Measures of Central hyperexcitability in chronic whiplast associated disorder - a systematic review and meta-analysis

Stone.Andrew M., Vicenzino, Bill, Lim, Edwin C. W. and Sterling, Michele (2013) Measures of Central hyperexcitability in chronic whiplast associated disorder - a systematic review and meta-analysis. Manual Therapy, 18 2: 111-117. doi:10.1016/j.math.2012.07.009


Author Stone.Andrew M.
Vicenzino, Bill
Lim, Edwin C. W.
Sterling, Michele
Title Measures of Central hyperexcitability in chronic whiplast associated disorder - a systematic review and meta-analysis
Journal name Manual Therapy   Check publisher's open access policy
ISSN 1356-689X
1532-2769
Publication date 2013
Year available 2012
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.math.2012.07.009
Volume 18
Issue 2
Start page 111
End page 117
Total pages 7
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Collection year 2013
Language eng
Formatted abstract
Objectives: To synthesise the evidence for central hyperexcitability in Chronic WAD (whiplash associated disorders) with meta-analysis, and review test protocols.
Methods: Chronic WAD was compared to healthy controls. Studies were eligible if they used measures of central hyperexcitability with standardised procedure. Meta-analyses (where possible) were conducted.
Results: The search yielded 27 trials of good quality and 13 were suitable for meta-analyses. Individuals with chronic WAD showed heightened sensitivity to the following tests (p < 0.05): Pressure Pain Thresholds at Head/Neck/Upper Thoracic area (H/N/UT) (SMD (Standardised mean differences) −1.36, 95% CI (confidence intervals) −1.89 to −0.82), Upper Limb (UL) (−1.33, 95% CI −2.50 to −0.16), Lower Limb (LL) (−1.01, 95% CI −1.70 to −0.33), flexor withdrawal (−0.73, 95% CI −1.11 to −0.35), Cold Pain Threshold at H/N/UT (0.91, 95% CI 0.66–1.17) and UL (0.66, 95% CI 0.37–0.94), Heat Pain Threshold at H/N/UT (−0.58, 95% CI −0.88 to −0.28), Electrocutaneous Stimulation at H/N/UT (−1.04, 95% CI −1.63 to −0.45) and LL (−0.85, 95% CI −1.67 to −0.03), and elbow extension with the Brachial Plexus Provocation Test (SMD −0.55, 95% CI −0.76 to −0.35).
Discussion: There is compelling evidence for central hyperexcitability in chronic WAD. This should be considered in the management of chronic WAD.
Keyword Whiplash
Systematic review
Central hyperexcitability
Quantitative sensory testing
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 1 September 2012

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2013 Collection
School of Health and Rehabilitation Sciences Publications
School of Medicine Publications
 
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Created: Mon, 18 Feb 2013, 11:03:27 EST by Chesne McGrath on behalf of Medicine - Royal Brisbane and Women's Hospital