A randomised cross-over trial to investigate the effects of a rigid cervical collar on three-dimensional angular movement and angular acceleration during emergency spinal immobilisation and extrication procedures in elite football (soccer) players: The RESTRICT study.

ABSTRACT

Objective To determine the effects of rigid collars on cervical movement and acceleration during triple spinal immobilisation and extrication.

Methods Procedures were performed on 15 non-injured volunteers in random order of collar and no-collar. Primary outcomes were angular movements and angular accelerations of the head relative to the thorax. Secondary outcome was the total procedure time.

Results Between collar and no-collar, small but significant differences were found for mean angular movements during 15° tilt tasks for lateral flexion (3.4°: 95%CI: 1.4°, 5.4°), flexion-extension (2.4° 95%CI: 0.4°, 4.4°), rotation (−3.7°: 95%CI: -7.2°, -0.2°) and total rotation (6°: 95%CI; 2.9°, 9.1°). For the lift and lower task there was a significant difference in total lateral flexion of only 0.3° (95%CI: 0.1°, 0.5°). Total movement during the procedure was significantly more for rotation without the collar (6.6°: 95% CI: 1.9°, 11.3°). Small but significant differences were found for angular acceleration only during the lift and lower task for maximum lateral flexion (−6.5 rads/s2, 95%CI: -12, -1 rads/s2), maximum rotation (−2.8 rads/s2, 95% CI: -5.2, -0.4 rads/s2) and minimum rotation (−3.5 rads/s2, 95%CI: -5.9, -0.1 rads/s2). The procedure was significantly longer with the collar (257.5s [95%CI: 245.3, 269.7s} versus 230.9s [95%CI: 215, 246.8s].

Conclusion There were statistically significant but clinically negligible differences between a rigid cervical collar and no-collar in some parameters for the triple immobilisation and extrication procedure in the sporting context. These novel results provide highlight important clinical considerations when immobilising and extricating players after a head or cervical injury.

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

ISRCTN:16515969

Funding Statement

This study did not receive any funding.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study was ethically approved by the University of Salford Ethics Committee(reference number 1403).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors.

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