Development of motor system dysfunction following whiplash injury

Sterling, Michele, Jull, Gwendolen, Vicenzino, Bill, Kenardy, Justin and Darnell, Ross (2003) Development of motor system dysfunction following whiplash injury. Pain, 103 1-2: 65-73. doi:10.1016/S0304-3959(02)00420-7

Author Sterling, Michele
Jull, Gwendolen
Vicenzino, Bill
Kenardy, Justin
Darnell, Ross
Title Development of motor system dysfunction following whiplash injury
Journal name Pain   Check publisher's open access policy
ISSN 0304-3959
Publication date 2003-05
Sub-type Article (original research)
DOI 10.1016/S0304-3959(02)00420-7
Volume 103
Issue 1-2
Start page 65
End page 73
Total pages 9
Editor Allan I. Basbaum
Place of publication Amsterdam
Publisher Elsevier BV
Collection year 2003
Language eng
Subject C1
321024 Rehabilitation and Therapy - Occupational and Physical
730303 Occupational, speech and physiotherapy
Abstract Dysfunction in the motor system is a feature of persistent whiplash associated disorders. Little is known about motor dysfunction in the early stages following injury and of its progress in those persons who recover and those who develop persistent symptoms. This study measured prospectively, motor system function (cervical range of movement (ROM), joint position error (JPE) and activity of the superficial neck flexors (EMG) during a test of cranio-cervical flexion) as well as a measure of fear of re-injury (TAMPA) in 66 whiplash subjects within 1 month of injury and then 2 and 3 months post injury. Subjects were classified at 3 months post injury using scores on the neck disability index: recovered (<8), mild pain and disability (10-28) or moderate/severe pain and disability (>30). Motor system function was also measured in 20 control subjects. All whiplash groups demonstrated decreased ROM and increased EMG (compared to controls) at 1 month post injury. This deficit persisted in the group with moderate/severe symptoms but returned to within normal limits in those who had recovered or reported persistent mild pain at 3 months. Increased EMG persisted for 3 months in all whiplash groups. Only the moderate/severe group showed greater JPE, within 1 month of injury, which remained unchanged at 3 months. TAMPA scores of the moderate/severe group were higher than those of the other two groups. The differences in TAMPA did not impact on ROM, EMG or JPE. This study identifies, for the first time, deficits in the motor system, as early as 1 month post whiplash injury, that persisted not only in those reporting moderate/severe symptoms at 3 months but also in subjects who recovered and those with persistent mild symptoms. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.
Keyword Anesthesiology
Clinical Neurology
Motor Dysfunction
Fear Of Movement/re-injury
Cervicocephalic Kinesthetic Sensibility
Cervical Muscle Dysfunction
Fear-avoidance Beliefs
Cervicogenic Headache
Afferent Activity
Neck Pain
Q-Index Code C1

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Created: Tue, 14 Aug 2007, 19:16:28 EST