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The implementation of a neck strengthening exercise program in elite rugby union: A team case study over one season. Phys Ther Sport 2022; 55:248-255. [DOI: 10.1016/j.ptsp.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 11/19/2022]
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2
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The assessment of neck strength: A guide for sports medicine clinicians. Phys Ther Sport 2022; 55:282-288. [DOI: 10.1016/j.ptsp.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/24/2022]
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Reliability of Repeated Isometric Neck Strength in Rugby Union Players Using a Load Cell Device. SENSORS 2022; 22:s22082872. [PMID: 35458855 PMCID: PMC9031103 DOI: 10.3390/s22082872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 02/04/2023]
Abstract
Concussion is the most common injury in professional Rugby Union (RU) players, with increasing incidence and severity each year. Strengthening the neck is an intervention used to decrease concussion incidence and severity, which can only be proven effective if strength neck measures are reliable. We conducted a repeated-measures reliability study with 23 male RU players. Neck strength was assessed seated in a ‘make’ test fashion in flexion, extension, and bilateral-side flexion. Flexion-to-extension and left-to-right side ratios were also computed. Three testing sessions were undertaken over three consecutive weeks. Intrasession and intersession reliabilities were assessed using typical errors, coefficient of variations (CV), and intraclass correlation coefficients (ICC). Intrasession reliability demonstrated good-to-excellent relative (ICC > 0.75) and good absolute (CV ≤ 20%) reliability in all directions (ICC = 0.86−0.95, CV = 6.4−8.8%), whereas intersession reliability showed fair relative (ICC: 0.40 to 0.75) and acceptable absolute (CV ≤ 20%) reliability for mean and maximal values (ICC = 0.51−0.69, CV = 14.5−19.8%). Intrasession reliability for flexion-to-extension ratio was good (relative, ICC = 0.86) and acceptable (absolute, CV = 11.5%) and was fair (relative, ICC = 0.75) and acceptable (absolute, CV = 11.5%) for left-to-right ratio. Intersession ratios from mean and maximal values were fair (relative, ICC = 0.52−0.55) but not always acceptable (absolute, CV = 16.8−24%). Assessing isometric neck strength with a head harness and a cable with a load cell device seated in semi-professional RU players is feasible and demonstrates good-to-excellent intrasession and fair intersession reliability. We provide data from RU players to inform practice and assist standardisation of testing methods.
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Nutt S, McKay MJ, Gillies L, Peek K. Neck strength and concussion prevalence in football and rugby athletes. J Sci Med Sport 2022; 25:632-638. [DOI: 10.1016/j.jsams.2022.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
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Peek K, Andersen J, McKay MJ, Versteegh T, Gilchrist IA, Meyer T, Gardner A. The Effect of the FIFA 11 + with Added Neck Exercises on Maximal Isometric Neck Strength and Peak Head Impact Magnitude During Heading: A Pilot Study. Sports Med 2022; 52:655-668. [PMID: 34590247 PMCID: PMC8480461 DOI: 10.1007/s40279-021-01564-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Higher neck strength has been postulated to reduce head impact magnitude during purposeful heading in football. OBJECTIVES This pilot trial explored the effect of a neck exercise programme on (1) neck strength and (2) head impact magnitude during heading in male and female adolescent football players. METHODS Boys and girls (aged 12-17 years) were randomised by team to the intervention (5 weeks of supervised neuromuscular neck exercises integrated into part 2 of the FIFA 11 + , completed three times per week) or the control group (usual part 2 of the FIFA 11 + , no neck exercises). Outcomes included isometric neck strength and head impact magnitude (peak linear acceleration and peak angular velocity) during standardised heading from a throw-in (at baseline and 6 weeks) plus completion of an evaluation survey by intervention players and coaches. RESULTS In total, 52 players (n = 31 intervention; n = 21 control) completed the study. Mixed-model analysis of variance (ANOVA) revealed significant differences in neck strength variables (p < 0.001), peak linear acceleration (p = 0.04) and peak angular velocity (p = 0.04) between the intervention and control groups over time. Intervention players demonstrated increases in mean composite neck strength (53.8% intervention vs 15.6% control) as well as decreases in mean peak linear head acceleration during heading (- 11.8% vs - 5.0%) from baseline to follow-up. Reduction in peak angular velocity was more pronounced in girls (- 27.7%) than boys (- 11.5%) in the intervention group. The addition of neck exercises into part 2 of the FIFA 11 + was feasible and accepted by players and coaches. CONCLUSION On average, players who completed neck exercises demonstrated an increase in isometric neck strength and a decrease in head impact magnitude during heading. These exercises were easily incorporated into usual training. Australian New Zealand Clinical Trials Registry (no: ACTRN12619001375145).
