Reliability of Repeated Isometric Neck Strength in Rugby Union Players Using a Load Cell Device

Abstract

Concussion is the most common injury in professional Rugby Union (RU) players, with increasing incidence and severity each year. Strengthening the neck is an intervention used to decrease concussion incidence and severity, which can only be proven effective if neck strength measures are reliable. We conducted a repeated-measures reliability study with 23 male RU players. Neck strength was assessed seated in a ‘make’ test fashion in flexion, extension, and bilateral side flexion. Flexion-to-extension and left-to-right side ratios were also computed. Three testing sessions were undertaken over three consecutive weeks. Intrasession and intersession reliabilities were assessed using typical errors, coefficient of variations (CV), and intraclass correlation coefficients (ICC). Intrasession reliability demonstrated good-to-excellent relative (ICC > 0.75) and good absolute (CV ≤ 20%) reliability in all directions (ICC = 0.86–0.95, CV = 6.4–8.8%), whereas intersession reliability showed fair relative (ICC: 0.40 to 0.75) and acceptable absolute (CV ≤ 20%) reliability for mean and maximal values (ICC = 0.51–0.69, CV = 14.5–19.8%). Intrasession reliability for flexion-to-extension ratio was good (relative, ICC = 0.86) and acceptable (absolute, CV = 11.5%), and was fair (relative, ICC = 0.75) and acceptable (absolute, CV = 11.5%) for left-to-right ratio. Intersession ratios from mean and maximal values were fair (relative, ICC = 0.52–0.55) but not always acceptable (absolute, CV = 16.8–24%). Assessing isometric neck strength with a head harness and a cable with a load cell device seated in semi-professional RU players is feasible and demonstrates good-to-excellent intrasession and fair intersession reliability. We provided data from RU players to inform practice and assist standardization of testing methods.