The August issue of the British Journal of Sports Medicine included a FIFA supplement focusing on head trauma in football. The Oslo Sports Trauma and Research Center was represented with two articles by PhD-fellow Truls Martin Straume-Næsheim and co-workers based on studies from the Norwegian elite football league (Tippeligaen). The studies show that there is no impairment in neuropsychological performance due to heading of the ball or previous football-related concussions.
The Norwegian elite football head trauma project was started in the beginning of 2004 as a consequence of the increased concern for neurocognitive impairments as a result of heading and head traumas in football. The study is funded by FIFA and done in close cooperation with F-MARC, the FIFA Medical Assessment and Research Center. Its main focus is to determine whether minor head impact causes concussive injury among Norwegian professional football players, as assessed by computerized neuropsychological tests (CogSport") and biochemical markers (serum S-100B protein levels).
The two newly published articles are both based on baseline investigations performed at the pre-season training camps for Norwegian teams in La Manga, Spain, in 2004. "Reproducibility of Computer-Based Neuropsychological Testing among Norwegian Elite Football Players" shows that the computer test used in the project (CogSport") had good reproducibility in a large cohort of professional Norwegian football players using the Norwegian translated version of the test. In addition, it concludes that the reaction time measures proved to be the most reliable and, consequently, the recommended parameter for assessing neuropsychological changes after a concussion.
In the second article; "Effects of Heading Exposure and Previous Concussions on Neuropsychological Performance among Norwegian Elite Footballers", CogSport" was used to assess neuropsychological consequences of previous concussions and life-time heading exposure. In contrast to the findings of Matser et al., Tysvær,and Witol & Webbe, this study did not find any relationship between self-reported heading exposure or history of previous concussions and neuropsychological performance in a group of elite football players. This was despite of the fact that we used computer-based tests, which have been shown to be more sensitive than the conventional paper and pencil tests used in the previous studies. The footballers performed as well as, and on some tests even better, than the normal population in the test data base.
However, it is important to emphasize that all heading and concussion data in our study were self-reported, as in the previous studies,. Even though the self-reported number of heading actions per match correlated well with a video-count during the subsequent season, this clearly represents a source for possible bias. Also, the self-reported total number of previous concussions is vulnerable to many pitfalls; misclassifications, recall bias, etc.
For these reasons, the baseline studies described are followed up with a prospective study. During the 2004 and 2005 seasons, the team medical personnel and locally recruited bioengineers have done a tremendous effort in examining and testing head injured players in the acute phase at the football fields throughout the country. These data will supply us with unique information about the effects of these traumas and able us to determine the consequences of minor head traumas in football with greater confidence.
Read more about the project here.