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Affiliation(s)
- Kerry Peek
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Susan Wakil Health Building, Camperdown, Sydney, NSW, Australia.
| | - Jordan Andersen
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Marnee J. McKay
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Susan Wakil Health Building, Camperdown, Sydney, NSW Australia
| | - Theo Versteegh
- School of Physical Therapy, Western University, London, ON Canada
| | - Ian A. Gilchrist
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON Canada
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Medical Faculty, Saarland University, Saarbrücken, Germany
| | - Andrew Gardner
- Priority Research Centre for Stroke and Brain Injury, School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW Australia ,Hunter New England Local Health District Sports Concussion Research Program, Calvary Mater Hospital, Waratah, NSW Australia
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Chavarro-Nieto C, Beaven M, Gill N, Hébert-Losier K. Neck strength in Rugby Union players: a systematic review of the literature. PHYSICIAN SPORTSMED 2021; 49:392-409. [PMID: 33554689 DOI: 10.1080/00913847.2021.1886574] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The incidence and severity of concussion injuries are increasing every year. Scientific evidence indicates that neck strength and girth could play a role in preventing head and neck injuries, or at least mitigating their severity. We aimed to examine the scientific literature addressing neck strength in Rugby Union with a focus on the potential role of neck strength on injury incidence, neck assessment protocols, neck strength measures, and neck strengthening exercises.We conducted a systematic search of the literature in January 2021 to locate published peer-reviewed articles from PubMed, SPORTDiscusTM, Web of Science®, and Scopus® e-databases. Overall, senior elite male players were stronger than younger-aged players. Forwards were stronger in extension than any other directions assessed, and were generally stronger and possessed larger necks and greater cross-sectional areas when compared to backs. Implementation of isometric exercise routines in professional players was reported to improve neck strength in all directions. There were no studies evaluating the incidence of concussion and neck strength or neck strengthening strategies in Rugby Union. Strengthening the neck continues to be one of the targeted modifiable risk factors with respect to limiting the severity and temporal effects of head injuries in Rugby Union, despite limited evidence regarding direct associations between neck strength and concussion.
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Affiliation(s)
- Christian Chavarro-Nieto
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand
| | - Martyn Beaven
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand
| | - Nicholas Gill
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand.,New Zealand Rugby, Thorndon, Wellington, New Zealand
| | - Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand
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The Influence of Neck Stiffness on Head Kinematics and Maximum Principal Strain Associated With Youth American Football Collisions. J Appl Biomech 2021; 37:288-295. [PMID: 33690168 DOI: 10.1123/jab.2020-0070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 11/21/2020] [Accepted: 01/08/2021] [Indexed: 11/18/2022]
Abstract
Understanding the relationship between head mass and neck stiffness during direct head impacts is especially concerning in youth sports where athletes have higher proportional head mass to neck strength. This study compared 2 neck stiffness conditions for peak linear and rotational acceleration and brain tissue deformations across 3 impact velocities, 3 impact locations, and 2 striking masses. A pendulum fitted with a nylon cap was used to impact a fifth percentile hybrid III headform equipped with 9 accelerometers and fitted with a youth American football helmet. The 2 neck stiffness conditions consisted of a neckform with and without resistance in 3 planes, representing the upper trapezius, the splenius capitis, and the sternocleidomastoid muscles. Increased neck stiffness resulted in significant changes in head kinematics and maximum principal strain specific to impact velocity, impact location, and striking mass.
