An Evaluation of the Balance Error Scoring System in Female Soccer Players Following Soccer Heading: A Pilot Study.
Georgios Kakavas, Athanasios Tsiokanos, Michael Potoupnis and 1 others
PMID 40041528WHAT IT FOUND
Ten headers increased several BESS balance scores in 28 female soccer players, but a foot-volley control also changed a score.
This pilot cannot prove heading causes balance impairment.
Key findings
01After the heading condition, statistically significant increases were found in the single-leg stance COP PATH score and the BESS scores on foam and firm surfaces.
02After the foot-volley control condition, a statistically significant increase was found in the tandem stance score.
03The BESS foam score increased by a mean of 1.93 after heading and 0.21 after footing, and the between-condition difference in this change was statistically significant.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a pilot with 28 female soccer players, and the authors said the small sample cannot show whether head impacts over the study period harmed balance or nervous system function. Only female players were studied, so it does not tell you what happens in male soccer players. The header condition was always done before the footer condition, so order effects cannot be ruled out. The paper's group descriptions are unclear: it mentions a concussion group and a healthy control group, but the heading and footer results are reported for 28 female athletes. BESS is usually best interpreted against a season baseline, but this study compared tests before and after each ball task rather than monitoring recovery after concussion. The paper notes BESS has low to moderate diagnostic accuracy and that subtle postural impairments may be missed on examination.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as proof that heading causes balance impairment or that force-plate BESS should guide return-to-play decisions. The study was a 28-person pilot, the foot-volley control also changed a balance score, and the authors said the small sample cannot assess whether head impacts harmed balance or nervous system function.