Cervical Range of Motion Discriminates Between Asymptomatic Persons and Those With Whiplash

Study Design. A comparative study of cervical range of motion in asymptomatic persons and those with whiplash. Objectives. To compare the primary and conjunct ranges of motion of the cervical spine in asymptomatic persons and those with persistent whiplash-associated disorders, and to investigate the ability of these measures of range of motion to discriminate between the groups. Summary of Background. Evidence that range of motion is an effective indicator of physical impairment in the cervical spine is not conclusive. Few studies have evaluated the ability to discriminate between asymptomatic persons and those with whiplash on the basis of range of motion or compared three-dimensional in vivo measures of range of motion in asymptomatic persons and those with whiplash-associated disorders. Methods. The study participants were 89 asymptomatic volunteers (41 men, 48 women; mean age 39.2 years) and 114 patients with persistent whiplash-associated disorders (22 men, 93 women; mean age 37.2 years) referred to a whiplash research unit for assessment of their cervical region. Range of cervical motion was measured in three dimensions with a computerized, electromagnetic, motion-tracking device. The movements assessed were flexion, extension, left and right lateral flexion, and left and right rotation. Results. Range of motion was reduced in all primary movements in patients with persistent whiplash-associated disorder. Sagittal plane movements were proportionally the most affected. On the basis of primary and conjunct range of motion, age, and gender, 90.3% of study participants could be correctly categorized as asymptomatic or as having whiplash (sensitivity 86.2%, specificity 95.3%). Conclusions. Range of motion was capable of discriminating between asymptomatic persons and those with persistent whiplash-associated disorders.

[1]  H. Alaranta,et al.  Flexibility of the spine: normative values of goniometric and tape measurements. , 1994, Scandinavian journal of rehabilitation medicine.

[2]  L Penning,et al.  Rotation of the Cervical Spine: A CT Study in Normal Subjects , 1987, Spine.

[3]  R A Deyo,et al.  Physician Views About Treating Low Back Pain: The Results of a National Survey , 1995, Spine.

[4]  A. Nordwall,et al.  Normal range of motion of the cervical spine. , 1989, Archives of physical medicine and rehabilitation.

[5]  T. R. Garrett,et al.  Normal range of motion of the cervical spine: an initial goniometric study. , 1992, Physical therapy.

[6]  S. Mior,et al.  The Northwick Park Neck Pain Questionnaire, devised to measure neck pain and disability. , 1994, British journal of rheumatology.

[7]  M. Codd,et al.  Low energy high frequency pulsed electromagnetic therapy for acute whiplash injuries. A double blind randomized controlled study. , 2020, Scandinavian journal of rehabilitation medicine.

[8]  L. M. Wellock.  Guides to the Evaluation of Permanent Impairment , 1972 .

[9]  L. Provinciali,et al.  Multimodal treatment to prevent the late whiplash syndrome. , 1996, Scandinavian journal of rehabilitation medicine.

[10]  M. Pearcy,et al.  Three-dimensional analysis of active cervical motion: the effect of age and gender. , 1996, Clinical biomechanics.

[11]  C. Lantz,et al.  Meta-analysis of normative cervical motion. , 1999, Spine.

[12]  T. Mayer,et al.  Noninvasive measurement of cervical tri-planar motion in normal subjects. , 1993, Spine.

[13]  S Siegler,et al.  Three‐Dimensional Flexibility Characteristics of the Human Cervical Spine In Vivo , 1998, Spine.

[14]  E. Culham,et al.  The Effect of Initial Head Position on Active Cervical Axial Rotation Range of Motion in Two Age Populations , 1996, Spine.

[15]  C. Hildingsson,et al.  Outcome after soft-tissue injury of the cervical spine. A prospective study of 93 car-accident victims. , 1990, Acta orthopaedica Scandinavica.

[16]  W. Spitzer,et al.  Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining "whiplash" and its management. , 1995, Spine.

[17]  J. Mehlsen,et al.  A comparison of physical characteristics between patients seeking treatment for neck pain and age-matched healthy people. , 1997, Journal of manipulative and physiological therapeutics.

[18]  Nathaniel R. Ordway,et al.  Cervical Sagittal Range‐of‐Motion Analysis Using Three Methods: Cervical Range‐of‐Motion Device, 3Space, and Radiography , 1997, Spine.

[19]  M J Pearcy,et al.  New method for the non-invasive three-dimensional measurement of human back movement. , 1989, Clinical biomechanics.

[20]  K. Hashemi.  Early mobilisation of acute whiplash injuries , 1986 .

[21]  Francis L. Merat,et al.  Introduction to robotics: Mechanics and control , 1987, IEEE J. Robotics Autom..

[22]  T. Stiles,et al.  Acute Treatment of Whiplash Neck Sprain Injuries: A Randomized Trial of Treatment During the First 14 Days After a Car Accident , 1998, Spine.

[23]  T. Tamaki,et al.  Three-Dimensional Motion Analysis of the Cervical Spine with Special Reference to the Axial Rotation , 1989, Spine.

[24]  V Feipel,et al.  Normal global motion of the cervical spine: an electrogoniometric study. , 1999, Clinical biomechanics.

[25]  M. Bankes,et al.  The behavioural response to whiplash injury. , 1998, The Journal of bone and joint surgery. British volume.

[26]  J. Danoff,et al.  Cervical motion assessment: a new, simple and accurate method. , 1986, Archives of physical medicine and rehabilitation.

[27]  S. Larsson,et al.  Three-Dimensional Analysis of Neck Motion: A Clinical Method , 1990, Spine.

[28]  D. Chaffin,et al.  Cervical range of motion and dynamic response and strength of cervical muscles , 1973 .

[29]  G. Fénelon,et al.  Early mobilization of acute whiplash injuries. , 1986, British medical journal.

[30]  G. Yamaguchi,et al.  Three-dimensional head kinematics and cervical range of motion in the diagnosis of patients with neck trauma. , 1996, Journal of manipulative and physiological therapeutics.