title: Cervical isometric strength and range of motion of elite rugby union players: a cohort study.
abstract: BACKGROUND
  Head and neck injury is relatively common in Rugby Union. Despite this, strength and range-of-motion characteristics of the cervical spine are poorly characterised. The aim of this study was to provide data on the strength and range-of-motion of the cervical spine of professional rugby players to guide clinical rehabilitation.
  
  
  METHODS
  A cohort study was performed evaluating 27 players from a single UK professional rugby club. Cervical isometric strength and range-of-motion were assessed in 3 planes of reference. Anthropometric data was collected and multivariate regression modelling performed with a view to predicting cervical isometric strength.
  
  
  RESULTS
  Largest forces were generated in extension, with broadly equal isometric side flexion forces at around 90% of extension values. The forwards generated significantly more force than the backline in all parameters bar flexion. The forwards had substantially reduced cervical range-of-motion and larger body mass, with differences observed in height, weight, neck circumference and chest circumference (p < 0.002). Neck circumference was the sole predictor of isometric extension (adjusted R(2) = 30.34).
  
  
  CONCLUSIONS
  Rehabilitative training programs aim to restore individuals to pre-injury status. This work provides reference ranges for the strength and range of motion of the cervical spine of current elite level rugby players.
authors.affiliation: Department of Trauma and Orthopaedics, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH164SB, UK.
authors.forename: David F
authors.initials: DF
authors.lastname: Hamilton
authors.affiliation: Gatherer (Physiotherapy Limited), Tudor House, Aylesbury, UK.
authors.forename: Don
authors.initials: D
authors.lastname: Gatherer
keywords: Cervical spine; Range of motion; Rugby; Strength