The relationship between neck strength and sports-related concussion in team sports : A systematic review with meta-analysis

Journal article


Garrett, Joel M., Mastrorocco, Marco, Peek, Kerry, van den Hoek, Daniel J. and McGuckian, Thomas B.. (2023). The relationship between neck strength and sports-related concussion in team sports : A systematic review with meta-analysis. Journal of Orthopaedic and Sports Physical Therapy. 53(10), pp. 585-593. https://doi.org/10.2519/jospt.2023.11727
AuthorsGarrett, Joel M., Mastrorocco, Marco, Peek, Kerry, van den Hoek, Daniel J. and McGuckian, Thomas B.
Abstract

OBJECTIVE: We aimed to quantify the relationship between neck strength and sports-related concussion (SRC) for athletes participating in team sports.

DESIGN: Etiology systematic review with meta-analysis.

LITERATURE SEARCH: PubMed, PsycINFO, MEDLINE, CINAHL, CENTRAL, and Scopus were searched on March 17, 2022, and updated on April 18, 2023.

STUDY SELECTION CRITERIA: Team sports where an opponent invades the player’s territory (eg, football, rugby, basketball) that reported at least 1 measure of neck strength, and 1 measure of SRC incidence, using cohort, case-control, or cross-sectional study designs. The Newcastle-Ottawa scale was used to assess risk of bias; certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach.

DATA SYNTHESIS: Studies were summarized qualitatively and quantitatively. To understand the relationship between neck strength and future SRC incidence, random-effects meta-analysis was conducted on prospective longitudinal studies.

RESULTS: From a total of 1445 search results, eight studies including 7625 participants met the inclusion criteria. Five studies reported a relationship between greater neck strength or motor control and reduced concussion incidence. Pooled results from 4 studies indicated small (r = 0.08-0.14) nonsignificant effects with substantial heterogeneity (I2>90%). The considerable heterogeneity is likely a result of synthesized studies with vastly different sample characteristics, including participant age, playing level, and sports.

CONCLUSIONS: There was very low–certainty evidence suggesting a small, nonsignificant relationship between greater neck strength and a lower risk of sustaining a SRC.

Keywordsathletic injuries; exercise training; invasion sport; sport injuries; strength
Year2023
JournalJournal of Orthopaedic and Sports Physical Therapy
Journal citation53 (10), pp. 585-593
PublisherJournal of Orthopaedic & Sports Physical Therapy, Inc.
ISSN0190-6011
Digital Object Identifier (DOI)https://doi.org/10.2519/jospt.2023.11727
PubMed ID37428807
Scopus EID2-s2.0-85167842364
Page range585-593
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All rights reserved
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Controlled
Output statusPublished
Publication dates
Online11 Aug 2023
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Deposited03 Apr 2025
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