Risk Factor Metrics for Adolescent Female Soccer Injury and Concussive Events

Abstract

PURPOSE: The vestibular, visual, and somatosensory (cervical proprioception) systems may have deficits without overt symptoms. One study identified athletes with pre-season neck pain, decreased balance, and/or headache as 2.4 to 3.65 times more likely to suffer concussion. The purpose of this study was to evaluate multiple baseline metrics as identifiers of risk for musculoskeletal and/or concussive injury. METHODS: 15 female high school varsity soccer athletes, mean age of 15 years (±1.2) and mean BMI of 20 (±2.4), were assessed using pre-season movement screens including King-Devick (K-D), balance error scoring system (BESS), lower quarter Y-balance test (LQ-YBT), and functional movement screen (FMS). Historical data was collected for neck pain, dizziness, and headache, and injuries were tracked during the competitive season. RESULTS: K-D score was 47.06 (±6.56) seconds. BESS score was 10.39 (±4.18) seconds, right LQ-YBT composite was 94.4 (±5.5) and left was 94.5 (±5.0). FMS score was 15.11 (±2.04). No statistical significance was identified in this study directly linking pre-season metrics as indicators for musculoskeletal or concussion injury. Concussion had correlational trends with each of the following pre-season metrics: history of prior concussion, pre-season headache, and neck pain. Statistical significance was found for individuals with pre-season neck pain who later suffered a musculoskeletal and/or a concussive injury (Fischer’s Exact test = 0.040). CONCLUSIONS: Pre-season metrics failed to identify athletes at risk of suffering a musculoskeletal injury or concussion. The data identified a possible link between pre-season neck pain and later injury or concussion and a correlative trend between pre-season metrics and musculoskeletal injury or concussion. Small sample size limited the power and generalizability of the study. The ability to identify those at risk of musculoskeletal injuries and/or concussion from simple pre-season metrics including prior history, current symptoms, and movements may be an important step in making youth athletic participation safer. Further studies with larger data sets using similar pre-season metrics may demonstrate utility for identifying individuals at risk for musculoskeletal and/or concussive injury.