Dizziness and unsteadiness following whiplash injury: characteristic features and relationship with cervical joint position error.

Dizziness and/or unsteadiness are common symptoms of chronic whiplash-associated disorders. This study aimed to report the characteristics of these symptoms and determine whether there was any relationship to cervical joint position error. Joint position error, the accuracy to return to the natural head posture following extension and rotation, was measured in 102 subjects with persistent whiplash-associated disorder and 44 control subjects. Whiplash subjects completed a neck pain index and answered questions about the characteristics of dizziness. The results indicated that subjects with whiplash-associated disorders had significantly greater joint position errors than control subjects. Within the whiplash group, those with dizziness had greater joint position errors than those without dizziness following rotation (rotation (R) 4.5 degrees (0.3) vs 2.9 degrees (0.4); rotation (L) 3.9 degrees (0.3) vs 2.8 degrees (0.4) respectively) and a higher neck pain index (55.3% (1.4) vs 43.1% (1.8)). Characteristics of the dizziness were consistent for those reported for a cervical cause but no characteristics could predict the magnitude of joint position error. Cervical mechanoreceptor dysfunction is a likely cause of dizziness in whiplash-associated disorder.

[1]  C. Hildingsson,et al.  Oculomotor problems after cervical spine injury. , 1989, Acta orthopaedica Scandinavica.

[2]  Longridge Ns,et al.  Dizziness from whiplash and head injury: differences between whiplash and head injury. , 1998 .

[3]  A. Mallinson,et al.  Dizziness from whiplash and head injury: differences between whiplash and head injury. , 1998, The American journal of otology.

[4]  A. Mallinson,et al.  Dizziness, Imbalance, and Whiplash , 1996 .

[5]  C. Tjell,et al.  Smooth Pursuit Neck Torsion Test-A Specific Test for Whiplash Associated Disorders? , 2002 .

[6]  H V Heikkilä,et al.  Cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury. , 1998, Archives of physical medicine and rehabilitation.

[7]  P. Dolan,et al.  Regional Assessment of Joint Position Sense in the Spine , 1998, Spine.

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

[9]  Gwendolen Jull,et al.  Deep Cervical Flexor Muscle Dysfunction in Whiplash , 2000 .

[10]  D. Fitzgerald Head trauma: hearing loss and dizziness. , 1996, The Journal of trauma.

[11]  J. Furman,et al.  Cervicogenic dizziness: a review of diagnosis and treatment. , 2000, The Journal of orthopaedic and sports physical therapy.

[12]  P T de Jong,et al.  Ataxia and nystagmus induced by injection of local anesthetics in the neck , 1977, Annals of neurology.

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

[14]  R. Ferrari,et al.  Development of persistent neurologic symptoms in patients with simple neck sprain. , 1999, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[15]  H Heikkilä,et al.  Cervicocephalic kinesthetic sensibility in patients with whiplash injury. , 1996, Scandinavian journal of rehabilitation medicine.

[16]  J. Goebel,et al.  Postural stability following mild head or whiplash injuries. , 1995, The American journal of otology.

[17]  Danny R. Miller,et al.  AND ITS MANAGEMENT , 1973 .

[18]  J. Bergenius,et al.  Dizziness symptom severity and impact on daily living as perceived by patients suffering from peripheral vestibular disorder. , 1999, Clinical otolaryngology and allied sciences.

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

[20]  C. André-deshays,et al.  Cervicocephalic kinesthetic sensibility in patients with cervical pain. , 1991, Archives of physical medicine and rehabilitation.

[21]  A. Duprat,et al.  A combined approach for the treatment of cervical vertigo. , 2000, Journal of manipulative and physiological therapeutics.

[22]  M. Johansson,et al.  Effects of acupuncture, cervical manipulation and NSAID therapy on dizziness and impaired head repositioning of suspected cervical origin: a pilot study. , 2000, Manual therapy.

[23]  T. Brandt Cervical vertigo--reality or fiction? , 1996, Audiology & neuro-otology.

[24]  Longridge Ns,et al.  Specific vocalized complaints in whiplash and minor head injury patients , 1998 .

[25]  G. Michael Halmagyi,et al.  Disorders of the vestibular system , 2006, Pathy's Principles and Practice of Geriatric Medicine.

[26]  N. Bogduk,et al.  Clinical Review Whiplash injury ’ Les Barnsley , 2002 .

[27]  U. Rosenhall,et al.  Smooth pursuit neck torsion test: a specific test for cervical dizziness. , 1998, The American journal of otology.

[28]  M. Revel,et al.  Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. , 1994, Archives of physical medicine and rehabilitation.

[29]  G. Jull,et al.  Cervicocephalic kinaesthesia: reliability of a new test approach. , 2001, Physiotherapy research international : the journal for researchers and clinicians in physical therapy.