An examination of neck strength, and other possible predictors of concussion risk in university athletes and how these variables relate to concussion recovery in this cohort. / Concussion incidence in university athletes has been increased drastically over the last two decades. Prevention of concussion injuries is still elusive and scarcely reported in the literature. Certain athletes are at greater risk for concussion than others. Identifying these risk factors is an important first step in identifying those who are at highest risk for concussion. Concussions are biomechanical injuries therefore addressing the strength of the neck musculature might be a significant modifiable risk factor in concussion prevention. Greater neck strength may help to attenuate the forces that cause concussion and either prevent injury or decrease the severity. There are some known risk factors for concussion, including age and female sex, however this does not account for all of the variability in concussion incidence in university athletes. Further exploration into the importance of neck strength and concussion in university athletes is required to identify alternative prevention strategies available to athletes. The purpose of this research was to examine if neck strength and anthropometric variables are significant predictors of concussion risk and concussion recovery time in Canadian university athletes. Chapter One provides a review of the current literature on concussion. It presents the background information for concussion risk, etiology, assessment, and management in university athletes. This chapter also reviews the literature to date on neck strength in concussion and assessments of neck strength in athletes. Chapter Two presents a study evaluating the risk of concussion in a group of Canadian university varsity athletes (n = 246). Neck strength and anthropometric variables are assessed for their significance in predicting concussion risk in this cohort along with published covariates. Neck pain and past concussion history were found to be the most significant predictors of concussion in this population. Chapter Three provides an exploration into the importance of neck strength and anthropometric variables in length of recovery in concussed athletes (n = 35). The Sport Concussion Assessment Tool, 3rd edition was used to evaluate symptom intensity in these athletes. A multiple linear regression model was used to predict recovery time. Symptom score and neck pain were the only significant predictors of concussion recovery time in varsity athletes. Chapter Four presents the implications of the two aforementioned studies for clinical practice, future research, and policy recommendations. More in-depth assessments prior to the beginning of competition should be considered in identifying athletes who are at greatest risk for concussion. Athletes with significant past concussion history should be evaluated more closely and informed of their heightened risk for subsequent injury. / Thesis / Master of Health Sciences (MSc)

Yes / There is no single, universally accepted method of measuring isometric neck strength to inform exercise prescription and injury risk prediction. This study aimed to establish the inter- and intra-rater reliability of a commercially available fixed frame dynamometer in measuring peak isometric neck strength. A convenience sample of male (n = 16) and female (n = 20) university students performed maximal isometric contractions for flexion (Flex), extension (Ext), left- (LSF) and right-side flexion (RSF) in a quadruped position over three sessions. The intra-rater reliability results were good-to-excellent for both males (ICC = 0.83–0.90) and females (ICC = 0.86–0.94) and acceptable (CV < 15%) across all directions for both males and females. The inter-rater reliability results were excellent (ICC = 0.96–0.97) and acceptable (CV < 11.1%) across all directions. Findings demonstrated a significant effect for sex (p ≤ 0.05): males were stronger in all four directions, and a significant effect for direction (p ≤ 0.05): Ext tested stronger (193 N) than Flex (176 N), LSF (130 N) and RSF (125 N). The findings show that the VALD fixed frame dynamometer can reliably assess isometric neck strength and can provides reference values for healthy males and females.

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