Sex differences in neck strength and head impact kinematics in university rugby union players

Williams, E.G.; Petrie, Freja J; Pennington, Thomas N; Powell, David R L; Arora, Hari; Mackintosh, Kelly A.; Greybe, Desney

doi:10.1080/17461391.2021.1973573

Cited by 31 publications

(52 citation statements)

References 50 publications

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“…Neck strength in flexion, extension, and right and left lateral flexion was reported by Collins et al [10] (in pounds), Fitzpatrick et al [26] (in Newtons), Kelshaw et al [23] (unitless and normalised with participant body mass), Schmidt et al [7] (as peak torque and rate of torque development), and Williams et al [28] (in Newtons). Fitzpatrick et al [26] also measured left and right rotational neck strength.…”

Section: Measurement Of Neck Strengthmentioning

confidence: 83%

“…Studies in Group 1 used field-based measurements of concussion and/or head kinematics and correlated them with head and neck characteristics [5,7,8,10,22,23,26,28].…”

Section: Group 1: Field-based Concussion And/or Head Impact Kinematic...mentioning

confidence: 99%

“…They reported 13 participants (nine male) sustained a mTBI (4% of study population). The other five studies in this group related HIK resulting from training and/or game-related head impacts to head-neck characteristics [5,7,23,26,28].…”

Section: Exposuresmentioning

confidence: 99%

“…All five of the HIK studies in Group 1 reported peak linear head acceleration [5,7,23,26,28], three reported peak rotational head acceleration [5,23,28], Fitzpatrick et al [26] reported peak rotational head velocity, and Mihalik et al [5] and Schmidt et al [7] also reported Head Impact Technology severity profile (HITsp), which is a weighted composite score that takes into account rotational and linear acceleration as well as impact location and duration [7]. Three articles [5,7,28] only included impacts over 10 G, while Kelshaw et al [23] had a threshold of 20 G. Fitzpatrick et al [26] did not report an impact threshold. Kelshaw et al [23] and Williams et al [28] both used video to confirm impacts, and Williams et al [28] additionally used waveform-analysis to rule out head acceleration data from non-impact events (biting, shouting, and insertion or removal of instrumented mouthguard).…”

Section: Measurement Of Head Impact Kinematicsmentioning

confidence: 99%

“…Three articles [5,7,28] only included impacts over 10 G, while Kelshaw et al [23] had a threshold of 20 G. Fitzpatrick et al [26] did not report an impact threshold. Kelshaw et al [23] and Williams et al [28] both used video to confirm impacts, and Williams et al [28] additionally used waveform-analysis to rule out head acceleration data from non-impact events (biting, shouting, and insertion or removal of instrumented mouthguard).…”

Section: Measurement Of Head Impact Kinematicsmentioning

confidence: 99%

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Head and Neck Characteristics as Risk Factors For and Protective Factors Against Mild Traumatic Brain Injury in Military and Sporting Populations: A Systematic Review

et al. 2022

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Background Investigators have proposed that various physical head and neck characteristics, such as neck strength and head and neck size, are associated with protection from mild traumatic brain injury (mTBI/concussion). Objectives To systematically review the literature and investigate potential relationships between physical head and neck characteristics and mTBI risk in athletic and military populations. Methods A comprehensive search of seven databases was conducted: MEDLINE, EMBASE, CINAHL, Scopus, SPORTDiscus, Cochrane Library, and Web of Science. Potential studies were systematically screened and reviewed. Studies on military and athletic cohorts were included if they assessed the relationship between physical head-neck characteristics and mTBI risk or proxy risk measures such as head impact kinematics. Results The systematic search yielded a total of 11,723 original records. From these, 22 studies met our inclusion criteria (10 longitudinal, 12 cross-sectional). Relevant to our PECO (Population, Exposure, Comparator, and Outcomes) question, exposures included mTBI incidence and head impact kinematics (acceleration, velocity, displacement) for impacts during sport play and training and in controlled laboratory conditions. Outcome characteristics included head and neck size (circumference, mass, length, ratios between these measures), neck strength and endurance, and rate of force development of neck muscles. Discussion We found mixed evidence for head and neck characteristics acting as risk factors for and protective factors against mTBI and increased susceptibility to head impacts. Head-neck strength and size variables were at times associated with protection against mTBI incidence and reduced impact kinematics (14/22 studies found one or more head-neck variable to be associated with protection); however, some studies did not find these relationships (8/22 studies found no significant associations or relationships). Interestingly, two studies found stronger and larger athletes were more at risk of sustaining high impacts during sport. Strength and size metrics may have some predictive power, but impact mitigation seems to be influenced by many other variables, such as behaviour, sex, and impact anticipation. A meta-analysis could not be performed due to heterogeneity in study design and reporting. Conclusion There is mixed evidence in the literature for the protective capacity of head and neck characteristics. We suggest field-based mTBI research in the future should include more dynamic anthropometric metrics, such as neck stiffness and response to perturbation. In addition, laboratory-based mTBI studies should aim to standardise design and reporting to help further uncover these complicated relationships.

