Objective The primary aim was to compare time from Sports Related Concussion (SRC) in female football players to return-to-play (RTP) clearance following a standardized rehabilitation protocol performed within either neck strengthening exercises protocol (NSE) or visual tracking speed (VTS) protocol. Secondary aims were to compare fatigue after SRC reported and headaches and reinjury occurrence at the 6-month follow-up between neck strengthening and visual tracking groups.

Design Randomized controlled trial.

Setting Forty-three women footballers with reported sports related concussion evaluated by the SCAT -5 test were randomly allocated to a neck strengthening (n = 22) or visual tracking (n = 21) rehabilitation group. Days from SRC to RTP clearance, SRC fatigue reported, headaches, and re-injury occurrence at the 6-month follow-up were reported.

Participants 43 women footballers.

Interventions (or Assessment of Risk Factors) VTS and neck strengthening groups.

Main Results Median time from HSI to RTP clearance was 15 days (95% confidence interval [CI]: 13, 17) in the neck strength group and 17 days (95% CI: 11, 24) in the visual tracking group, which was not significantly different (P = .37). Fatigue reported recovery was greater in the neck strengthening group at RTP clearance by 15% (95% CI: 1%, 28%) and by 15% (95% CI: 1%, 29%) at 2-month follow-up, respectively. Improvement in headaches from baseline was 0.91 cm (95% CI: 0.34, 1.48) greater at 2-month follow-up in the pain-threshold group. Two re injuries occurred in both the neck strengthening and visual tracking groups between RTP clearance and the 6-month follow-up.

Conclusions Neck strengthening rehabilitation did not accelerate RTP clearance but resulted in greater recovery of fatigue and better maintenance of headaches, compared to visual tracking rehabilitation.