Concussion incidence and recovery in Swedish elite soccer - Prolonged recovery in female players.

Abstract

Sport-related concussions are an increasingly recognized health problem. Soccer is the most popular sport in the world although recent studies on concussion incidence are scarce. Here, a nationwide prospective study on concussion incidence, symptom severity, risk factors, gender differences, and return-to-play after concussion was performed in 51 Swedish elite soccer teams during the 2017 season. In the 1st and 2nd soccer leagues for men and women, a Sport Concussion Assessment Tool (SCAT)-based questionnaire study was performed at preseason (baseline) and from 48hours to 3months post-concussion. We followed 959 players (389 women, 570 men) for 25146 player game hours (9867hours for women, 15279hours for men). Concussion incidence (n=36concussions during the season) was 1.19/1000 player game hours (females 1.22/1000hours, males 1.18/1000hours; P=.85). Twenty-seven percent of all players(8%of females, 40%of males) continued to play immediately after the concussion. When compared to male players, female players had worse initial symptom severity scores (median and IQR 30 (17-50.5) vs 11 (4-26.25), P=.02) on SCATand longer return-to-play (P=.02). Risk factors for concussion were baseline symptoms and previous concussion. In Swedish elite soccer, the concussion incidence was 1.19/1000 without gender differences. Most players recovered to play within 4weeks post-injury. Almost one third of players continued to play at time of concussion. Female players had worse initial symptoms and longer return-to-play time than males, and a prolonged recovery beyond 3months was only observed among female players.