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.

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).

Injury Reduction Programs for Reducing the Incidence of Sport-Related Head and Neck Injuries Including Concussion: A Systematic Review.

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).

Evaluating the reliability of a novel neck-strength assessment protocol for healthy adults using self-generated resistance with a hand-held dynamometer.

PURPOSE: To evaluate the intra- and inter-session test-retest agreement of a novel neck-strength assessment protocol using a hand-held dynamometer. BACKGROUND: A literature review found a lack of neck-strength assessment protocols that are both portable and reliable. Hand-held dynamometry is a portable and inexpensive method of assessing muscle strength, but it is not commonly used for neck-strength assessment. METHODS: A hand-held dynamometer was used to evaluate neck strength in 30 healthy participants. The device measured maximum force in cervical flexion, extension, side flexion, side flexion with rotation, and pure rotation, using the ipsilateral hand to apply isometric resistance over 3 seconds. Three measurements were taken over 6-8 days. RESULTS: Test-retest intra-class correlation coefficients (ICCs) showed high reliability, ranging from 0.94 to 0.97 for all tested directions from Trial 1 to Trial 2 (intra-session reliability, ICC [2,1], absolute). ICC values demonstrated good to high inter-session reliability, ranging from 0.87 to 0.95 for all tested directions from Trial 1 to Trial 3 (ICC [2,1], absolute). CONCLUSION: The results suggest that the five test positions of the neck and upper-quadrant strength assessment protocol can be performed using hand-held dynamometry with good to high reliability.

Objectif : Évaluer la convergence test-retest intra et intersessionnelle d'un nouveau protocole d'évaluation de la force du cou au moyen d'un dynamomètre portatif. Contexte: Une recension des écrits a révélé un manque de protocoles d'évaluation de la force du cou à la fois portables et fiables. La dynamométrie manuelle est une méthode portable et peu coûteuse d'évaluation de la force musculaire, mais elle n'est pas utilisée couramment pour évaluer la force du cou. Méthodes : On a utilisé un dynamomètre portatif pour évaluer la force du cou chez 30 participants en bonne santé. On a mesuré la force maximale en flexion cervicale, extension, flexion latérale, flexion latérale avec rotation et rotation pure en utilisant la main ipsilatérale pour appliquer une résistance isométrique pendant 3 secondes. On a pris trois mesures en 6 à 8 jours. Résultats : Les coefficients de corrélation intraclasse (CCI) de test-retest ont révélé une grande fiabilité variant de 0,94 à 0,97 dans le cas de toutes les directions vérifiées de l'essai 1 à l'essai 2 (fiabilité intrasessionnelle) [CCI (2,1), absolu]. Les valeurs CCI ont démontré une fiabilité intersessionnelle variant de bonne à élevée, variant de 0,87 à 0,95 dans le cas de toutes les directions mises à l'épreuve de l'essai 1 à l'essai 3 [CCI (2,1), absolu]. Conclusion : Les résultats indiquent qu'il est possible d'appliquer le protocole d'évaluation de la force du cou et du quadrant supérieur par les cinq positions d'essai en utilisant la dynamométrie manuelle, et qu'il produit une fiabilité variant de bonne à élevée.