O3270: Soccer-related Concussion in Children and Adults over the past 10 Years: A Systematic Review

Background: Soccer is the most popular sport worldwide. Every year in the USA, more athletes are practicing this activity, pursuing pleasure or health. As a result, soccer related concussions have increased despite an overall reduction in the number of concussions across all sport activities. Few papers have studied the mechanism of injury but most have been done in high income countries or focus in small populations preventing a generalization. Our goal is to analyze the data and consolidate knowledge of soccer related concussion over the past 10 years.

Methods: A systematic review of the literature was performed. We used the definition of the American Academy of Neurology which states a Sport-Related Concussion is an injury resulting from a blow to the head causing an alteration in mental status and 1 or more symptoms (headache, nausea, vomiting, etc). Primary studies with children and adults diagnosed with soccer-related concussion published between 2013 - 2023 in Spanish or English, were included. Of the 1,210 published studies, forty-five met our inclusion criteria.

Results: The USA has the largest number of published studies. Soccer-related concussions were more frequent in females (57.67%) than in males (42.32%). A higher number of concussions have been reported in midfielders, and the most common mechanism is player-to-player. It was well established that the first provider to diagnose were certified athletic trainers within the first 24 hours. About 42.22% of the studies included a neurological evaluation, 15.55% SCAT(post-concussive symptom questionnaire) and 11.11% ImPACT evaluation. The need for hospitalization was found in 8.85% of the studies and only 1 player required surgical intervention. At the time of the concussion, confusion, dizziness, and amnesia were reported more frequently. However, after the concussion, headaches and dizziness were prevalent. Follow-up data was included on 35.55% of the studies. On average, children missed 15 practice days, and returned to school in 8 days.

Conclusion: We concluded that midfielders are more commonly affected and confirm the most common mechanism of injury is player to player. The first provider to evaluate were certified athletic trainers, and usually perform their examinations within the first 24 hours. Future research should focus on low- and middle-income countries, the circumstances around head to head injuries by age, sex and level of professionalism as well as the importance of an early diagnosis by a certified specialist and a careful follow-up, to protect the players and improve their outcomes.