Cervical range of motion, cervical and shoulder strength in senior versus age-grade Rugby Union International front-row forwards

Davies, Mark S.; Moore, Isabel S.; Moran, Patrick; Mathema, Prabhat; Ranson, Craig

doi:10.1016/j.ptsp.2015.10.001

Cited by 10 publications

(16 citation statements)

References 33 publications

(51 reference statements)

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“…Noteworthy is that these ratios are marginally greater than those presented elsewhere using different methods of testing (isokinetic and break test), wherein flexion-to-extension ratios in Rugby Union ranged, on average, from 0.65 to 0.7 [14,33]. Results of previous studies at different levels of competition have shown greater absolute values in extension compared to flexion in Rugby Union players [34][35][36], with younger players possessing lower strength ratios compared to senior players [17], and forwards exhibiting lower ratios than backs [19,33]. These imbalances in neck musculature are a potential risk factor for neck injuries, where flexion-to-extension ratio imbalances have been associated with higher head angular and linear accelerations in other cohorts [37].…”

Section: Discussionmentioning

confidence: 79%

“…Although the break test is the most common method used in Rugby Union, clinicians have expressed concerns regarding the 'aggressiveness' of this method and the potential to injure players during testing [12]. The resistance is applied to evoke a maximal muscle contraction in flexion, extension, and bilateral lateral flexion directions using a head harness attached to a cable and dynamometer or load cell until the initiation of the movement (i.e., positional failure) [11,[13][14][15][16][17]. Previous reliability studies with this neck strength assessment method demonstrate good-to-excellent intrarater and interrater reliability (intraclass correlation coefficient (ICC) 0.80-0.92) when implemented in seated or lying positions [11,18].…”

Section: Introductionmentioning

confidence: 99%

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Reliability of Repeated Isometric Neck Strength in Rugby Union Players Using a Load Cell Device

Chavarro-Nieto

Beaven

Gill

et al. 2022

Sensors

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Concussion is the most common injury in professional Rugby Union (RU) players, with increasing incidence and severity each year. Strengthening the neck is an intervention used to decrease concussion incidence and severity, which can only be proven effective if strength neck measures are reliable. We conducted a repeated-measures reliability study with 23 male RU players. Neck strength was assessed seated in a ’make’ test fashion in flexion, extension, and bilateral-side flexion. Flexion-to-extension and left-to-right side ratios were also computed. Three testing sessions were undertaken over three consecutive weeks. Intrasession and intersession reliabilities were assessed using typical errors, coefficient of variations (CV), and intraclass correlation coefficients (ICC). Intrasession reliability demonstrated good-to-excellent relative (ICC > 0.75) and good absolute (CV ≤ 20%) reliability in all directions (ICC = 0.86–0.95, CV = 6.4–8.8%), whereas intersession reliability showed fair relative (ICC: 0.40 to 0.75) and acceptable absolute (CV ≤ 20%) reliability for mean and maximal values (ICC = 0.51–0.69, CV = 14.5–19.8%). Intrasession reliability for flexion-to-extension ratio was good (relative, ICC = 0.86) and acceptable (absolute, CV = 11.5%) and was fair (relative, ICC = 0.75) and acceptable (absolute, CV = 11.5%) for left-to-right ratio. Intersession ratios from mean and maximal values were fair (relative, ICC = 0.52–0.55) but not always acceptable (absolute, CV = 16.8–24%). Assessing isometric neck strength with a head harness and a cable with a load cell device seated in semi-professional RU players is feasible and demonstrates good-to-excellent intrasession and fair intersession reliability. We provide data from RU players to inform practice and assist standardisation of testing methods.

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Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Reliability of Repeated Isometric Neck Strength in Rugby Union Players Using a Load Cell Device

Chavarro-Nieto

Beaven

Gill

et al. 2022

Sensors

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“…Measurements. The cervical range of motion was examined using the CROM goniometer [7,23,24]. The examinations were performed in a Spine Kinesiology facility.…”

Section: Methodsmentioning

confidence: 99%

Assessment of Interrater and Intrarater Reliability of Cervical Range of Motion (CROM) Goniometer

