Objectives: Primary prevention of concussions is a priority in contact sports, with growing interest in the role of neck strength in mitigating the risks of concussion. The aim of this study was to determine if neck function was associated with in-season concussions in adolescent rugby union and league athletes, and to establish clinical values to identify players with increased risk of sustaining a concussion. Design: Prospective cohort study. Methods: Assessment of neck function included isometric strength, endurance and proprioception. In-season concussion injuries were recorded. Preliminary multivariate analysis-of-covariance models were conducted to investigate differences in neck function between players who did and did not sustain an in-season concussion. If significant, receiver operated characteristic curves were used to determine optimal cut-points for each variable to distinguish between concussion groups. Unadjusted odds ratios were estimated from the cross tabulation chi-squared test. Significance was set at p < 0.1. Results: A total of 43 players (aged 15-18 years) were assessed during preseason. Eleven players sustained a concussion during the season. Players who sustained a concussion during the season had weaker neck extension strength in kilogrammes (p = 0.043, effect size = 0.74) and when normalised to body weight (p = 0.041, effect size = 0.74). The optimal cut-point for extension strength was 32.1 kg (sensitivity 0.64, specificity 0.75) and 3.71 N/kg (sensitivity 0.64, specificity 0.66). Players with a flexor to extensor strength ratio above 0.74 were 3-times more likely to sustain a concussion (p = 0.09). There were no differences for other neck function variables. Conclusions: Interventions targeting neck strength could reduce the risk of concussion. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of Sports Medicine Australia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

BACKGROUND:Mixed martial arts (MMA) is experiencing a surge in popularity in Australia. Previous research has suggested knockout (KO) and technical knockout (TKO) are frequent outcomes during competition, raising concern about the brain health of athletes. This study aims to describe fight outcomes in Australian MMA and to explore differences in fight-ending outcomes between male and female athletes, amateur and professional competition, and different weight classes. HYPOTHESIS:There is no difference in the incidence of KO/TKO between level of competition, sex, and weight class. STUDY DESIGN:Descriptive epidemiology study. LEVEL OF EVIDENCE:Level 3. METHODS:Retrospective analysis of 143 Australian MMA events from 2020 to 2023 was conducted using video replay to assess fight outcomes between sex and level of competition. Binary logistic regression analysis was used to determine relationships between weight class and KO/TKO fight outcomes. RESULTS:Male competition (34%) had a significantly greater number of KO/TKO secondary to head strikes fight outcomes compared with female competition (23%) (P = 0.01). The KO/TKO rate secondary to head strikes for amateur and professional male competition was 16.6 and 18.7 per 100 athlete-exposures (AEs), respectively. The amateur and professional female rate was 12.6 and 7.4 per 100 AEs, respectively. Amateur male light heavyweight and heavyweight, and professional male heavyweight were at greater odds of a KO or TKO compared with other weight classes in their equivalent level of competition. CONCLUSION:There is a sex and professional level disparity in the incidence of fight-ending head trauma in Australian MMA. The study findings highlight the urgent need for targeted safety protocols and medical oversight, particularly for men in heavier weight classes. CLINICAL RELEVANCE:This study highlights the need for enhanced safety protocols and medical oversight in Australian MMA, particularly for male athletes in heavier weight divisions.

Head, neck and face injuries are a concern in contact sports. This exploratory study aimed to establish 1) injury risk factors for head, neck and face injuries and 2) clinical cut-off values related to strength, endurance and proprioception of the cervical spine in a team of professional rugby league players. Pre-season assessments of isometric strength of the flexor, extensor and lateral flexor muscles, endurance of the flexor muscles and joint position error were conducted. Injuries resulting in games missed were recorded. Cross-tabulations were used to determine the unadjusted odds ratios for the measures as risk factors for playing season injuries. The unadjusted odds ratio (OR) values indicated that if a player had weaker extensors of the neck (<36.4 kg, p = 0.014; <3.4N/kg, p = 0.014) or asymmetry of isometric strength of their lateral flexor muscles (left-to-right ratio <0.91, p = 0.005), their odds of games missed due to season head, neck and face injuries was increased (OR extensors = 8; 95% CI = 1.5-42.5 OR asymmetry of lateral flexor muscles OR = 12.6; 95% CI = 2.0-79.4). As muscle strength is modifiable, the clinical application of this study would involve targeting players in the team beneath the clinical cut-off value.