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EPIDEMIOLOGY of NECK INJURIES ACCOMPANYING SPORT CONCUSSIONS in YOUTH OVER a 13-YEAR PERIOD IN a COMMUNITY-BASED HEALTHCARE SYSTEM. Int J Sports Phys Ther 2019; 14:334-344. [PMID: 31681492 DOI: 10.26603/ijspt20190334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The same trauma that produces concussion may also produce neck injury. The signs of concussion and neck injury are similar, and symptoms after acceleration-deceleration trauma to the head-neck complex do not accurately discriminate between them. Research on the epidemiology of neck injury among sport-concussed youth is sparse. Purpose The purpose of this study was to investigate the epidemiology of diagnosed neck injury in non-sport-related concussion (Non-SRC) versus sport-related concussion (SRC) in youth by age, sex, and sport. Study design Cross-sectional epidemiologic study. Methods De-identified data from community-based electronic health records over 13 years were extracted to analyze rates and characteristics of neck injuries among non-SRCs and SRCs in youth aged five to 21. Neck injury diagnosis prevalence rates and odds ratios were calculated to estimate risk of neck injury among concussed youth, comparing non-SRCs to SRCs by age and sex. Results Sixteen thousand, eight hundred eighty-five concussion records were extracted, of which 3,040 SRCs and 2,775 non-SRCs in youth aged five to 21 were identified by cross-filtering sport-related keywords (e.g., football, basketball, soccer, running, swimming, batting, horseback riding, skiing, etc.) with all ICD-9 and ICD-10 concussion codes. The prevalence of neck injuries diagnosed among SRCs (7.2%) was significantly different than the prevalence of neck injuries diagnosed among non-SRCs (12.1%, p < 0.000). Neck injury diagnoses were significantly more prevalent in females overall (p < 0.000) and among non-SRCs (p < 0.000). The prevalence of neck injury diagnoses was not significantly higher in concussed females versus concussed males with SRC (p = 0.164).Among youth aged five to 21 exposed to concussions, non-SRCs were more likely to be accompanied by a neck injury diagnosis than SRCs (OR 1.66; 95% CI 1.39 to 1.98; p < 0.000). Similarly, female-to-male neck injury proportion ratios were significantly higher in females in non-SRCs compared to SRCs (IPR 1.90, 95% CI 1.60 to 2.25, p < 0.000).Sports with highest prevalence of concussion differ from sports with highest prevalence of concussion-related neck injury in both sexes. Conclusions The overall prevalence of diagnosed neck injuries in youth was higher in non-SRCs compared to SRCs (12.1 vs. 7.2%, p < 0.001), with the highest prevalence at age 14 in both sexes. The risk of neck injury diagnosis accompanying concussion was significantly higher in females compared to males (6.1% difference; p < 0.000).
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Tiwari D, Goldberg A, Yorke A, Marchetti GF, Alsalaheen B. CHARACTERIZATION OF CERVICAL SPINE IMPAIRMENTS IN CHILDREN AND ADOLESCENTS POST-CONCUSSION. Int J Sports Phys Ther 2019; 14:282-295. [PMID: 30997280 PMCID: PMC6449018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Patients with concussion may present with cervical spine impairments, therefore accurate characterization of cervical post-concussion impairments is needed to develop targeted physical therapy interventions. PURPOSE To characterize the type, frequency and severity of cervical impairments in children and adolescents referred for physical therapy after concussion.Study design: Retrospective, descriptive study. METHODS A retrospective analysis was conducted for 73 consecutive children and adolescents who received cervical physical therapy following a concussion. Data was classified into six broad categories. The frequency and intensity of cervical impairments within and across the categories was reported. RESULTS Ninety percent of patients demonstrated impairments in at least three out of five assessment categories whereas 55% demonstrated impairments in at least four out five assessment categories. Of the five assessment categories, posture (99%) and myofascial impairment (98%) demonstrated highest impairment frequency followed by joint mobility (86%) and muscle strength (62%). Cervical joint proprioception was the least commonly evaluated assessment category. CONCLUSION High prevalence of cervical spine impairments was observed in the subjects included in this study with muscle tension, joint mobility, and muscle strength being most commonly affected. The categories of impairments examined in this cohort were consistent with the recommendations of the most recent clinical practice guidelines for neck pain. This study provides preliminary data to support the framework for a cervical spine evaluation tool in children and adolescents following concussion. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Devashish Tiwari
- Massachusetts College of Pharmacy and Health Sciences, Worcester, MA, USA
| | | | - Amy Yorke
- University of Michigan-Flint, Flint, MI, USA
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Feasibility and Effect of Cervical Resistance Training on Head Kinematics in Youth Athletes: A Pilot Study. Am J Phys Med Rehabil 2019; 97:292-297. [PMID: 29557889 DOI: 10.1097/phm.0000000000000843] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Greater neck girth and strength may be associated with a lower risk of sport-related concussion due to mitigation of head accelerations by the neck. However, neck strengthening exercise remains unstudied in youth athletes. Therefore, this pilot study assessed the feasibility and effect of targeted neck strengthening exercises in youth athletes. Seventeen participants were allocated to perform 8-wk manual resistance-based neck strengthening (n = 13) or control resistance exercise (n = 4) programs. Before and after the intervention, participants completed laboratory-based assessments of neck size, strength, and head kinematics during standardized test loading in each plane of motion. Descriptive statistics were calculated to compare pre-post changes between the two groups. All participants safely and successfully completed the intervention. Neck girth and strength increased in both groups, with greater increases in the neck strengthening group. Across all planes of motion, overall changes in head linear and angular velocity decreased in both groups, with greater decreases in ΔV in the neck strengthening group and greater decreases in Δω in controls. These results suggest the potential for resistance exercise training to reduce youth athletes' risk for sport-related concussion by increasing neck girth and strength. Additional research is needed to determine optimal neck strengthening programs.
