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ToolsFOWNES-WALPOLE, Molly, HEYWARD, Omar, TILL, Kevin, MACKAY, Lois, STODTER, Anna, AL-DAWOUD, Marwan, BUSSEY, Melanie Dawn, GORDON, Leigh, HAIRSINE, James, KIRK, Chris, MADDEN, Rob, MCBRIDE, Lesley, MCDANIEL, Alexander, MCKNIGHT, Pete, MILL, Nathan, PEEK, Kerry, PRATT, Gavin, RYAN, Des, SALMON, Danielle, SCHROEDER, Lindsey, TWENTYMAN, Craig, VERSTEEGH, Theo, WILLIAMS, Elisabeth and JONES, Ben (2025). Combining evidence and practice to optimise neck training aimed at reducing head acceleration events in sport: a systematic review and Delphi-consensus study. British Journal of Sports Medicine. [Article]
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35723:934504
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Fownes-Walpole et al 2025 Neck strength Delphi ACCEPTED.pdf - Accepted Version
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Fownes-Walpole et al 2025 Neck strength Delphi ACCEPTED.pdf - Accepted Version
Available under License Creative Commons Attribution.
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Abstract
Head acceleration events (HAEs) can potentially have adverse consequences for athlete brain health. In sports, in which head injuries have the highest incidence, identifying strategies to reduce HAE frequency and magnitude is a priority. Neck training is a potential strategy to mitigate against the magnitude of HAEs. This two-part study aimed to (1) systematically review the literature of neck training interventions in sport and (2) undertake an expert Delphi consensus on the best practices for neck training implementation to reduce HAEs in sport. Part I: a systematic search of four databases was undertaken from the earliest records to September 2024. The PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines were followed, and a quality assessment was completed using a modified Downs and Black assessment tool and the GRADE (Grading of Recommendations Assessment, Development and Evaluation). Papers were eligible if they both (1) implemented a reproducible exercise intervention targeting the neck within collision, combat or motor sport, and (2) assessed outcomes relating to either: the physical profile of the neck; head/neck injury incidence; and/or HAEs. Part II: 18 international experts, with experience in research and/or applied practice of neck exercise training, concussion and/or HAEs, reviewed the part I findings before completing a three-round Delphi consensus process. Part I included 21 papers, highlighting the heterogeneity of existing interventions. Part II resulted in 57 statements coded into five categories: contextual factors (n=17), neck training periodisation (n=12), training adaptations (n=10), neck training content (n=15) and athlete adherence (n=3). This study presents recommendations for neck exercise training aiming to reduce HAEs in sport, supporting both practice and future research.
More Information
Identification Number:
ORCID for Molly Fownes-Walpole:
orcid.org/0009-0001-9010-7519
orcid.org/0009-0001-9010-7519
ORCID for Omar Heyward:
orcid.org/0000-0002-7390-6511
orcid.org/0000-0002-7390-6511
ORCID for Kevin Till:
orcid.org/0000-0002-9686-0536
orcid.org/0000-0002-9686-0536
ORCID for Anna Stodter:
orcid.org/0000-0002-1037-9398
orcid.org/0000-0002-1037-9398
ORCID for Melanie Dawn Bussey:
orcid.org/0000-0002-5746-3861
orcid.org/0000-0002-5746-3861
ORCID for Leigh Gordon:
orcid.org/0000-0002-0455-6204
orcid.org/0000-0002-0455-6204
ORCID for Chris Kirk:
orcid.org/0000-0002-6207-027X
orcid.org/0000-0002-6207-027X
ORCID for Kerry Peek:
orcid.org/0000-0002-2194-3353
orcid.org/0000-0002-2194-3353
ORCID for Ben Jones:
orcid.org/0000-0002-4274-6236
orcid.org/0000-0002-4274-6236
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