Does strengthening the cervical spine musculature enhance neck strength and reduce sports-related concussions in rugby and football players? A systematic literature review.

OBJECTIVES

The aim is to search for high-quality evidence to determine whether strengthening cervical spine musculature can reduce sports-related concussions and improve neck strength in football and rugby players.

DESIGN

Systematic literature review.

METHODS

We searched PubMed, SPORTDiscus, Medline, CINAHL, Cochrane Library, Web of Science, and Scopus databases from January 2002 to September 2022. We focused on randomised controlled trials (RCTs) and cohort or pre-post studies assessing cervical musculature strengthening (CMS) interventions in football and rugby players.

RESULTS

The search returned 940 articles. After screening and critical appraisal, 10 studies involving 3453 participants were retained for the review; seven studies providing complete data were synthesised into the meta-analysis, and the remaining three were synthesised into a narrative format. Two studies answered the primary objective that strengthening the cervical spine musculature reduces the incidence of sports-related concussions in male rugby players by 45 %, with a risk ratio of 0.55 (95 % CI 0.33 to 0.92, P < 0.05). However, no studies provided evidence that strengthening the musculature of the cervical spine reduces sports-related concussions in football (soccer) or female rugby players. Eight studies answered the secondary objective that CMS has a greater beneficial effect on neck strength, specifically in neck extension, for male rugby players, but the evidence is limited for football (soccer) and female rugby players.

CONCLUSION

The evidence in this systematic review suggests that the incorporation of CMS programs into rugby training may reduce concussion risk by almost half. However, further research is needed to evaluate the effectiveness of CMS in football and female rugby players.

PROSPERO: CRD4202236054.