Jonathan Elliott1, Neil Heron2,3,4, Theo Versteegh5, Ian A Gilchrist6, Michael Webb7, Pooler Archbold8, Nigel D Hart9, Kerry Peek10. 1. Ulster Hospital, Upper Newtownards Road, Dundonald, Belfast, BT16 1RH, UK. 2. Centre for Public Health Research, Queen's University, Belfast, UK. 3. Department of General Practice, Keele University, Keele, England, UK. 4. Team Ineos, World Tour Professional Cycling Team, Manchester, UK. 5. School of Physical Therapy, Western University, London, ON, Canada. 6. School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada. 7. Ulster Rugby, Kingspan Stadium, Mount Merrion Ave, Belfast, BT6 0FT, UK. 8. Belfast Royal Victoria Hospital, Belfast, UK. 9. School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK. 10. Discipline of Physiotherapy, Faculty of Medicine and Health, University of Sydney, Susan Wakil Health Building, Camperdown, NSW, Australia. kerry.peek@sydney.edu.au.
Abstract
BACKGROUND: Sport-related head and neck injuries, including concussion, are a growing global public health concern with a need to explore injury risk reduction strategies such as neck exercises. OBJECTIVES: To systematically review the literature to investigate: (1) the relationship between neck strength and sport-related head and neck injuries (including sport-related concussion (SRC); and (2) whether neck exercise programs can reduce the incidence of (a) sport-related head and neck injuries; and (b) SRC. METHODS: Five databases (Ovid MEDLINE, CINAHL, EMBASE, SPORTDiscus, and Web of Science) and research lists of included studies were searched using a combination of medical subject headings and keywords to locate original studies which reported the association between incidence of head and/or neck injury and neck strength data, or included a neck exercise intervention either in isolation or as part of a more comprehensive exercise program. RESULTS: From an initial search of 593 studies, six were included in this review. A narrative synthesis was performed due to the heterogeneity of the included studies. The results of two observational studies reported that higher neck strength, but not deep neck flexor endurance, is associated with a lower risk of sustaining a SRC. Four intervention studies demonstrated that injury reduction programs that included neck exercises can reduce the incidence of sport-related head and neck injuries including SRC. CONCLUSION: Consideration should be given towards incorporating neck exercises into injury reduction exercise programs to reduce the incidence of sport-related head and neck injuries, including SRC. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (registration number: 194217).
BACKGROUND: Sport-related head and neck injuries, including concussion, are a growing global public health concern with a need to explore injury risk reduction strategies such as neck exercises. OBJECTIVES: To systematically review the literature to investigate: (1) the relationship between neck strength and sport-related head and neck injuries (including sport-related concussion (SRC); and (2) whether neck exercise programs can reduce the incidence of (a) sport-related head and neck injuries; and (b) SRC. METHODS: Five databases (Ovid MEDLINE, CINAHL, EMBASE, SPORTDiscus, and Web of Science) and research lists of included studies were searched using a combination of medical subject headings and keywords to locate original studies which reported the association between incidence of head and/or neck injury and neck strength data, or included a neck exercise intervention either in isolation or as part of a more comprehensive exercise program. RESULTS: From an initial search of 593 studies, six were included in this review. A narrative synthesis was performed due to the heterogeneity of the included studies. The results of two observational studies reported that higher neck strength, but not deep neck flexor endurance, is associated with a lower risk of sustaining a SRC. Four intervention studies demonstrated that injury reduction programs that included neck exercises can reduce the incidence of sport-related head and neck injuries including SRC. CONCLUSION: Consideration should be given towards incorporating neck exercises into injury reduction exercise programs to reduce the incidence of sport-related head and neck injuries, including SRC. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (registration number: 194217).
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