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Comparison of Active Cervical Range of Motion for Elite
Male Players within Two Helmeted Sports Utilising Differing
Helmet Systems
(Ice Hockey and American Football)
•This study suggests that the wearing of
protective equipment might mitigate
against the reduction in active cervical
range of motion (ACROM), in extension
and flexion, which would otherwise be
expected in such physical contact sports
cf. Rugby union.
•Whether this finding is due to the
presence of protective equipment or
other factors such as the unique types of
play, contact or training is yet to be
determined.
•Recognition of the mechanisms which
can lead to a reduction in a players’
ACROM may help guide healthcare
professionals to address the changes
with appropriate rule adaptations,
treatment and rehabilitation in those
contact sports where protective
equipment is either inadequate or not
worn.
Two elite level sports, Cardiff Devils
Ice hockey and American football,
(Figure 5) were selected for testing of
their(ACROM) using a cervical range of
motion device (CROM device) (Figure 6).
Figure 5 Cardiff Devils
logo
Subjects
Ice hockey players n=12
(age 25.8±4.5 years; time playing
at elite level 17.7±6.9 years)
American football players n=15
(age 22±1.9 years; time playing at
elite level 5 ± 8yrs).
Table 1
Anthropometric data was recorded prior to cervical
spine warm up exercises being performed, consisting
of three movement repetitions through all ranges of
ACROM without, then with the subject wearing the
CROM device. Finally data for all ACROM was then
recorded using a previously described methodology [5]
(Figure 7).
Flex:ext
Flex
Ext
Tot
(degrees)
(degrees)
(degrees)
Control [5] 54 ± 9
77 ± 3
131 ±21 0.7 ± 0.1
55 ± 8
66 ± 7
121 ±15 0.8 ± 0.2
Ice Hockey 52 ±13
n = 12
68 ±15
119 ±21 0.8 ± 0.3
American
Football
n = 15
Figure 6 CROM device in
position
Ceri Ann Jones,
Bianca B Zietsman,
Andrew Heusch
Peter W McCarthy
CT-DRU,
WIoC,
USW,
Treforest,
Pontypridd,
CF37 1DL
Rugby
Forwards
n = 26
*46 ± 3 *43 ± 9 *89 ± 12 *1.1± 0.1
Table 1: this table details the ACROM results gathered from the
three sports shown against control data.
All measurements reported as degrees and displayed as mean ± 1
Standard deviation. (* indicates significant decrease from control
values
p <0.01)
Although there was a significant difference in
flexion between Rugby forwards and American
footballers (p<0.01), there was no such difference
between the Rugby forwards and ice hockey
players.
Figure 7 - Assessment Procedure
Measurements were taken in (G) Neutral, (H) Full Extension and
(I) Full Flexion
Reduced Cervical range of motion (ROM) may
have serious impact on ADL’s,
possibly resulting in
movement problems,
creating local and/or
referred pain ,
muscle spasm,
dizziness, nausea
and
vomiting [1].
Sport and risk of injury go hand in hand,
increasing in proportion to the amount of high
impact contact [2]. Some sports mitigating risk of
serious injury having mandatory use of protective
equipment (Figure 1)
Group means were compared for flexion/extension.
All measurements taken were compared against data
for age-matched controls [5] and a sample of Rugby
Union forwards [4]. Data analysis was performed
using SPSS: ANOVA with post hoc tukey and student
t-test analysis.
Anecdotal evidence [3] suggests rather than reducing
injuries, athletes perceive themselves to be better
protected and more likely to put themselves in injurious
situations (Figure 3).
Figure 3 – Tackles in Sport
(E) Ice hockey (F) American football
1. Treleaven J, Jull G, Sterling M. Dizziness And
Unsteadiness Following Whiplash Injury: Characteristic
Features And Relationship With Cervical Joint Position
Error. Journal of Rehabilitative Medicine 2003,35:36-43
2. Hootman J M, Dick R, Agel J.. (2007). Epidemiology of
Collegiate Injuries for 15 Sports: Summary and
Recommendations for Injury Prevention Initiatives.
Journal of Athletic Training. 42 (2), 311-319.
3. LaPrade RF, Burnett QM, Zarzour R, Moss, R. The
Effect of the Mandatory Use of Face Masks on Facial
Lacerations and Head and Neck Injuries in Ice Hockey.
American Journal of Sports Medicine 1995, 23: 772-775.
4. Lark SD, McCarthy PW. Cervical range of motion and
proprioception in rugby players versus non-rugby
players. Journal of Sport Sciences 2007, 25: 887 – 89.
5. Youdas JW, Garrett TR, Suman VJ, Bogard CL, Hallman
HO, Carey JR. Normal Range of Motion of the Cervical
Spine: An Initial Goniometric Study. Physical Therapy
1992, 72:770-780.
Figure 4 – Tackles in Sport
Rugby union tackle
Figure 1 - Protective Equipment
(A) American football protective equipment , (B) lateral view of an
American Football player, (C) Ice hockey body armour , (D) Ice
hockey helmet .
Previous research showing
participation in Rugby Union,
(Figure 4) without any use of
safety equipment, can significantly
affect a players’ active cervical
ROM (ACROM) [4] in relation to
time in the sport, a single season
and even over a single game.
For further information contact
http://ctdru.research.southwales.ac.uk/
Email: [email protected]
Acknowledgements:
Funding Source:
First Person
Second Contributor