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Peek K, Gatherer D, Bennett KJM, Fransen J, Watsford M. Muscle strength characteristics of the hamstrings and quadriceps in players from a high-level youth football (soccer) Academy. Res Sports Med 2018; 26:276-288. [PMID: 29506423 DOI: 10.1080/15438627.2018.1447475] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The objective of this study was to investigate knee muscle strength characteristics in players from a high-level youth football Academy. In total, 110 players (aged 8-15 years) underwent muscle strength assessments carried out by a research physiotherapist using a computer-linked hand-held dynamometer. Results indicated that isometric hamstrings and quadriceps strength increased with age, whereas the isometric hamstring to quadriceps (H/Q) ratio decreased with age. A number of youth football players (n = 20; 18%; 95% CI: 11-27%) demonstrated isometric H/Q ratios of less than 0.60, as well as muscle strength asymmetries between limbs for the hamstrings (n = 40, 36%; 95% CI: 27-46%) and quadriceps (n = 51, 46%; 95% CI 37-56%), potentially increasing injury risk. This study provides new evidence that the isometric H/Q ratio reduces with advancing age during adolescence which may have important implications for junior athlete development and long-term injury prevention in football.
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Affiliation(s)
- Kerry Peek
- a School of Medicine and Public Health , University of Newcastle, University Drive , Callaghan , Australia
| | | | - Kyle J M Bennett
- c Applied Sports Science and Exercise Testing Laboratory, Faculty of Science and Information Technology , University of Newcastle , Ourimbah , Australia
| | - Job Fransen
- d Sport and Exercise Science, Faculty of Health , University of Technology Sydney , Moore Park , Australia
| | - Mark Watsford
- d Sport and Exercise Science, Faculty of Health , University of Technology Sydney , Moore Park , Australia
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12
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Traumatic vertebral artery dissection in high school rugby players: A report of two cases. J Clin Neurosci 2018; 47:137-139. [DOI: 10.1016/j.jocn.2017.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 10/02/2017] [Indexed: 11/19/2022]
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Patton DA, McIntosh AS, Denny G. A Review of the Anthropometric Characteristics, Grading and Dispensation of Junior and Youth Rugby Union Players in Australia. Sports Med 2017; 46:1067-81. [PMID: 26886476 DOI: 10.1007/s40279-016-0481-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The grading of Australian junior and youth rugby union players has received substantial media attention in recent years. Media reports have focussed on size mismatches observed between players, especially players with Polynesian heritage, and the concerned parents who fear for the safety of their child owing to perceived mismatches. Although such concerns are well meaning, few media reports recognise the need for substantial evidence to determine the best grading system for junior and youth rugby union players. The current study reviewed relevant literature pertinent to the grading and dispensation of junior and youth rugby union players. Using primary and secondary search strategies, a total of 33 articles reporting the anthropometric characteristics of junior and youth rugby players were identified. Anthropometric data from the literature were compared with normative population data and currently used dispensation criteria. Junior and youth rugby players were found to be taller and heavier than normative population data. Current dispensation criteria, in terms of body mass, were found to vary and it is suggested that criteria be revised and standardised across rugby unions throughout Australia. Although it is acknowledged that other factors are important for grading players, anthropometric characteristics should be considered as potential dispensation criteria to supplement current age-based grading for junior and youth rugby union players. Measuring the body mass and stature of each junior player upon pre-season registration is suggested, which would provide data to establish valid dispensation criteria for the following season.
