A Systematic Review of Peer-Reviewed Studies on Preventing Sport-Related Concussion (SRC) in Adult Football (Soccer): Mapping Sparce Evidence of Rule Changes and Head-Neck Training.

Background/

Objectives

Acute health impacts and longer-term sequelae of sport-related concussion (SRC) are recognized concerns in football (soccer), warranting investigation of interventions to reduce the incidence. The purpose of this study was to identify, synthesize and evaluate interventions used in preventing sport-related concussion (SRC) in adult soccer players.

Methods

Five databases (MEDLINE, CINAHL, Embase, SPORTDiscus, PsycINFO) were searched on 6 September 2024 and updated on 17 December 2025 for concussion prevention intervention studies involving adult footballers. Study quality was assessed with the Modified Downs and Black Checklist. A narrative synthesis of all included studies followed Synthesis Without Meta-Analysis (SWiM) guidelines.

Results

From 3463 records, five studies met inclusion criteria: three reported rule changes and two reported head-neck training interventions. The low volume of studies discovered were non-randomized and rated fair or poor on quality assessment. Whilst these interventions were grounded in sound and well-reasoned mechanisms to mitigate SRC risks, none reported statistically significant directional effects. This, combined with high heterogeneity, prevented data pooling and no firm conclusions could be drawn about the effectiveness of any intervention.

Conclusions

Sparce, preliminary, heterogeneous evidence represents research to reduce SRC in adult soccer players, and this is limited to investigating rule changes and head-neck training and interventions. A larger volume of primary research is needed to determine meaningful practice recommendations of these and other conceivable interventions.