Abstract
Concussion in rugby is a significant concern, with rugby having the highest concussion rate among sports. Dynamic head stabilization (DHS) is crucial for reducing forces acting on the brain during impacts, but the most effective training methods for improving DHS remain unclear. This study aimed to investigate the effectiveness of a plyometric neck training program on improving DHS and associated neck muscle characteristics in female rugby players. Eighteen female rugby players completed a 7-week plyometric neck training program. Pre- and post-training assessments included head kinematics during anticipated and unanticipated perturbations, eccentric neck strength, rate of torque development (RTD), and rate of force development (RFD) during a wall rebound exercise. Linear mixed-effects models were used to evaluate changes, and custom analyses were used to investigate relationships between changes in kinematic responses to perturbation and changes in neck muscle characteristics. Plyometric training significantly reduced peak angular acceleration (d = -0.68, p = 0.004) and total displacement (d = -0.61, p < 0.001) of the head during unanticipated perturbations, and significantly reduced total head displacement (d = -0.67, p = 0.022) during anticipated impacts. Eccentric peak torque improved moderately in both flexor (d = -0.61, p < 0.001) and extensor (d = -0.6, p < 0.001) muscles. Extensor eccentric RTD showed a small but significant improvement (d = -0.48, p = 0.042). Improvements in flexor eccentric peak torque were significantly associated with decreases in peak head acceleration (r = -0.55, p = 0.019), and with decreases in total head displacement (r = -0.48, p = 0.042) during anticipated impacts. Improvements in flexor RTD were significantly associated with reductions in head acceleration during unanticipated impacts (r = -0.29, p = 0.013). This study provides evidence supporting the use of plyometric neck training as a potential strategy for reducing concussion risk in female rugby players, warranting further investigation in real- world rugby scenarios.