@article{ref1,
title="Heading and unintentional head impacts have opposing associations with patient reported outcomes in amateur soccer players",
journal="Research in sports medicine",
year="2018",
author="Hunter, Liane E. and Ifrah, Chloe and Zimmerman, Molly E. and Kim, Mimi and Lipton, Richard B. and Stewart, Walter F. and Lipton, Michael L.",
volume="26",
number="4",
pages="390-400",
abstract="The effects of soccer-related head impacts, beyond overt concussions, on Patient Reported Outcomes (PROs) have not been explored to date. Generalized estimating equations were employed to determine the association between soccer-related head impacts (headers in the prior 2 weeks, unintentional head impacts in the prior 2 weeks, headers in the prior 12 months and lifetime concussions) on PROs including depression, anxiety, sleep disturbance and sleep impairment. Compared to players with no unintentional head impacts in the prior 2 weeks, players with one unintentional exposure reported more symptoms of anxiety (p = 0.002) and players with 2+ exposures reported more symptoms of depression (p = 0.006) and anxiety (p < 0.001). In contrast, players in the 3rd Quartile of 12 mo. headers reported less anxiety (p = 0.001), sleep disturbance (p = 0.002) and sleep impairment (p < 0.001) compared to those in the 1st quartile. Unintentional head impacts are associated with worse PROs while more headers are paradoxically associated with better PROs.<p /> <p>Language: en</p>",
language="en",
issn="1543-8627",
doi="10.1080/15438627.2018.1492396",
url="http://dx.doi.org/10.1080/15438627.2018.1492396"
}