Introduction: Combat sport athletes are exposed to intentional strikes to the head. These strikes result in height linear and rotational acceleration forces that can result in concussion and neck injury. Despite experiencing ongoing post-concussion symptoms, combat sport athletes continue to participate in their sport. Neck muscle strength has been described as a modifiable risk factor for the prevention of concussion, but neck strength has been found to be reduced in the presence of concussion symptoms, including neck pain in non-combat sport populations. The relationship between concussion-related symptoms and cervical spine muscle strength has not been investigated in combat sport athletes. This study investigated neck strength in combat sport athletes compared with a control group, and explored relationships between symptom-based outcome measures and cervical spine muscle strength. Methods: Forty male combat sport athletes (Muay Thai and Mixed Martial Arts) and 40 male control athletes were recruited from local combat sport clubs and a university campus. Cervical spine isometric muscle strength was assessed at a private physiotherapy clinic. Spearman’s rank correlations were used to identify relationships between the Post-Concussion Symptom Scale (PCSS) and the Neck Disability Index (NDI) with cervical spine isometric muscle strength. Results: Combat sport athletes were found to have higher isometric muscle strength in the directions of flexion, extension and right and left anterolateral flexion (all p < 0.05). Higher PCSS total scores were correlated (p < 0.05) with a lower isometric strength in the direction of cervical spine flexion (rs = -0.33), right anterolateral flexion (rs = -0.39), and left anterolateral flexion (rs = -0.32) among combat sport athletes. Similarly, higher severity scores were correlated (p < 0.05) with lower isometric strength in the direction of flexion (rs = -0.40), right anterolateral flexion (rs = -0.49), and left anterolateral flexion (rs = -0.42). Finally, higher NDI scores were correlated with a lower neck strength in all four directions (rs = -0.39 – -0.52, p < 0.5). Discussion: Combat sport athletes had higher isometric strength of the cervical spine compared with the control group. Differences in cervical spine strength may be related to long-term training adaptations. Athletes with higher symptom scores had lower neck strength scores. Combat sport athletes require adequate strength of the cervical spine muscles to withstand the repeated linear and rotational forces sustained during participation. The reduction in neck strength in athletes who are symptomatic may lessen their ability to absorb the forces from strikes that they are subjected to during training and competition. Impact and application to the field: Clinicians should consider screening neck strength in athletes involved in combat sport when they present with concussion-related symptoms. This may help identify whether a targeted strengthening program is warranted. My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract.

Objectives: To investigate for differences in vestibulo-ocular function between active male combat sport athletes and a healthy control group. In addition, to explore the relationship between symptom-based outcome measures with vestibulo-ocular function.Design: Cross-sectional.Methods: 40 male adult combat sport athletes and 40 active male control participants were recruited from 4 martial arts schools and a University campus in Queensland, Australia. All participants completed a standardised protocol which was used to assess vestibulo-ocular function. The protocol included 3 components: 1) oculomotor function, 2) benign paroxysmal positional vertigo screening, and 3) vestibulo-ocular reflex function. The Post Concussion Symptom Scale, Vestibular/Ocular Motor Screening tool and Dizziness Handicap Inventory were used as symptom-based outcome measures.Results: More combat sport athletes had oculomotor abnormalities than control group participants. There were no between group differences in benign paroxysmal positional vertigo, vestibulo-ocular reflex function and the video-head impulse test gain (ms). Combat sport athletes had higher symptom-based outcome scores. The Vestibular/Ocular Motor Screening tool and Dizziness Handicap Inventory were found to have moderate positive relationships with the total number of abnormalities detected in the combat sport group.Conclusions: Vestibulo-ocular function is imperative for combat sport athletes to perform evasive manoeuvres and land their own strikes. The present study findings may aid clinicians in the identification of combat sport athletes with underlying vestibulo-ocular dysfunction, prompting further investigation.(c) 2022 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Objective The first aim of this study was to compare the results of the vestibular/ocular motor screening (VOMS) in combat sport athletes with a healthy control population. Second, to explore differences between athletes with and without a concussion history. Third, to examine the relationship between VOMS and the Post-Concussion Symptom Scale (PCSS) in combat sport athletes. Participants Forty active male combat sport athletes and 40 healthy male control participants were recruited from 4 clubs and a University in Australia. Methods Participants completed the VOMS in a primary care physiotherapy clinic. Participants completed an injury questionnaire and the PCSS. Results An "abnormal" score in at least one subtest or near point convergence (NPC) was recorded in 45% of the combat group compared with 22.5% of the control group. All VOMS scores and NPC distance were greater in the combat group compared with control group (p < 0.05). The VOMS scores were found to be moderately positively correlated with the PCSS. There was no difference in VOMS between athletes with and without a history of concussion (p > 0.05). Conclusion VOMS scores differed between combat sport athletes and control participants. The PCSS may aid clinicians in identifying athletes who have underlying vestibular/oculomotor impairment.