Wolan-Nieroda

Guzik

Mocur

et al. 2020

BioMed Research International

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Purpose. The current study was designed to assess interrater and intrarater validity of cervical range of motion measurements performed with a CROM goniometer. Material and Methods. The study involved 95 healthy university students (31 males and 64 females) aged 20-24 years. Two examiners performed measurements of cervical range of motion using a CROM goniometer. The same subjects were examined again after two weeks, in the same conditions. The results acquired by one rater during the first and the second examination were compared for reproducibility, while the results obtained by the two examiners were compared to assess validity and reliability of the tool. Cronbach’s alpha was applied to determine intrarater reliability, and the values of correlations were used to assess the interrater agreement. Results. Analysis of the results showed both intrarater and interrater agreement in all the measures of cervical range of motion. The highest intrarater and interrater concordance was observed in the measure of extension. Intrarater agreement for Examiner 1 was reflected by Cronbach’s alpha=0.85, and for Examiner 2 by Cronbach’s alpha=0.89. As for the interrater agreement in the measure of extension, the value of correlation in both the first and the second measurement amounted to r=0.89. Conclusions. Measurements performed with the CROM goniometer show interrater and intrarater agreement in assessments of cervical range of motion. The CROM goniometer can be recommended for use in daily clinical practice.

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“…A major limitation of this study is that the method of measuring neck strength is not well established and has not been published in the peer-reviewed literature. However, isometric neck muscle testing is well validated, 4,14,17,21,34,35 and this study's technique overcomes limitations of previous HHD methods relating to tester strength, 36 the potential for eccentric strength capture as per a "break contraction" method, 10,15 and maintaining a standardized head position compared with self-testing. 34 Reviewing the force output measured during this study, the players strength was similar to that of U18 school rugby players (mean ± 95% CI = 333.4 ± 79.4 N), which was a similar population.…”

Section: Strengths and Limitationsmentioning

confidence: 96%

“…Neck strength research involving U18 players has previously been limited to front-row players only. 10,16 Another strength of this study is the results are valid across elite age-group environments as "real-world" methodology was employed. For instance, the effects of the intervention occurred despite less than 100% adherence, reflecting that in real life, players miss training and thus do not receive the ideal training load as was intended.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Eight Weeks of Self-Resisted Neck Strength Training Improves Neck Strength in Age-Grade Rugby Union Players: A Pilot Randomized Controlled Trial

et al. 2021

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Background: Greater neck strength is associated with fewer head and neck injuries. Neck-strengthening programs are commonly burdensome, requiring specialist equipment or significant time commitment, which are barriers to implementation. Hypothesis: Completing a neck-strengthening program will increase isometric neck strength in age-group rugby players. Study Design: A pilot randomized controlled exercise intervention study. Level of Evidence: Level 2. Methods: Twenty-eight U18 (under 18) male regional age-group rugby union players were randomized (intervention n =15/control n = 13). An 8-week exercise program was supervised during preseason at the regional training center. Control players continued their “normal practice,” which did not include neck-specific strengthening exercises. The 3-times weekly trainer-led intervention program involved a series of 15-second self-resisted contractions, where players pushed maximally against their own head, in forward, backward, left, and right directions. Outcome Measure: Peak isometric neck strength (force N) into neck flexion, extension, and left and right side flexion was measured using a handheld dynamometer. Results: Postintervention between-group mean differences (MDs) in isometric neck strength change were adjusted for baseline strength and favored the intervention for total neck strength (effect size [ES] = 1.2, MD ± 95% CI = 155.9 ± 101.9 N, P = 0.004) and for neck strength into extension (ES = 1.0, MD ± 95% CI = 59.9 ± 45.4 N, P = 0.01), left side flexion (ES = 0.7, MD ± 95% CI = 27.5 ± 26.9 N, P = 0.05), and right side flexion (ES = 1.3, MD ± 95% CI = 50.5 ± 34.4 N, P = 0.006). Conclusion: This resource-efficient neck-strengthening program has few barriers to implementation and provides a clear benefit in U18 players’ neck strength. While the present study focused on adolescent rugby players, the program may be appropriate across all sports where head and neck injuries are of concern and resources are limited. Clinical Relevance: Greater neck strength is associated with fewer head and neck injuries, including concussion. Performing this neck exercise program independently, or as part of a whole-body program like Activate, an interactive guide for players and coaches, could contribute to lower sports-related head and neck injuries.

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Cervical range of motion, cervical and shoulder strength in senior versus age-grade Rugby Union International front-row forwards

Cited by 10 publications

References 33 publications

Reliability of Repeated Isometric Neck Strength in Rugby Union Players Using a Load Cell Device

Reliability of Repeated Isometric Neck Strength in Rugby Union Players Using a Load Cell Device

Assessment of Interrater and Intrarater Reliability of Cervical Range of Motion (CROM) Goniometer

Eight Weeks of Self-Resisted Neck Strength Training Improves Neck Strength in Age-Grade Rugby Union Players: A Pilot Randomized Controlled Trial

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