Considerations in the physical rehabilitation of patients with whiplash-associated disorders

Jull, Gwendolen A. (2011) Considerations in the physical rehabilitation of patients with whiplash-associated disorders. Spine, 36 25S: S286-S291. doi:10.1097/BRS.0b013e318238823c

Author Jull, Gwendolen A.
Title Considerations in the physical rehabilitation of patients with whiplash-associated disorders
Journal name Spine   Check publisher's open access policy
ISSN 0362-2436
Publication date 2011-12-01
Year available 2011
Sub-type Article (original research)
DOI 10.1097/BRS.0b013e318238823c
Open Access Status Not Open Access
Volume 36
Issue 25S
Start page S286
End page S291
Total pages 6
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
Study Design. Review of research identifying physical impairments in the neuromuscular system in subjects with whiplash-associated disorders.
Objective. Review the impairments in movement and neuromuscular function toward constructing research informed exercise programs.
Summary of Background Data. Pain and injury to the musculoskeletal system result in loss of motion and impaired neuromuscular function which impacts on functional activities,
work and quality of life. Therapeutic exercise is a mainstay of rehabilitation, but the nature of the exercises prescribed are currently various and the effect sizes of current programs for patients with whiplash-associated disorders are modest at best.
Methods. A review was undertaken of research investigating the changes in cervical motion and neuromuscular function to better inform exercise prescription and identify areas for future research.
Results. Reduced range of movement as well as pathological movement patterns (reduced acceleration and velocity, reduced smoothness and irregular axes of neck movement) have been documented in subjects with whiplash-associated disorders. In
relation to neuromuscular control, changes have been demonstrated in neck muscles’ spatial and temporal relationships as well as in their strength and endurance. The presence or not and the extent of changes is highly variable between individuals and appears to have some relationship to pain intensity. It appears that there is a need for
specifi city in exercise prescription to address particular impairments rather than the use of generic programs. High pain intensity can modify effects of a therapeutic exercise program.
Conclusion. Pain and injury result in reorganization of the motor control strategies of neck muscles and movement. Further research is required to determine if outcomes after a whiplash injury can be improved by using research informed, individually prescribed
exercise programs matched to the individual’s presentation. Research into best methods of pain management is also required to facilitate physical rehabilitation.
Keyword Neuromuscular function
Therapeutic exercise
Chronic neck pain
Q-Index Code CX
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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