Part 1: Evaluating Neck-Strengthening Protocols to Reduce the Incidence of Traumatic Brain Injury: Traditional vs. Nontraditional Neck-Strengthening Techniques.

ABSTRACT: Schroeder, LH, McDaniel, AT, Wang, Y, Dickens, GM, Pantani, V, and Kubinak, H. Part 1: evaluating neck-strengthening protocols to reduce the incidence of traumatic brain injury: traditional vs. nontraditional neck-strengthening techniques. J Strength Cond Res 38(1): 21-29, 2024-A common cause of traumatic brain injuries (TBIs) is the head's kinematic response to rapid movement, which can be reduced with dynamic neck strengthening. This study aimed to determine the most effective neck-strengthening program by comparing a traditional and nontraditional program. Isometric neck strength was assessed in 32 subjects randomly assigned to one of the traditional and nontraditional neck-strengthening programs. The nontraditional program used a novel neck-strengthening device. After weeks 6 and 10 of training, isometric neck strength was reassessed. With the collected data, linear mixed models were established to compare the changes in neck strength between the 2 groups during the 10-week training period. Statistical analysis results suggest that, for both cervical extension (CE) and cervical flexion (CF), subjects in the novel neck-strengthening device group had a significantly higher gain of strength during the 10 weeks than the traditional group. With test statistics of -2.691 and -3.203 and corresponding 2-sided p-value of 0.01289 and 0.003889, respectively, we conclude that there is a statistically significant difference in the linear slopes of increase for both CE and CF between the 2 groups. As to left cervical lateral flexion and right cervical lateral flexion, the novel neck strength group had increased strength gains compared with the traditional group. However, the increase was not enough to demonstrate significant findings. Results were considered significant at p < 0.05. The results of this study show that the novel neck-strengthening device may be an effective mechanism for preventing mild TBIs.

Efficacy of Army Combat Fitness Test 12-Week Virtual Exercise Program.

INTRODUCTION: The Army Combat Fitness Test (ACFT) is the fitness assessment used by the Army launched in April of 2022. The ACFT consists of six physically demanding motor movements that parallel to the stressors experienced by the modern-day combat soldier. The aim of this study is to determine the efficacy of a 12-week virtual exercise program on the individual and their overall ACFT scores. MATERIALS AND METHODS: Thirteen soldiers from the Army National Guard (age = 29.8 ± 6.2 years; height = 175.7 ± 6.1 cm; service experience ≥ 18 months to 18 years) volunteered to complete three sessions. In session 1, baseline height, body mass, body composition, and ACFT scores were collected. Session 2 consisted of a suspension trainer (ST) tutorial in which all participants familiarized themselves with the set-up and utilization of the suspension training tool kit. Upon completion of session 2, a TRX Elite ACFT Kit containing one suspension trainer, four resistance bands, and the 12-week virtual exercise training program available via iphone operating system and Android were given to all participants. In session 3, post-assessments of body mass, body composition, and ACFT scores were collected. Data were statistically analyzed using a paired-sample t-test with a Bonferroni correction (P < .00065) to adjust for multiple comparisons. RESULTS: There were no significant changes in mean body mass (83.8 ± 16.5 kg vs. 83.9 ± 16.6 kg; P = .752); however, there was a significant reduction in mean percentage body fat (19.5 ± 6.4% vs. 18.3 ± 6.5%; P < .0001). Mean scores from four of the six individual ACFT assessments, specifically, deadlift, standing power throw, hand-release push-ups, and sprint-drag-carry, displayed improvements, but did not attain statistical significance. The overall mean ACFT scores displayed significant improvements (319.4 ± 39.9 vs. 390.4 ± 68.5; P < .0001). CONCLUSIONS: The TRX Elite ACFT Kit which includes one suspension trainer, four varying resistance bands, and on-demand access to a stepwise 12-week virtual exercise program was deemed effective by increasing the overall mean ACFT scores among participants. From a practitioner's perspective, the TRX Elite ACFT Kit should be widely distributed to all Army units and recruiting commands to provide vital assistance for recruits and soldiers to train and prepare for the ACFT. Moreover, given the ease and portability of the TRX Elite ACFT Kit, recruits and soldiers will be able to effectively train anytime, anywhere.

Efficacy of a 6-Week Suspension Training Exercise Program on Fitness Components in Older Adults.

The purpose of this study was to determine the efficacy of a 6-week suspension training exercise program on fitness components in older adults. Eleven participants (age = 80 ± 5 yrs) completed a 6-week suspension training exercise program. Pre- and post-fitness assessments comprised of body composition, handgrip dynamometer, functional reach, and balance. The 6-week suspension training intervention required individuals to perform suspension training exercises for fifty minutes, twice per week. A paired sample t-test was used to determine differences from pre-and post-assessments. An improvement was observed in functional reach (57.2 ± 6.4 cm vs 68.6 ± 4.3 cm; p = 0.02) and overall balance score (67.5 ± 2.4 vs 72.2 ± 2.2; p = 0.02). A 6-week suspension training exercise program can be adequate to enhance core stability and overall balance amongst older adults. This paradigm should be explored further to determine the effects on fall-risk and fall prevention.

Evaluating the Intra-Rater and Inter-Rater Reliability of Fixed Tension Scale Instrumentation for Determining Isometric Neck Strength.

PURPOSE: The purpose of this study was to evaluate the reliability of a fixed tension scale instrumentation, comparing the intra-rater and inter-rater reliability between seating and standing measurement techniques. Instrumentation developed from this study will be utilized to assess isometric neck strength in future studies comparing neck strengthening protocols. METHODS: Isometric neck strength for eight movements (cervical/capital flexion, cervical/capital extension, left/right lateral flexion, left/right cervical rotation) as well as anthropometric measurements were evaluated for thirty-one participants through the use of a novel neck strength assessment protocol. RESULTS: The fixed tension scale instrumentation and methods used in this study demonstrated good to excellent intra-rater reliability (ICC range from 0.78 to 0.97) as well as moderate to excellent inter-rater reliability (ICC range from 0.73 to 0.91) for both measurement techniques. PRACTICAL APPLICATIONS: This study will provide foundational knowledge for the reliable assessment of neck strength. Additionally, the findings will provide a cost-effective, portable, and reliable instrument for measuring isometric neck strength. CONCLUSIONS: Seated and standing measurement techniques demonstrated similar intra and inter-rater reliability. Inter-rater reliability tended to be lower with motions (capital flexion and extension) that required the participants to face directly towards or away from the instrumentation. This could be due to participant positioning or unfamiliarity with those specific movements. The assessment protocol utilized in this study demonstrated comparable inter-rater reliability to another cost-effective method for evaluating isometric neck strength.