanasios TsiokanosMichael PotoupnisPanagiotis V. Tsaklis# 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 2https://doi.org/10.26603/001c.87922
spellingShingle Georgios Kakavas
Ioannis Giannakopoulos Sr.
Athanasios Tsiokanos
Michael Potoupnis
Panagiotis V. Tsaklis
The Effect of Ball Heading and Subclinical Concussion On the Neuromuscular Control Of The Lower Limb: A Systematic Review
International Journal of Sports Physical Therapy
title The Effect of Ball Heading and Subclinical Concussion On the Neuromuscular Control Of The Lower Limb: A Systematic Review
title_full The Effect of Ball Heading and Subclinical Concussion On the Neuromuscular Control Of The Lower Limb: A Systematic Review
title_fullStr The Effect of Ball Heading and Subclinical Concussion On the Neuromuscular Control Of The Lower Limb: A Systematic Review
title_full_unstemmed The Effect of Ball Heading and Subclinical Concussion On the Neuromuscular Control Of The Lower Limb: A Systematic Review
title_short The Effect of Ball Heading and Subclinical Concussion On the Neuromuscular Control Of The Lower Limb: A Systematic Review
title_sort effect of ball heading and subclinical concussion on the neuromuscular control of the lower limb a systematic review
url https://doi.org/10.26603/001c.87922
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