AbstractsMedical & Health Science

Background: Rugby is a high speed collision sport during which the neck is often exposed to loads that place it at risk of injury. When injuries do occur they range from catastrophic injuries where permanent spinal cord damage may result, through to minor injuries where the primary symptom is neck pain (NP). As a potential preventative strategy it has been proposed that neck muscle strength and endurance may play a role in the prevention or mitigation of minor neck injury. Aims: The overall aim of this thesis was to explore the efficacy of a neck specific exercise intervention in improving neck neuromuscular function (neck muscle strength and endurance) and alleviating or minimizing symptoms of minor neck injury (neck pain and stiffness). To evaluate the efficacy of this intervention, a testing apparatus and an experimental protocol capable of reliably measuring neck strength and endurance were designed and developed. In order to address these aims, the thesis was constructed around a number of independent but linked research projects. Methods: A sequential multi-study approach was used to examine neck strength, endurance, NP and neck stiffness (NS) in rugby players. A critical review of the literature examined the existing neck injury surveillance data and potential factors or mechanisms that may play a role in the occurrence of neck injuries. A retrospective online survey was employed to examine the impact neck injuries sustained while playing rugby have on the subsequent health of retired players. A custom testing apparatus was designed and built to examine neck strength and endurance in a simulated contact posture, and its reliability established. This apparatus was then used with a cohort of amateur forwards, backs and healthy controls to examine the effect of a 20-week competitive season on neck neuromuscular performance. Evidence gathered from the thesis studies was used to design a neck exercise intervention for rugby players. The efficacy of this intervention was then examined in a cohort of professional rugby players using measures of neuromuscular function and perceived neck dysfunction (NP and NS) over a competitive season and compared with a group of players who did not receive the intervention. Results: Neck pain and NS proved to be frequently reported current health complaints for retired professional rugby players. The majority of players surveyed sustained a neck injury (79%) during their careers. Of these, 91% reported currently experiencing symptoms of either NP and/or NS. These findings indicate that most professional players will sustain a neck injury and that this injury, or the accumulation of microtrauma in the neck region over their careers will have long-term health and disability consequences. The testing apparatus developed assessed the neck isometrically in a simulated contact position. Assessment of neck strength over a single session revealed that, in the adopted body position, neck strength in the four examined directions could be reliably assessed using three trials…