The Role of Neck Musculature in Traumatic Brain Injuries in Older Adults: Implications From Sports Medicine

Wood, Tyler; Morrison, Shannon; Sosnoff, Jacob J.

doi:10.3389/fmed.2019.00053

Cited by 10 publications

(6 citation statements)

References 46 publications

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“…Furthermore, studies have linked younger age and female sex with higher susceptibility for sport-related concussions (23) and detrimental late effects of repetitive head impacts because of lower neck strength (6,8). A recent systematic review and an epidemiological study both demonstrated that neck strength is a significant predictor of concussions in youth athletes (10,40). Considering the high number of soccer players worldwide and the considerable amount of repetitive head impacts through heading the ball as a tactical maneuver, there is a clear need to protect the developing brains of child and adolescent athletes.…”

Section: Discussionmentioning

confidence: 99%

“…However, the association between neck strength and head kinematics after purposeful headers is not well understood, and further research is required before considering specific neck and trunk strengthening programs as a risk reduction strategy (6,16,30,40). Increased neck strength facilitates increased coupling of the head and torso, thereby increasing effective mass and potentially decreasing head acceleration during and after head impacts (19,27).…”

Section: Introductionmentioning

confidence: 99%

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Neck and Trunk Strength Training to Mitigate Head Acceleration in Youth Soccer Players

Müller

Zentgraf

2020

Journal of Strength and Conditioning Research

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Müller, C and Zentgraf, K. Neck and trunk strength training to mitigate head acceleration in youth soccer players. J Strength Cond Res 35(12S): S81–S89, 2021—Heading in soccer involves repetitive head accelerations that may be detrimental for brain health. One way to mitigate adverse effects may be to increase head-neck stabilization and thus reduce the kinematic response after intentional headers. This study aimed to (a) assess associations between neck strength and head kinematics and (b) evaluate an exercise intervention designed to increase strength and attenuate head acceleration during intentional heading in youth soccer players. In 22 athletes, we used accelerometers to assess associations between neck strength and peak linear acceleration (PLA). We attached the accelerometers to the occiput and sternum, allowing us to differentiate between total, trunk, and head PLA. Longitudinally, we evaluated the effects of a 14-week twice-weekly resistance training in a subsample of 14 athletes compared with regular soccer training (N = 13). Results showed that female athletes had lower isolated neck strength (p ≤ 0.004), lower functional neck strength (p ≤ 0.017), and higher total PLA during purposeful headers compared with males (17.2 ± 3.5 g and 13.0 ± 2.3 g, respectively, at 9.6 m·s−1 ball velocity during impact; p = 0.003). The intervention group showed moderate to large strength gains ( = 0.16–0.42), resulting in lower PLA (total −2.4 g, trunk −0.8 g, and head −1.5 g) during headers. We conclude that a resistance training focusing on cervical and trunk musculature is practicable in youth soccer, elicits strength gains, and helps to mitigate PLA during purposeful heading. Results should encourage youth strength and conditioning professionals to incorporate neck exercises as a risk reduction strategy into their training routine.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neck and Trunk Strength Training to Mitigate Head Acceleration in Youth Soccer Players

Müller

Zentgraf

2020

Journal of Strength and Conditioning Research

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“…Presuming there is a correlation with poorer outcomes after concussion and EDS, it is reasonable to consider why this might be. It has been reported that reduced neck strength is a risk factor for sport-related concussion [10]. EDS patients commonly suffer both neck pain and cervical instability [11, 12].…”

Section: Discussionmentioning

confidence: 99%

Underlying Ehlers-Danlos syndrome discovered during neuro-ophthalmic evaluation of concussion patients: a case series

Gami¹,

Singman

2019

BMC Ophthalmol

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Background The Ehlers-Danlos syndromes are a heterogenous group of diseases that cause connective tissue defects. At present, there are no published reports focusing upon the neuro-ophthalmic symptoms that might occur in EDS patients after mild traumatic brain injury. The demographics and clinical course of seven patients with subclinical EDS and mild traumatic brain injury are presented. Case presentation This series describes patients with Ehlers Danlos Syndrome whose diagnosis was discovered in a neuro-ophthalmic clinic for brain injury. Patient demographics and neuro-ophthalmological symptoms are presented. Conclusions Patients with subclinical EDS and brain injury may experience a slower, less complete recovery course. Heightened awareness of undiagnosed or underlying Ehlers Danlos Syndrome is important for patients and providers.

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“…Their review shares similar aims with this review but is broader in its inclusion of head and neck injuries other than solely mTBI, addresses strengthening interventions specifically, and is narrower in its focus on only athletic populations. Other reviews on this topic have either not been systematic [32][33][34][35][36][37][38][39][40][41] or have had a more narrow scope than this review by limiting their search to either specific experimental paradigms [42,43] or specific physical neck characteristics [44]. To our knowledge, this review is the first systematic review to holistically assess physical characteristics of the head and neck and how they relate to mTBI risk in a broad range of settings.…”

Section: Reviews From Other Perspectivesmentioning

confidence: 99%

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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The Role of Neck Musculature in Traumatic Brain Injuries in Older Adults: Implications From Sports Medicine

Cited by 10 publications

References 46 publications

Neck and Trunk Strength Training to Mitigate Head Acceleration in Youth Soccer Players

Neck and Trunk Strength Training to Mitigate Head Acceleration in Youth Soccer Players

Underlying Ehlers-Danlos syndrome discovered during neuro-ophthalmic evaluation of concussion patients: a case series

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

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