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Updated: Feb 3, 2026
A Neuroscientific Approach to the Examination of Concussions in Student-Athletes
Published on: December 8, 2014
Isometric Cervical Muscular Strength in Pediatric Athletes With Multiple Concussions
Glenn Engelman1, Patrick Carry2, Ada Sochanska3
1Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado.
Objective:
To compare maximal cervical muscle strength among athletes with a history of 2 or more concussions relative to athletes with no history of a previous concussion.
Design:
Athletes in the 2 groups were frequency-matched. Linear mixed models were used to test for differences in peak isometric flexion, extension, left lateral flexion, and right lateral flexion cervical muscle torque between groups.
Setting:
Pediatric sports medicine clinic.
Participants:
Athletes with a history of multiple concussions (n = 16) and athletes with no previous concussion history (n = 17). INTERVENTIONS (OR ASSESSMENT OF RISK FACTORS OR INDEPENDENT VARIABLES):: Concussion history (group), age, sex, neck girth, and height.
Main Outcome Measures:
Peak isometric torque measured with a stationary isokinetic dynamometer during a 3-second isometric hold.
Results:
There was no significant difference in peak flexion [mean difference: 21.2%, 95% confidence interval (CI): -6.6% to 57.4%, P = 0.1413], extension (mean difference: 17%, 95% CI, -6.8% to 47.1%, P = 0.1667), left lateral (mean difference: 4.4%, 95% CI, -16.9% to 31.1%, P = 0.7011), or right lateral (mean difference: 9.3%, 95% CI, -14.5% to 39.8%, P = 0.4627) isometric torque in the concussion group relative to the control group. Across all muscle actions, neck torque was significantly (P < 0.05) higher in male compared with female athletes. Increasing neck girth was also associated with a significant (P < 0.05) increase in neck torque.
Conclusions:
There was no evidence of a consistent cervical muscle strength deficit among athletes with a history of 2 or more concussions relative to athletes with no previous history of a concussion. Age, neck girth, and sex were significantly associated with cervical muscle strength.
Clinical Relevance:
Isometric cervical muscle strength testing may not be a reliable test for differentiating athletes with a history of multiple concussions relative to athletes with no history of concussions in the pediatric and adolescent population. Our study presents a reliable methodology for testing cervical muscle strength among young athletes.
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