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Affiliation(s)
- Declan Alexander Patton
- Australian Centre for Research into Injury in Sport and its Prevention, Federation University Australia, Lydiard Street, Ballarat, VIC, 3350, Australia. .,Australian Rugby Union, St Leonards, NSW, Australia.
| | - Andrew Stuart McIntosh
- Australian Centre for Research into Injury in Sport and its Prevention, Federation University Australia, Lydiard Street, Ballarat, VIC, 3350, Australia
| | - Greg Denny
- Australian Rugby Union, St Leonards, NSW, Australia
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Carlson M. Sex-Based Differences as a Predictor of Recovery Trajectories in Young Athletes After a Sports-Related Concussion: Letter to the Editor. Am J Sports Med 2016; 44:NP30-1. [PMID: 27252553 DOI: 10.1177/0363546516651047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Davies M, Moore IS, Moran P, Mathema P, Ranson CA. Cervical range of motion, cervical and shoulder strength in senior versus age-grade Rugby Union International front-row forwards. Phys Ther Sport 2016; 19:36-42. [PMID: 27134215 DOI: 10.1016/j.ptsp.2015.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 07/09/2015] [Accepted: 10/02/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To provide normative values for cervical range of motion (CROM), isometric cervical and shoulder strength for; International Senior professional, and International Age-grade Rugby Union front-row forwards. DESIGN Cross-sectional population study. SETTING All international level front-row players within a Rugby Union Tier 1 Nation. PARTICIPANTS Nineteen Senior and 21 Age-grade front-row forwards underwent CROM, cervical and shoulder strength testing. MAIN OUTCOME MEASURES CROM was measured using the CROM device and the Gatherer System was used to measure multi-directional isometric cervical and shoulder strength. RESULTS The Age-grade players had significantly lower; cervical strength (26-57% deficits), cervical flexion to extension strength ratios (0.5 vs. 0.6), and shoulder strength (2-36% deficits) than the Senior players. However, there were no differences between front-row positions within each age group. Additionally, there were no differences between age groups or front-row positions in the CROM measurements. CONCLUSIONS Senior Rugby Union front-row forwards have greater cervical and shoulder strength than Age-grade players, with the biggest differences being in cervical strength, highlighting the need for age specific normative values. Importantly, Age-grade players should be evaluated to ensure they have developed sufficient cervical strength prior to entering professional level Rugby Union.
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Affiliation(s)
| | - Isabel S Moore
- Sports Injury Research Group, Cardiff School of Sport, Cardiff Metropolitan University, UK
| | | | | | - Craig A Ranson
- Welsh Rugby Union, Cardiff, UK; Sports Injury Research Group, Cardiff School of Sport, Cardiff Metropolitan University, UK.
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16
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Hrysomallis C. Neck Muscular Strength, Training, Performance and Sport Injury Risk: A Review. Sports Med 2016; 46:1111-24. [DOI: 10.1007/s40279-016-0490-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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17
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Morel B, Hautier CA. The neuromuscular fatigue induced by repeated scrums generates instability that can be limited by appropriate recovery. Scand J Med Sci Sports 2016; 27:209-216. [PMID: 26799622 DOI: 10.1111/sms.12646] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2015] [Indexed: 11/29/2022]
Abstract
The aim of this study was to evaluate the influence of the fatigue on the machine scrum pushing sagittal forces during repeated scrums and to determine the origin of the knee extensor fatigue. Twelve elite U23 rugby union front row players performed six 6-s scrums every 30 s against a dynamic scrum machine with passive or active recovery. The peak, average, and the standard deviation of the force were measured. A neuromuscular testing procedure of the knee extensors was carried out before and immediately after the repeated scrum protocol including maximal voluntary force, evoked force, and voluntary activation. The average and peak forces did not decrease after six scrums with passive recovery. The standard deviation of the force increased by 70.2 ± 42.7% (P < 0.001). Maximal voluntary/evoked force and voluntary activation decreased (respectively 25.1 ± 7.0%, 14.6 ± 5.5%, and 24 ± 9.9%; P < 0.001). The standard deviation of the force did not increase with active recovery and was associated with lower decrease of maximal voluntary/evoked force and voluntary activation (respectively 12.8 ± 7.9%, 4.9 ± 6.5%, and 7.6 ± 4.1%; all P < 0.01). As a conclusion repeated scrummaging induced an increased machine scrum pushing instability associated with central and peripheral fatigue of the knee extensors. Active recovery seems to limit all these manifestations of fatigue.
