Neck strengthening reduces the risk of concussion: A critical appraisal topic

Clinical Scenario: A concussion is a traumatic brain injury (TBI) that is caused by a direct or indirect blow. Symptom duration and severity vary depending on the individual and trauma. There are multiple predisposing factors that can increase the risk of concussion such as collision sports, sport position, history of concussions, age, being female, and neck strength. Neck strength is a risk factor that can be assessed and modified to reduce the risk of concussions.

Clinical Question: Does neck strengthening reduce the risk of concussions in collision sports?

Summary of Key Findings: Based on the studies’ findings, neck strengthening may mitigate the risks of concussions in collision sports. Among the individuals that sustained a concussion, weak extension strength was the weakest. A handheld dynamometer is a reliable tool to measure neck strength.

Clinical Bottom Line: Implementing neck strengthening may reduce the risk of concussions in collision sports. The outcome measures showed that after increasing neck strength the incidence of concussions decreased. In the subjects that sustained a concussion, overall neck strength was weaker, especially in extension.

Strength of Recommendation: Based on CEBM and PEDro scores of evidence assessments, the strength of recommendation is a B.