The effects of neck pain, posture and balance on whiplash patients with chronic neck pain.
From: Postural control deficit in acute QTF grade II whiplash injuries. Gait Posture, 2007 Dec 14.
STUDY DESIGN: Experimental in vivo study.
OBJECTIVE: The objective was to investigate the balance control in patients with acute QTF grade II whiplash injuries of the cervical spine.
SUMMARY OF BACKGROUND DATA: Posture measurement in chronic pain patients after whiplash injuries of the neck has revealed an impaired regulation of balance. However, so far it is unclear if this is caused by the accident or other factors that are associated with the pain chronification process.
METHODS: 40 patients with acute QTF grade II whiplash injuries and 40 healthy matched controls were examined on a posturography platform. The stability index ST(Sigma) and the Fourier analysis FA(Sigma) (0.10-1.00Hz) were established for eight standing positions and sum scores were calculated. The pain index was established using a visual analog scale ranging from 0 to 100. A follow-up examination was conducted for the patients after 2 months.
RESULTS: The patients with acute whiplash injuries of the cervical spine achieved significantly poorer results for both ST(Sigma) and FA(Sigma) than the healthy controls. There were no differences between the eight standing positions for both ST(Sigma) and FA(Sigma). After 2 months, 17 patients had no change in the pain development, 21 patients showed an improvement in pain intensity and 2 patients had deteriorated. The subgroup of patients with improvement in pain intensity showed a significant improvement in balance control concerning the FA(Sigma) compared to patients with unchanged pain intensity.
CONCLUSION: Patients with acute whiplash injuries have a reduced balance control as compared to matched controls. This study gives an indication that post-traumatic neck pain is associated with impairments of postural control.
COMMENT: A focus on posture correction for chronic neck pain sufferers. It could be that weakening of soft tissue through scar formation in supporting muscular and ligamentous structures along with subsequent or concomittant degenerative joint disease leads to an imbalance of anti-gravity forces resulting in a forward head posture and subsequent deterioration in postural control. Additionally related aggressive acute care intervention to minimize scar tissue formation. Initial anti-inflammatory methods, early mobilization: passive and active. A focus on posture may also help to minimize related psychosocial complications of chronic neck pain.