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Affiliation(s)
- B Morel
- LUNAM Université, Université du Maine, Laboratoire Motricité, Interaction, Performance EA4334, UFR Sciences et Technique, Le Mans Cedex, France
| | - C A Hautier
- Centre de Recherche et d'Innovation sur le Sport, UFRSTAPS, Université Claude Bernard Lyon 1, Villeurbanne Cedex, France
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Hislop MD, Stokes KA, Williams S, McKay CD, England M, Kemp SPT, Trewartha G. The efficacy of a movement control exercise programme to reduce injuries in youth rugby: a cluster randomised controlled trial. BMJ Open Sport Exerc Med 2016; 2:e000043. [PMID: 27900148 PMCID: PMC5117042 DOI: 10.1136/bmjsem-2015-000043] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2015] [Indexed: 12/15/2022] Open
Abstract
Background Injuries to youth rugby players have become an increasingly prominent health concern, highlighting the importance of developing and implementing appropriate preventive strategies. A growing body of evidence from other youth sports has demonstrated the efficacy of targeted exercise regimens to reduce injury risk. However, studies have yet to investigate the effect of such interventions in youth contact sport populations like rugby union. Objective To determine the efficacy of an evidence-based movement control exercise programme compared with a sham exercise programme to reduce injury risk in youth rugby players. Exercise programme compliance between trial arms and the effect of coach attitudes on compliance will also be evaluated. Setting School rugby coaches in England will be the target of the researcher intervention, with the effects of the injury prevention programmes being measured in male youth players aged 14–18 years in school rugby programmes over the 2015–2016 school winter term. Methods A cluster-randomised controlled trial with schools randomly allocated to either a movement control exercise programme or a sham exercise programme, both of which are coach-delivered. Injury measures will derive from field-based injury surveillance, with match and training exposure and compliance recorded. A questionnaire will be used to evaluate coach attitudes, knowledge, beliefs and behaviours both prior to and on the conclusion of the study period. Outcome measures Summary injury measures (incidence, severity and burden) will be compared between trial arms, as will the influence of coach attitudes on compliance and injury burden. Additionally, changes in these outcomes through using the exercise programmes will be evaluated. Trial registration number ISRTCNN13422001.
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Affiliation(s)
- M D Hislop
- Department for Health , University of Bath , Bath , UK
| | - K A Stokes
- Department for Health , University of Bath , Bath , UK
| | - S Williams
- Department for Health , University of Bath , Bath , UK
| | - C D McKay
- Department for Health , University of Bath , Bath , UK
| | - M England
- Rugby Football Union , Twickenham , UK
| | | | - G Trewartha
- Department for Health , University of Bath , Bath , UK
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Barrett MD, McLoughlin TF, Gallagher KR, Gatherer D, Parratt MT, Perera JR, Briggs TW. Effectiveness of a tailored neck training program on neck strength, movement, and fatigue in under-19 male rugby players: a randomized controlled pilot study. Open Access J Sports Med 2015; 6:137-47. [PMID: 25999771 PMCID: PMC4427068 DOI: 10.2147/oajsm.s74622] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the effect of a tailored neck muscle conditioning program on neck muscle strength, neck muscle fatigue, and range of neck movement in 16–18-year-old male rugby players. Materials and methods Thirty-four male rugby players were divided into forward and back playing positions and randomized within these groups. Seventeen players were randomly assigned to each group. The test group was given a tailored 6-week exercise regime based on their baseline measurements to be performed three times a week in addition to their normal training and playing. The control group trained and played as normal. The outcome measures used were cervical spine range of movement, neck strength, and neck muscle fatigability. Results There were no clinically relevant statistically significant differences between the two groups. Trends identified between the two groups suggest that a tailored neck exercise program increases neck strength, particularly neck extension, and increases resistance to fatigue, as well as influencing right- and left-sided neck muscle balance. A reduction in range of movement was also demonstrated in the test group. There was a great deal of variability in range of movement and strength within this age group. No previously undiagnosed neck conditions were detected, and there were no adverse events reported. Conclusion This study has shown that neck strength, range of movement, and susceptibility of the neck muscles to fatigue can be influenced using a focused neck training regime. It forms an important basis for a larger, multicenter study to ensure the neck is given due attention in rugby training and receives the same focus of conditioning as other parts of the body.
