Does the semi-rigid collar add to the care of a potential cervical spine injury? An experimental approach to assess the impact of a semi-rigid collar in the tilt of an athlete.

Project Description

Cervical spine (CxSp) injuries are prevalent in rugby union, with reported incident rates ranging from 8.9% to 41.3% (Leahy et al., 2019). A significant portion of these injuries, approximately 46%, necessitate immediate removal from play (Swain et al., 2010). Current protocols advocate for full immobilisation and extrication if the Canadian CxSp rules aren't met. This includes the sizing and application of a semi-rigid collar, with two 15-degree tilts onto a split spinal board (Stiell et al., 2001; World Rugby, n.d.). However, existing research on semi-rigid collars primarily focuses on their efficacy in road traffic collisions (Engsberg et al., 2013; Nutbeam et al., 2021), raising questions about their suitability in controlled trauma environments such as rugby pitches.

This study aims to investigate the variation in CxSp range of motion (ROM) during semi-rigid collar application by newly-trained individuals and assess CxSp movements during athlete tilting, with and without collar use. Findings will offer insights into semi-rigid collar efficacy in sporting trauma settings.

Using a pre-post randomised design, participants will undergo training resembling Rugby Football Union Pre-Hospital Immediate Care In Sport courses, covering collar sizing and application techniques (part 1) and 15 degree tilting manoeuvres (part 2). Learning styles will be accommodated through a four-step process, which will involve demonstration, deconstruction, formulation and performance (Jenko et al., 2012).

Participants will be assessed on these skills using inertial measurement units and infrared marker-based motion capture to measure the variance in CxSp movement. Collar refitting during the study's second part will be conducted by the research team who are experienced in the protocol. This will ensure that the variance in tilting technique is not due to erroneous collar sizing and application from part 1, enhancing result reliability. This research aims to enhance global medical understanding of semi-rigid collar use in sports-related trauma scenarios.