Neck pain is a growing aeromedical concern for military forces on an international scale. Neck pain prevalence in the global military helicopter community has been reported in the range of 56.6-84.5%. Despite this high prevalence, historically, research examining helicopter aircrews has focused predominantly on low back pain. A number of recent studies have emerged examining flight-related factors that are hypothesized to contribute to the development of flight-related neck pain. Loading factors such as the posture adopted during flight, use of night vision goggles, and vibration have all been found to contribute to neck pain and muscular fatigue. Prolonged or repeated exposureto these loading factors has been hypothesized to perpetuate or contribute to the development of neck pain. Despite the high number of helicopter aircrew personnel that suffer from neck pain, very few individuals seek treatment for the disorder. The focus of medical personnel should, therefore, be directed toward a solution that addresses not only the issue of muscular fatigue, but the hesitancy to seek treatment. Previous research in military and civilian populations have used exercise therapy as a treatment modality for neck pain and have found improved endurance capacity in the neck musculature and reduced self-reported neck pain.

The aim of this study was to evaluate New Zealand high school rugby union players’ and community coaches’ concussion knowledge (CK), concussion attitude (CA) and concussion reporting intentions (CRI) and to explore the impact gender, age, ethnicity, socio-economic status, experience, and concussion history had on these outcome measures. This cross-sectional study utilised the Rosenbaum Concussion Knowledge and Attitudes survey to evaluate CK, CA and CRI. The survey and demographic information were completed by 533 high school players (61.5% male, M = 16.2 yrs) and 733 community rugby coaches (93.0% male, M = 42.2 yrs). Coaches displayed greater awareness, safer attitudes, and stronger reporting intentions towards concussion than players. Among players, differences in CK, CA and CRI were observed by gender, ethnicity, and socio-economic status. Among coaches, differences in CRI were found by age and coaching experience. No differences were observed for age or concussion history in players. Gender, ethnicity, and grade coached were not significant for coaches. Players who identified as Māori or Pasifika and those from schools in low socio-economic areas displayed poorer CK and CA. Years of experience for both players and coaches played a critical role in improving CA and is a factor that should be considered when welcoming new participants to either role. Concussion non-disclosure is a systemic issue and is common across gender, ethnicity and socio-economic status and appears to worsen as the playing season progresses. More work is needed to develop educational strategies that are both culturally responsive, sustainable, and address reporting behaviours.

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