Evaluation of Neck Strength and Concussion Risk: A Systematic Review.

Concussions are a major concern in sports, particularly contact sports. Neck strength may be a protective factor in limiting concussion risk by reducing head acceleration. This meta-analysis aimed to determine whether an increase in neck strength reduced concussion risk in athletes. Articles were selected based on determined inclusion and exclusion criteria. Five articles met the criteria and were included in our analysis. Standardized mean differences and 95% confidence intervals were calculated for each and visualized using a forest plot. Across five planes of motion (flexion, extension, right and left flexion, and total), no statistically significant differences in neck strength were found. Some studies reported a positive trend in increased neck strength and concussion risk reduction, indicating possible clinical significance. In conclusion, evidence remains inconclusive on the association between neck strength and concussion risk. Further large, randomized controlled trials are needed to recommend neck strength as a preventive strategy.