Hemelryck Walter, Calistri Josselin, Papadopoulou Virginie, Theunissen Sigrid, Dugardeyn Christian, Balestra Costantino
Environmental & Occupational Physiology Laboratory, Haute École Paul Henri Spaak, Belgium.
Braine l'Alleud Hospital (CHIREC), Waterloo, Belgium.
Int J Sports Phys Ther. 2018 Feb;13(1):28-38.
World Rugby Union laws are constantly evolving towards stringent injury-prevention, particularly for contested scrums, since front row players are most at risk of cervical spine injuries. Recently, some countries have also introduced tailored training programs and minimum performance requirements for playing in the front row. Nevertheless, these approaches lack an objective assessment of each cervical muscle that would provide protective support.
Since front row players are the most at risk for cervical spine injuries due to the specific type of contact during scrums, the purpose of this study was to ascertain whether significant differences exist in neck muscle size and range of motion between front row players and players of other positions, across playing categories.
Cross-sectional controlled laboratory study.
129 sub-elite male subjects from various first-team squads of Belgian Rugby clubs were recruited. Subjects were grouped according to age: Junior (J) < 19 years old, Senior (S) 19 to 35 years old and Veteran (V) > 35 years old; as well as playing position: Front row players (J = 10, S = 12, V = 11 subjects), (Rest of the) pack (J = 12, S = 12, V = 10), backs (J = 10, S = 11, V = 11). An age-matched control group of non-rugby players was also recruited (J = 10, S = 10, V = 10).For each subject, the total neck circumference (NC) and the cervical range of motion (CROM) were measured. In addition, the thickness of the trapezius (T), splenius capitis (SCa), semispinalis capitis (SCb), semispinalis cervicis (SPC), sternocleidomastoid muscles (SCOM), and the total thickness of all four structures (TT), were measured using ultrasonography.
In each age category, compared to controls, rugby players were found to have decreased CROM, an increase in neck circumference (NC), and increased total thickness (TT), trapezius (T), semispinalis capitis (SCb) and sternocleidomastoid muscles (SCOM) sizes. For junior players, the thickness of the semispinalis cervicis (SPC) was also increased compared to controls. The CROM was decreased in front row players compared to pack and back players for all age categories; Front row seniors also showed an increase in trapezius (T), splenius capitis (SCa), semispinalis capitis (SCb) and total thickness (TT), compared to back players.
In regard of the differences in cervical values found between player positions, the implementation of both range of motion and echography muscle thickness assessments could serve to create an additional measurement for all front row players, that could complement current pre-participation screening used by rugby federations by objectively monitoring muscular size and motion amplitude around the cervical spine.
世界橄榄球联盟的规则一直在朝着严格的 injury-prevention 方向不断发展，尤其是对于有争球的情况，因为前排球员颈椎受伤的风险最高。最近，一些国家还针对前排球员推出了量身定制的训练计划和最低表现要求。然而，这些方法缺乏对每块颈部肌肉的客观评估，而这种评估本可以提供保护支持。
由于前排球员在争球时因特定的接触类型而颈椎受伤风险最高，本研究的目的是确定在前排球员与其他位置的球员之间，以及在不同比赛类别中，颈部肌肉大小和活动范围是否存在显著差异。
横断面对照实验室研究。
招募了来自比利时橄榄球俱乐部各个一线阵容的129名次精英男性受试者。受试者根据年龄分组：青少年组（J）＜19岁，成年组（S）19至35岁，老将组（V）＞35岁；以及比赛位置：前排球员（青少年组 = 10人，成年组 = 12人，老将组 = 11人），（其余的）前锋组（青少年组 = 12人，成年组 = 12人，老将组 = 10人），后卫组（青少年组 = 10人，成年组 = 11人，老将组 = 11人）。还招募了一个年龄匹配的非橄榄球运动员对照组（青少年组 = 10人，成年组 = 10人，老将组 = 10人）。对每个受试者测量了总颈围（NC）和颈椎活动范围（CROM）。此外，使用超声测量了斜方肌（T）、头夹肌（SCa）、头半棘肌（SCb）、颈半棘肌（SPC）、胸锁乳突肌（SCOM）的厚度，以及所有这四个结构的总厚度（TT）。
在每个年龄类别中，与对照组相比，发现橄榄球运动员的CROM降低，颈围（NC）增加，总厚度（TT）、斜方肌（T）、头半棘肌（SCb）和胸锁乳突肌（SCOM）的大小增加。对于青少年球员，与对照组相比，颈半棘肌（SPC）的厚度也增加了。在所有年龄类别中，前排球员的CROM均低于前锋组和后卫组球员；成年前排球员与后卫球员相比，斜方肌（T）、头夹肌（SCa）、头半棘肌（SCb）和总厚度（TT）也有所增加。
鉴于在球员位置之间发现的颈椎数值差异，实施活动范围和超声肌肉厚度评估可为所有前排球员创造一项额外的测量指标，通过客观监测颈椎周围的肌肉大小和活动幅度，可补充橄榄球联合会目前使用的赛前筛查。
