Conditional recommendations are made supporting preventive interventions concussion education and rules prohibiting high-risk activity for both pediatric and adult amateur athletes and neck strengthening exercise in adult amateur athletes .
Strong recommendations are supported for head protective equipment in both pediatric and adult amateur athletes .
Strong recommendations regarding newer football helmet technology in adult amateur athletes and rules governing the implementation of body-checking in youth ice hockey are supported .
Background Awareness of the magnitude of contact sports-related concussions has risen exponentially in recent years .
Our objective is to conduct a prospect ively registered systematic review of the scientific evidence regarding interventions to prevent contact sports-related concussions .
Does Cervical Muscle Strength in Youth Ice Hockey Players Affect Head Impact Biomechanics?
Objective : To evaluate the effect of cervical muscle strength on head impact biomechanics . Design : Prospect i ve cohort . Setting : Field setting . Participants : Thirty-seven volunteer ice hockey players ( age = 15.0 ± 1.0 years , height = 173.5 ± 6.2 cm , mass = 66.6 ± 9.0 kg , playing experience = 2.9 ± 3.7 years ) . Interventions : Participants were equipped with accelerometer-instrumented helmets to collect  head impact biomechanics ( linear and rotational acceleration ) throughout an entire playing season . Before the season , isometric cervical muscle strength was measured for the anterior neck flexors , anterolateral neck flexors , cervical rotators , posterolateral neck extensors , and upper trapezius . Data were analyzed using r and om intercept general mixed linear models , with each individual player as a repeating factor/cluster . Main Outcome Measures : Dependent variables included linear and rotational head accelerations . Cervical strength data were categorized into tertiles , creating groups with high , moderate , and low strength . Strength measures were averaged and normalized to body mass . Results : Significant differences in cervical muscle strength existed across our strength groups ( P < 0.05 ) . No differences were observed in linear or rotational acceleration across strength groups for the anterior neck flexors ( PLin = 0.399 ; PRot = 0.060 ) , anterolateral neck flexors ( PLin = 0.987 ; PRot = 0.579 ) , cervical rotators ( PLin = 0.136 ; PRot = 0.238 ) , posterolateral neck extensors ( PLin = 0.883 ; PRot = 0.101 ) , or upper trapezius ( PLin = 0.892 ; PRot = 0.689 ) . Conclusions : Our hypothesis that players with greater static neck strength would experience lower result ant head accelerations was not supported . This contradicts the notion that cervical muscle strength mitigates head impact acceleration . Because we evaluated cervical strength isometrically , future studies should consider dynamic ( ie , isokinetic ) methods in the context of head impact biomechanics
Conditional recommendations are made supporting preventive interventions concussion education and rules prohibiting high-risk activity for both pediatric and adult amateur athletes and neck strengthening exercise in adult amateur athletes .
Strong recommendations are supported for head protective equipment in both pediatric and adult amateur athletes .
Strong recommendations regarding newer football helmet technology in adult amateur athletes and rules governing the implementation of body-checking in youth ice hockey are supported .
Background Awareness of the magnitude of contact sports-related concussions has risen exponentially in recent years .
Our objective is to conduct a prospect ively registered systematic review of the scientific evidence regarding interventions to prevent contact sports-related concussions .