The Effect of the FIFA 11 + with Added Neck Exercises on Maximal Isometric Neck Strength and Peak Head Impact Magnitude During Heading: A Pilot Study

Abstract

Background Higher neck strength has been postulated to reduce head impact magnitude during purposeful heading in football. Objectives This pilot trial explored the efect of a neck exercise programme on (1) neck strength and (2) head impact magnitude during heading in male and female adolescent football players. Methods Boys and girls (aged 12–17 years) were randomised by team to the intervention (5 weeks of supervised neuromuscular neck exercises integrated into part 2 of the FIFA 11+, completed three times per week) or the control group (usual part 2 of the FIFA 11+, no neck exercises). Outcomes included isometric neck strength and head impact magnitude (peak linear acceleration and peak angular velocity) during standardised heading from a throw-in (at baseline and 6 weeks) plus completion of an evaluation survey by intervention players and coaches. Results In total, 52 players (n=31 intervention; n=21 control) completed the study. Mixed-model analysis of variance (ANOVA) revealed signifcant diferences in neck strength variables (p<0.001), peak linear acceleration (p=0.04) and peak angular velocity (p=0.04) between the intervention and control groups over time. Intervention players demonstrated increases in mean composite neck strength (53.8% intervention vs 15.6% control) as well as decreases in mean peak linear head acceleration during heading (−11.8% vs−5.0%) from baseline to follow-up. Reduction in peak angular velocity was more pronounced in girls (−27.7%) than boys (−11.5%) in the intervention group. The addition of neck exercises into part 2 of the FIFA 11+was feasible and accepted by players and coaches. Conclusion On average, players who completed neck exercises demonstrated an increase in isometric neck strength and a decrease in head impact magnitude during heading. These exercises were easily incorporated into usual training. Australian New Zealand Clinical Trials Registry (no: ACTRN12619001375145).