Combining evidence and practice to optimise neck training aimed at reducing head acceleration events in sport: a systematic review and Delphi-consensus study (2025)

1. http://orcid.org/0009-0001-9010-7519Molly Fownes-Walpole1,2,
2. http://orcid.org/0000-0002-7390-6511Omar Heyward1,3,
3. http://orcid.org/0000-0002-9686-0536Kevin Till1,2,
4. Lois Mackay1,4,
5. http://orcid.org/0000-0002-1037-9398Anna Stodter1,5,
6. Marwan Al-Dawoud1,
7. http://orcid.org/0000-0002-5746-3861Melanie Dawn Bussey6,
8. http://orcid.org/0000-0002-0455-6204Leigh Gordon7,
9. James Hairsine3,
10. http://orcid.org/0000-0002-6207-027XChristopher Kirk8,
11. Rob Madden9,10,
12. Lesley McBride11,
13. Alexander McDaniel12,
14. Pete McKnight13,
15. Nathan Mill14,
16. http://orcid.org/0000-0002-2194-3353Kerry Peek15,
17. Gavin Pratt16,
18. Des Ryan17,
19. Danielle Salmon18,19,
20. Lindsey Schroeder12,
21. Craig Twentyman20,
22. Theo Versteegh21,
23. Elisabeth Williams22,
24. http://orcid.org/0000-0002-4274-6236Ben Jones1,7,23,24,25

1. ¹Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
2. ²Leeds Rhinos Rugby League Club, Leeds, UK
3. ³Rugby Football Union, Twickenham, UK
4. ⁴England Netball, Loughborough, UK
5. ⁵Centre for Sport Coaching, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
6. ⁶School of Physical Education Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
7. ⁷Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, South Africa
8. ⁸Sport and Human Performance Research Group, Sheffield Hallam University, Sheffield, South Yorkshire, UK
9. ⁹OPTIM7SE, London, UK
10. ¹⁰Team Anthony Joshua, London, UK
11. ¹¹School of Healthcare, University of Leicester, Leicester, UK
12. ¹²University of North Carolina Wilmington, Wilmington, North Carolina, USA
13. ¹³Freelance Performance Consultant, Yorkshire, UK
14. ¹⁴Saint Helens R.F.C, Merseyside, UK
15. ¹⁵Discipline of Physiotherapy, The University of Sydney, Camperdown, New South Wales, Australia
16. ¹⁶Ultimate Fighting Combat Performance Institute, Las Vegas, Nevada, USA
17. ¹⁷University of Galway, Galway, Ireland
18. ¹⁸International Rugby Players Association, Dublin, Ireland
19. ¹⁹Sport Injury Prevention Research Centre, University of Calgary Faculty of Kinesiology, Calgary, Alberta, Canada
20. ²⁰All Blacks Sevens, Wellington, New Zealand
21. ²¹TopSpin Technologies Ltd, Ontario, Toronto, Canada
22. ²²Applied Sports, Technology, Exercise and Medicine Research Centre (A-STEM), Faculty of Science and Engineering, Swansea University, Swansea, Wales, UK
23. ²³Premiership Rugby, London, UK
24. ²⁴England Performance Unit, Rugby Football League, Manchester, UK
25. ²⁵School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia

1. Correspondence to Molly Fownes-Walpole; m.fownes-walpole{at}leedsbeckett.ac.uk

• Neck
• Training
• Sport
• Brain Concussion

• Neck
• Training
• Sport
• Brain Concussion

Footnotes

• X @MFownesWalpole, @Omar_Heyward, @KTConditioning, @loismackay, @annastodr, @bussey_melanie, @ChrisKirk_ASP, @LMcBPhysio, @peek_kerry, @23benjones

• Contributors MF-W, KT, OH, AS and BJ conceptualised and designed the research project. MF-W, LM and KT completed the systematic review. MFW and OH completed the GRADE. MF-W, KT, OH, AS and BJ constructed the Delphi-consensus-Round-1 survey. MF-W constructed the Round 2 and 3 surveys and completed the inductive content analysis. OH reviewed the statements and text. MF-W was responsible for the interpretation of results and drafted the manuscript. Other authors contributed towards the consensus statements and all authors critically reviewed and edited the manuscript prior to submission. MF-W is the author guarantor.

• Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

• Competing interests One author (TV) works for a company that designs and sells a neuromuscular neck training device. All other authors have no competing interests to declare, however, due to the nature of the study many of the authors work in research or practice involving neck strength or other interventions to reduce concussion/head acceleration events in sports.

• Provenance and peer review Not commissioned; externally peer reviewed.

• Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.