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Section: Measurement Of Neck Strengthmentioning

confidence: 83%

“…Studies in Group 1 used field-based measurements of concussion and/or head kinematics and correlated them with head and neck characteristics [5,7,8,10,22,23,26,28].…”

Section: Group 1: Field-based Concussion And/or Head Impact Kinematic...mentioning

confidence: 99%

Section: Exposuresmentioning

confidence: 99%

Section: Measurement Of Head Impact Kinematicsmentioning

confidence: 99%

Section: Measurement Of Head Impact Kinematicsmentioning

confidence: 99%

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Head and Neck Characteristics as Risk Factors For and Protective Factors Against Mild Traumatic Brain Injury in Military and Sporting Populations: A Systematic Review

et al. 2022

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Assessing the feasibility of a neck‐strength training intervention in university women's rugby

Petrie,

Williams,

Mackintosh

et al. 2024

European Journal of Sport Science

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Cervical muscle strength has been demonstrated to reduce concussion risk in high school athletes, and interventions to improve this in male rugby players have elicited strength improvements. However, the feasibility of introducing neck‐strengthening interventions into women's rugby has not been investigated. This study sought to pilot a neck‐strength intervention in university‐level women's rugby players. A fixed‐frame dynamometer was used to assess the multi‐directional isometric neck‐strength of 14 university women's rugby players (20.3 ± 1.0 years). Between baseline and end‐of‐season testing, a neck‐strengthening program was completed. Interviews were conducted with six players and two coaches to understand program engagement. Interviews were transcribed verbatim and processed via inductive content analysis. Increases in absolute neck‐strength post‐intervention in left and right lateral flexion (left 85.4 ± 29.7 N to 108.2 ± 41.6 N, p = 0.02, right 87.4 ± 33.3 N to 110.5 ± 40.3 N, p = 0.01) and flexion (128.4 ± 28.8 N to 147.9 ± 30.5 N, p = 0.01) were perceived positively by the players although there were suggestions that greater adaptability according to training age and more variety was required. Participants initially demonstrated limited awareness of neck‐strength training but engaged well with the exercises once the potential benefits were understood. This intervention shows promise as an effective, palatable strategy to improve neck‐strength in university women's rugby players. Further research is needed to establish whether such improvements in neck‐strength are associated with meaningful reductions in head impact occurrence.

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The state of play for contact training and coaching in women's rugby

Stodter,

Dane

2024

European Journal of Sport Science

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This article aims to review and comment upon the current “state of play” for research around contact and tackle training in women's rugby, covering tackle injury risk, match contact demands, players' experiences of contact coaching and contact skill preparation. In women's rugby, the tackle is the most common match technical‐physical contest, accounting for around two‐thirds of all injuries and carrying the greatest injury burden. Players' experience and technical abilities are key determinants of tackle safety and performance. Despite this, there is limited research available that connects insight into women's rugby contact demands with the how and why of effective tackle and contact training and coaching in context. This review suggests that adapting and adopting progressive tackle skill training frameworks and gender‐responsive coaching practices can aid tackle skill learning in women's rugby. Creative transdisciplinary research and more effective translation and implementation activities that take place within the vibrant and growing context of women's rugby can enhance science and safety whilst working as a medium for social change.

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Sex differences in neck strength and head impact kinematics in university rugby union players

Cited by 31 publications

References 50 publications

Head and Neck Characteristics as Risk Factors For and Protective Factors Against Mild Traumatic Brain Injury in Military and Sporting Populations: A Systematic Review

Head and Neck Characteristics as Risk Factors For and Protective Factors Against Mild Traumatic Brain Injury in Military and Sporting Populations: A Systematic Review

Assessing the feasibility of a neck‐strength training intervention in university women's rugby

The state of play for contact training and coaching in women's rugby

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