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Neck Strength: A Protective Factor Reducing Risk for Concussion in High School Sports
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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“Under physiological conditions, sex-specific differences in mitochondrial respiration, bioenergetics, and reactive oxygen species production have been reported in both human and animal studies.”
From Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know (2019) · cites this paper as [117]
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“In healthy human subjects, women had higher levels of N -acetylaspartate, a marker of neuronal bioenergetics, in gray and white matter.”
From Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know (2019) · cites this paper as [117]
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Metadata
- 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
- Venue
- The Journal of Primary Prevention
- Published
- 2014-06-15
- Volume
- 35
- Issue
- 5
- Pages
- 309-319
- ISSN
- 0278-095X (ISSN-L)
- 1573-6547
- 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 › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
- Physical Sciences › Engineering › Biomedical Engineering › 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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