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Affiliation(s)
- Matthew D Barrett
- Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom
| | | | - Kieran R Gallagher
- Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom
| | - Don Gatherer
- The Gatherer Partnership, Aylesbury, United Kingdom
| | - Michael Tr Parratt
- Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom
| | - Jonathan R Perera
- Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom
| | - Tim Wr Briggs
- Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom
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20
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Salmon DM, Handcock PJ, Sullivan SJ, Rehrer NJ, Niven BE. Reliability of repeated isometric neck strength and endurance testing in a simulated contact posture. J Strength Cond Res 2014; 29:637-46. [PMID: 25226308 DOI: 10.1519/jsc.0000000000000689] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The purpose of this study was to examine the reliability of repeated isometric measurements of neck strength and endurance in a simulated rugby contact posture. Data were collected from healthy active university students (n = 20) over 3 sessions. Each session consisted of a single maximal voluntary contraction (MVC) and endurance trial for extension and flexion. The endurance trials were analyzed to determine the area under the force curve (%AUC) and the time to fatigue (TTF). Reliability was calculated using the SEM and minimal detectable change (MDC). The results revealed that the MVC values for extension were nonsignificant for session (p = 0.21), whereas some session differences were seen for flexion (p = 0.01), where session 1, 115.3 N was less than session 3, 126.4 N (p = 0.03). For %AUC, flexion values (%AUC 86.0) were greater than extension (%AUC 59.4) (p = 0.02). A similar effect was observed for TTF with flexion (125.0 seconds) having significantly greater TTF than extension (86.1 seconds). For peak force, the greatest SEM and MDC were achieved for extension (15.3 and 42.3 N), while flexion produced lower values (11.3 and 31.2 N). In contrast, for the endurance trials, SEM and MDC were greater in flexion than in extension. The findings from this study indicate that the neck musculature can be reliably assessed in a simulated contact posture. For peak force, extension provided more consistent measures across time as there seems to be a learning effect for flexion. Additionally, the SEM and MDC scores provide a useful tool for future assessment of neck strength and endurance.
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Affiliation(s)
- Danielle M Salmon
- 1School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand; 2Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand; and 3Centre for the Application of Statistics and Mathematics, University of Otago, Dunedin, New Zealand
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21
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Hamilton DF, Gatherer D. Cervical isometric strength and range of motion of elite rugby union players: a cohort study. BMC Sports Sci Med Rehabil 2014; 6:32. [PMID: 25120916 PMCID: PMC4130114 DOI: 10.1186/2052-1847-6-32] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 07/14/2014] [Indexed: 11/10/2022]
Abstract
Background Head and neck injury is relatively common in Rugby Union. Despite this, strength and range-of-motion characteristics of the cervical spine are poorly characterised. The aim of this study was to provide data on the strength and range-of-motion of the cervical spine of professional rugby players to guide clinical rehabilitation. Methods A cohort study was performed evaluating 27 players from a single UK professional rugby club. Cervical isometric strength and range-of-motion were assessed in 3 planes of reference. Anthropometric data was collected and multivariate regression modelling performed with a view to predicting cervical isometric strength. Results Largest forces were generated in extension, with broadly equal isometric side flexion forces at around 90% of extension values. The forwards generated significantly more force than the backline in all parameters bar flexion. The forwards had substantially reduced cervical range-of-motion and larger body mass, with differences observed in height, weight, neck circumference and chest circumference (p < 0.002). Neck circumference was the sole predictor of isometric extension (adjusted R2 = 30.34). Conclusion Rehabilitative training programs aim to restore individuals to pre-injury status. This work provides reference ranges for the strength and range of motion of the cervical spine of current elite level rugby players.