BACKGROUND:Injury to the head and neck are common in combat sport athletes. Impairments of the cervical spine have been found in some athletes who participate in sports with high forces and collisions. There is a lack of research on the effects of combat sports on the cervical spine. OBJECTIVE:The primary study aim was to investigate differences in cervical spine characteristics between combat athletes and a similarly aged active control group. The secondary aim was to investigate the relationship between symptom-based outcome measures and characteristics of the cervical spine. DESIGN:Cross-sectional. METHOD:40 male adult combat sport athletes and 40 male adult control participants were recruited from 4 combat sport clubs and a university campus, Australia. Cervical spine assessments were conducted at a private physiotherapy clinic. The Neck Disability Index and the Post-Concussion Symptom Scale were used as symptom-based outcome measures. RESULTS:Combat sport athletes had a reduced range of cervical motion, but greater isometric strength and endurance compared with a control group (p < 0.05). The Neck Disability Index and Post-Concussion Symptom Scale were negatively correlated with cervical spine range of motion and isometric strength, meaning that higher scores correlated with a reduction in function. CONCLUSIONS:Differences were observed in characteristics of the cervical spine in combat sport athletes compared with a control group. Higher symptom-based outcome scores correlated with reduced range of motion and strength of cervical spine muscles. Further investigation to establish clinical cut-off scores for functional impairment may be warranted.

Objective: The purpose of this study was to describe the concussion-related symptoms reported among combat sport athletes with and without a history of concussion, and a history of neck injury. Design: Cross-sectional survey. Setting: Data were collected using an online survey instrument. Participants: Three hundred and nine adult combat sport athletes. Main outcome measures: Self-reported 12-month concussion history and neck injury history and a 22 item symptom checklist. Results: A history of concussion was reported by 19.1% of athletes, a history of neck injury was reported by 23.0%, and 13.6% reported both injuries. Neck pain was the most frequently reported symptom. Athletes with a history of injury had significantly greater proportions of 'high' total symptoms and symptom severity scores compared with athletes with no history of injury. Athletes with a history of concussion had 2.35 times higher odds of reporting 'high' total symptoms and symptoms severity scores. Conclusion: Athletes with a history of concussion or neck injury have greater odds of presenting with higher symptom scores. The presence of high total symptom scores and high symptom severity scores may indicate a need for further investigation into domains commonly associated with concussion. (C) 2020 Elsevier Ltd. All rights reserved.

Medical Journal of AustraliaVolume 1, Issue 9 p. 400-400 Correspondence SCREENING FOR NEONATAL HYPOTHYROIDISM Bridget Wilcken, Bridget Wilcken Oliver Latham Laboratory, Psychiatric Centre, North Ryde, N.S.W., Cox's Road, 2113Search for more papers by this authorD. A. Brown, D. A. Brown Oliver Latham Laboratory, Psychiatric Centre, North Ryde, N.S.W., Cox's Road, 2113Search for more papers by this author Bridget Wilcken, Bridget Wilcken Oliver Latham Laboratory, Psychiatric Centre, North Ryde, N.S.W., Cox's Road, 2113Search for more papers by this authorD. A. Brown, D. A. Brown Oliver Latham Laboratory, Psychiatric Centre, North Ryde, N.S.W., Cox's Road, 2113Search for more papers by this author First published: 01 May 1979 https://doi.org/10.5694/j.1326-5377.1979.tb126994.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume1, Issue9May 1979Pages 400-400 RelatedInformation