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010 Effects of a strength and proprioceptive training programme on neck function and concussion injury risk in elite scottish rugby union players
  1. Stuart Bailey1,
  2. Russell Martindale1,
  3. Lars Engebretsen2,
  4. Jen Sweeting3,
  5. Jared Deacon3,
  6. Florence Laing3,
  7. Chris Leck3,
  8. Debbie Palmer1,4
  1. 1School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
  2. 2Oslo Sports Trauma Research Center, Oslo, Norway
  3. 3Scottish Rugby Union, Edinburgh, UK
  4. 4Institute for Sport, PE and Health Sciences, Moray House School of Education and Sport, Edinburgh, UK


Background Cervical musculature function (strength, endurance, and proprioception) may be a modifiable risk factor for concussion in contact sports. The ability to enhance neck function and reduce concussive risk needs to be determined.

Objective To assess the efficacy of a training programme to enhance neck function and lower match concussion injury risk in rugby union players.

Design Repeated-measures intervention with control.

Setting Premiership rugby union players in Scotland during the 2018/19 season.

Patients (or Participants) Premiership players selected for Scotland Rugby academies (intervention group; INT; n = 30) or those with their clubs (control group; CON; n = 20).

Interventions (or Assessment of Risk Factors) A neck training programme was implemented twice per week during the 2018/19 season for INT, while CON performed no systematic neck training.

Main Outcome Measurements For both INT and CON neck strength (maximal voluntary contraction; MVC), endurance (exercise capacity; TTF) and proprioception pre- and post-season, and match concussion injury incidence were recorded.

Results Left and right cervical flexion MVC force and flexion TTF all significantly increased in the intervention group (p < 0.001), with no significant change in the control group. While there were increases in cervical flexion and extension MVC force in both groups from pre to post-season, there was a significantly greater increase amongst the intervention group (p < 0.05). Concussion incidence was lower in INT versus CON (INT: 7.7/1000 match hours; CON: 18.4/1000 match hours). However, this was not a significant alteration in risk (incidence rate ratio: 0.42; 95% CI: 0.08–2.1).

Conclusions The neck function programme increased cervical MVC force and flexion exercise capacity, beyond any changes induced by a season of rugby union. The intervention group also had a lower incidence of concussion across the season. This pilot study shows good promise and highlights the need for further investigation.

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