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 noncontact 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) × 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 27.8g ± 3.2g. 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 98g 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.