Repetitive Head Impacts in Football Do Not Impair Dynamic Postural Control

Purpose The purpose of this study was to assess the effect of repetitive head impacts experienced by football players compared to non-contact athletes on dynamic postural control during both Single Task (ST) and Dual Task (DT) conditions. Methods Thirty four football players wearing accelerometer instrumented helmets and 13 cheerleaders performed a dynamic postural control battery, consisting of ST and DT gait initiation, gait, and gait termination, both prior to and following the football season. A 2 (group) x 2 (time) repeated measures ANOVA compared performance across 32 dynamic postural outcomes. A linear regression was performed on postural control change scores with common head impact kinematics serving as the independent variables. Results The football players experienced a mean of 538.1 + 409.1 head impacts in the season with a mean linear acceleration of 27.8 + 3.2 g's. There were no significant interactions for any of the ST or DT dynamic postural control tasks. There was a significant relationship between head impact kinematics and the lateral center of pressure displacement during the anticipatory postural adjustment phase (r2 = 0.26, p=0.010) and transitional phase (r2 = 0.511, p=0.042) during ST gait initiation. For both measures, the number of impacts exceeding 98 g's was the only significant predictor of decreased center of pressure displacement. Conclusions A single competitive football season did not adversely affect dynamic postural control when comparing football players to cheerleaders who do not experience repetitive head impacts. Furthermore, there were limited relationships with head impact kinematics suggesting that a single season of football does not adversely affect most outcome measures of instrumented dynamic postural control. These findings are consistent with most studies which fail to identify clinical differences related to repetitive head impacts. Corresponding Author: Thomas Buckley, Ed.D., ATC, Associate Professor, Department of Kinesiology and Applied Physiology, University of Delaware, 541 South College Ave, Newark, DE 19716, (P) 302.831.4783, (F) 302.831.3693, TBuckley@udel.edu This study was funded, in part, by a grant from the National Institute of Health/Neurological Disorders and Stroke (1R15NS070744). The funding agency had no role in the development of this manuscript or the decision to submit to Medicine and Science in Sports and Exercise. The authors have no relationships with companies or manufacturers who will benefit from the results of the present study. The results of the present study do not constitute endorsement by ACSM. The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. Submitted for publication March 2018. Accepted for publication August 2018. © 2018 American College of Sports Medicine

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