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Cited by 327Traumatic Brain Injury ResearchSports injuries and preventionAutomotive and Human Injury Biomechanics

Neck Strength: A Protective Factor Reducing Risk for Concussion in High School Sports

Collins, Christy L., Fletcher, Erica N., Fields, Sarah K., Kluchurosky, Lisa, Rohrkemper, Mary Kay, Comstock, R. Dawn, Cantu, Robert C.·2014·The Journal of Primary Prevention
DOI 10.1007/s10935-014-0355-2
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Abstract

As the number of high school students participating in athletics continues to increase, so will the number of sports-related concussions unless effective concussion prevention programs are developed. We sought to develop and validate a cost-effective tool to measure neck strength in a high school setting, conduct a feasibility study to determine if the developed tool could be reliably applied by certified athletic trainers (ATs) in a high school setting, and conduct a pilot study to determine if anthropometric measurements captured by ATs can predict concussion risk. In the study's first phase, 16 adult subjects underwent repeated neck strength testing by a group of five ATs to validate the developed hand-held tension scale, a cost effective alternative to a hand-held dynamometer. In the second phase, during the 2010 and 2011 academic years, ATs from 51 high schools in 25 states captured pre-season anthropometric measurements for 6,704 high school athletes in boys' and girls' soccer, basketball, and lacrosse, as well as reported concussion incidence and athletic exposure data. We found high correlations between neck strength measurements taken with the developed tool and a hand-held dynamometer and the measurements taken by five ATs. Smaller mean neck circumference, smaller mean neck to head circumference ratio, and weaker mean overall neck strength were significantly associated with concussion. Overall neck strength (p < 0.001), gender (p < 0.001), and sport (p = 0.007) were significant predictors of concussions in unadjusted models. After adjusting for gender and sport, overall neck strength remained a significant predictor of concussion (p = 0.004). For every one pound increase in neck strength, odds of concussion decreased by 5 % (OR = 0.95, 95 % CI 0.92-0.98). We conclude that identifying differences in overall neck strength may be useful in developing a screening tool to determine which high school athletes are at higher risk of concussion. Once identified, these athletes could be targeted for concussion prevention programs.

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Authors
Collins, C. L., Fletcher, E. N., Fields, S. K., Kluchurosky, L., Rohrkemper, M. K., Comstock, R. D., & Cantu, R. C.
Affiliations
  • Nationwide Children's Hospital (US)
  • University of Colorado Denver (US)
  • Colorado School of Public Health (US)
  • Boston University (US)
Corresponding author
Comstock, R. Dawn
ORCID
Venue
The Journal of Primary Prevention
Publisher
Springer Science and Business Media LLC
Published
2014-06-15
Volume
35
Issue
5
Pages
309-319
ISSN
  • 0278-095X (ISSN-L)
  • 1573-6547
DOI
10.1007/s10935-014-0355-2
OpenAlex
W2077683717
Cited by
327
References
31
Citations by year
2026: 16 · 2025: 37 · 2024: 31 · 2023: 27 · 2022: 25 · 2021: 41 · 2020: 32 · 2019: 32 · 2018: 32 · 2017: 23 · 2016: 16 · 2015: 9 · 2014: 6
FWCI
13.60
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • The Journal of Primary Prevention (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Operating Committee on Standards for Athletic Equipment
  • Centers for Disease Control and Prevention
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
Keywords
neck muscle strength, sports-related concussion, high school athletes, hand-held dynamometry, anthropometry, neck circumference, athletic trainers, concussion screening, concussion prevention, soccer, basketball, lacrosse
MeSH terms
Adolescent, Adult, Age Factors, Anthropometry, Brain Concussion, Equipment Design, Feasibility Studies, Female, Humans, Male, Neck Muscles, Pilot Projects, Risk Factors, Sex Factors, Reproducibility of Results, Incidence, Muscle Strength, Muscle Strength Dynamometer

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