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Affiliation(s)
- David F Hamilton
- Department of Trauma and Orthopaedics, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH164SB, UK
| | - Don Gatherer
- Gatherer (Physiotherapy Limited), Tudor House, Aylesbury, UK
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22
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Hamilton DF, Gatherer D, Robson J, Graham N, Rennie N, Maclean JGB, Simpson AHRW. Comparative cervical profiles of adult and under-18 front-row rugby players: implications for playing policy. BMJ Open 2014; 4:e004975. [PMID: 24797427 PMCID: PMC4025467 DOI: 10.1136/bmjopen-2014-004975] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To compare the cervical isometric strength, fatigue endurance and range of motion of adult and under-18 age-grade front-row rugby players to inform the development of a safe age group policy with particular reference to scrummaging. DESIGN Cross-sectional cohort study. SETTING 'Field testing' at Murrayfield stadium. PARTICIPANTS 30 high-performance under-18 players and 22 adult front-row rugby players. OUTCOME MEASURES Isometric neck strength, height, weight and grip strength. RESULTS Youth players demonstrated the same height and grip strength as the adult players; however, the adults were significantly heavier and demonstrated substantially greater isometric strength (p<0.001). Only two of the 'elite' younger players could match the adult mean cervical isometric strength value. In contrast to school age players in general, grip strength was poorly associated with neck strength (r=0.2) in front-row players; instead, player weight (r=0.4) and the number of years' experience of playing in the front row (r=0.5) were the only relevant factors in multivariate modelling of cervical strength (R(2)=0.3). CONCLUSIONS Extreme forces are generated between opposing front rows in the scrum and avoidance of mismatch is important if the risk of injury is to be minimised. Although elite youth front-row rugby players demonstrate the same peripheral strength as their adult counterparts on grip testing, the adults demonstrate significantly greater cervical strength. If older youths and adults are to play together, such findings have to be noted in the development of age group policies with particular reference to the scrum.
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Affiliation(s)
- D F Hamilton
- Department of Trauma and Orthopaedics, University of Edinburgh, Edinburgh, UK
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Eckner JT, Oh YK, Joshi MS, Richardson JK, Ashton-Miller JA. Effect of neck muscle strength and anticipatory cervical muscle activation on the kinematic response of the head to impulsive loads. Am J Sports Med 2014; 42:566-76. [PMID: 24488820 PMCID: PMC4344320 DOI: 10.1177/0363546513517869] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Greater neck strength and activating the neck muscles to brace for impact are both thought to reduce an athlete's risk of concussion during a collision by attenuating the head's kinematic response after impact. However, the literature reporting the neck's role in controlling postimpact head kinematics is mixed. Furthermore, these relationships have not been examined in the coronal or transverse planes or in pediatric athletes. HYPOTHESES In each anatomic plane, peak linear velocity (ΔV) and peak angular velocity (Δω) of the head are inversely related to maximal isometric cervical muscle strength in the opposing direction (H1). Under impulsive loading, ΔV and Δω will be decreased during anticipatory cervical muscle activation compared with the baseline state (H2). STUDY DESIGN Descriptive laboratory study. METHODS Maximum isometric neck strength was measured in each anatomic plane in 46 male and female contact sport athletes aged 8 to 30 years. A loading apparatus applied impulsive test forces to athletes' heads in flexion, extension, lateral flexion, and axial rotation during baseline and anticipatory cervical muscle activation conditions. Multivariate linear mixed models were used to determine the effects of neck strength and cervical muscle activation on head ΔV and Δω. RESULTS Greater isometric neck strength and anticipatory activation were independently associated with decreased head ΔV and Δω after impulsive loading across all planes of motion (all P < .001). Inverse relationships between neck strength and head ΔV and Δω presented moderately strong effect sizes (r = 0.417 to r = 0.657), varying by direction of motion and cervical muscle activation. CONCLUSION In male and female athletes across the age spectrum, greater neck strength and anticipatory cervical muscle activation ("bracing for impact") can reduce the magnitude of the head's kinematic response. Future studies should determine whether neck strength contributes to the observed sex and age group differences in concussion incidence. CLINICAL RELEVANCE Neck strength and impact anticipation are 2 potentially modifiable risk factors for concussion. Interventions aimed at increasing athletes' neck strength and reducing unanticipated impacts may decrease the risk of concussion associated with sport participation.
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Affiliation(s)
- James T. Eckner
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA,Michigan NeuroSport, University of Michigan, Ann Arbor, Michigan, USA
| | - Youkeun K. Oh
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Monica S. Joshi
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - James K. Richardson
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | - James A. Ashton-Miller
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, Michigan, USA,Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
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