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Assessing Head/Neck Dynamic Response to Head Perturbation: A Systematic Review

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Abstract

Background

Head/neck dynamic response to perturbation has been proposed as a risk factor for sports-related concussion.

Objectives

The aim of this systematic review was to compare methodologies utilised to assess head/neck dynamic response to perturbation, report on magnitude, validity and reliability of the response, and to describe modifying factors.

Methods

A systematic search of databases resulted in 19 articles that met the inclusion and exclusion criteria.

Results

Perturbation methods for head/neck dynamic response included load dropping, quick release and direct impact. Magnitudes of perturbation energy varied from 0.1 to 11.8 J. Head/neck response was reported as neck muscle latency (18.6–88.0 ms), neck stiffness (147.2–721.9 N/rad, 14–1145.3 Nm/rad) and head acceleration (0.2–3.8g). Reliability was only reported in two studies. Modifying factors for head/neck response included younger and older participants presenting increased responses, females showing better muscular reactivity but similar or increased head kinematics compared with males, and bracing for impact limiting muscular activity and head kinematics.

Discussion

Substantial differences in experimental and reporting methodologies limited comparison of results. Methodological factors such as impact magnitude should be considered in future research.

Conclusion

Each methodology provides valuable information but their validity for anticipated and unanticipated head impacts measured in vivo needs to be addressed. Reports on head/neck response should include measurement of transmitted force, neck muscle latency, head linear and rotational accelerations, and neck stiffness. Modifying factors of anticipation, participants’ age, sex, and sport are to be considered for head/neck dynamic response.

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CRD42016051057 (last updated on 27 February 2017).

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Acknowledgements

The authors thank the Auckland University of Technology for the AUT SRIF RCRG Neck Strength Project grant 2016.

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Authors and Affiliations

  1. Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand

    Enora Le Flao, Matt Brughelli, Patria A. Hume & Doug King

  2. National Institute of Stroke and Applied Neuroscience (NISAN), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand

    Patria A. Hume

  3. School of Science and Technology, University of New England, Armidale, NSW, Australia

    Doug King

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Correspondence to Enora Le Flao.

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Funding

This systematic review formed part of the AUT SRIF RCRG Neck Strength Project grant 2016. This funding supported development of the research strategy, data extraction and analyses by the primary investigators. The funder had no input into the interpretation or publication of the study results.

Conflict of interest

Enora Le Flao, Matt Brughelli, Patria A. Hume and Doug King declare that they have no conflicts of interest relevant to the content of this review.

Author contributions

According to the definition given by the International Committee of Medical Journal Editors (ICMJE), the authors listed above qualify for authorship based on making one or more substantial contributions to the intellectual content of the manuscript. Enora Le Flao and Matt Brughelli were responsible for the conception and design of the review, and the acquisition, analysis and interpretation of data. They also contributed to the drafting of the manuscript and critical revision. In addition, Matt Brughelli contributed to funding acquisition. Doug King contributed to the drafting of the manuscript and to critical revision. Patria Hume contributed to critical revision and funding acquisition.

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Le Flao, E., Brughelli, M., Hume, P.A. et al. Assessing Head/Neck Dynamic Response to Head Perturbation: A Systematic Review. Sports Med 48, 2641–2658 (2018). https://doi.org/10.1007/s40279-018-0984-3

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