Can measuring passive neck muscle stiffness in whiplash injury patients help detect false whiplash claims?

Aljinović, Jure; Barišić, Ivana; Poljičanin, Ana; Kuzmičić, Sandra; Vukojević, Katarina; Bokun, Dijana Gugić; Vlak, Tonko

doi:10.1007/s00508-020-01631-y

Cited by 10 publications

(18 citation statements)

References 22 publications

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“…We did not find a difference in stiffness between left and right trapezius muscles in whiplash injury patients before and after PT. This is in accordance with the results from our previous study [16] but differs from Zhang et al [27], which reported a significant difference between dominant and non-dominant upper trapezius muscle. This difference could be due to different study populations.…”

Section: Discussionsupporting

confidence: 91%

“…That study was conducted on 75 participants in each group, with the intra-observer reliability of SWE values of stiffness of the trapezius muscle being 0.8. The authors suggested that more participants were needed to have more precise results, and inter-observer reliability was not calculated [16]. We were unable to find published reports on how SWE values change after physical therapy (PT) and studies investigating SWE as a potential prognostic factor of recovery after a whiplash injury.…”

Section: Introductionmentioning

confidence: 99%

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Neck Disability Index Is Better in Classification of Recovery after Whiplash Injury in Comparison with Ultrasound Shear Wave Elastography of Trapezius Muscle

et al. 2021

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A prospective observational study comparing shear wave elastography (SWE) of trapezius muscle with Neck Disability Index (NDI) in a prediction model of health status six months after a whiplash injury. Both SWE values, measured by two radiologists, and NDI scores were obtained at baseline and after physical therapy (PT) (6-month period). Those values were compared with a 3-point Likert scale (no, partial or full recovery). Twenty-two subjects completed the study. A decrease in trapezius stiffness was detected by both radiologists, statistically significant for one (Δ10.1 kPa; p = 0.04) but not for the second radiologist (Δ8.63 kPa; p = 0.07). The measurements showed excellent intra-observer (ICC 0.75–0.94) and inter-observer (ICC 0.78–0.88) reliability. After six months, fully recovered patients showed lower NDI scores than partially recovered patients (Δ22.98; p < 0.001). SWE values did not differ with the recovery status (55.6 ± 9.7 vs. 57 ± 15.8, Δ1.45; p = 0.82). The single most accurate variable in classifying health status six months after whiplash injury was the relative change of NDI, and it showed the highest accuracy (73.9%) and low Akaike information criterion (AIC = 39.2). Overall, the most accurate classification was obtained when combining NDI and SWE after physical therapy with an accuracy of 77.3% and a decrease in AIC (32.8).

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Neck Disability Index Is Better in Classification of Recovery after Whiplash Injury in Comparison with Ultrasound Shear Wave Elastography of Trapezius Muscle

et al. 2021

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“…Seventy-five people with whiplash injuries were compared with 75 age-and gender-matched controls. The results showed that sternocleidomastoid and splenius capitis muscle SWE could not be used in diagnosing whiplash injury due to the highly asymmetrical data distribution and variance in tone of 300% between patients [10]. Trapezius muscle showed symmetrical data distribution with clinically relevant results described by higher stiffness in whiplash injury than in the control population group (87.84 ± 23.23 kPa vs. 57.47 ± 13.82 kPa, n = 75).…”

Section: Evaluation Of the Hypothesismentioning

confidence: 91%

Lack of Objective Measurement in the Initial Screening and Follow-Up of Patients Who Report Whiplash Injury—Is Elastography of the Trapezius Muscle an Answer?

Aljinović

Barun

Benzon

et al. 2022

JCM

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Background: Painfully decreased cervical range of motion accompanied by muscle spasm is a common presentation of whiplash injury of the neck. Stiffness of the cervical muscles can be assessed by ultrasound shear wave elastography (SWE), expressed in kilopascals (kPa). The hypothesis: SWE of the trapezius muscle is an objective measurement suitable for the initial screening and follow-up of patients who report whiplash injury. Methods and results: A total of 99 patients after whiplash injury were compared to 75 control participants. Mean trapezius stiffness was 82.24 ± 21.11 vs. 57.47 ± 13.82 for whiplash patients and controls, respectively. The cut-off value of SWE of 75.8 kPa showed 77% accuracy in correctly assigning patients to the whiplash or control group. To evaluate whether SWE can be used as a follow-up method of recovery after a whiplash injury, initial and endpoint SWE (after six months, n = 24) was carried out. Patients reporting no recovery showed similar SWE values as completely recovered patients. This finding refutes the second part of our hypothesis. Conclusions: SWE is a method that can be used for the initial screening of patients with whiplash injury, but we are still searching for an objective measurement that can be used in the follow-up of recovery.

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“…Thirteen studies (43.3%) included a reliability analysis (Alfuraih et al, 2020;Aljinović et al, 2020;Dieterich et al, 2020;Ertekin et (Wang, Cui, et al, 2022), [26] (Wang, Liu, et al, 2022) and [27] (Zhang et al, 2022). Leong et al, 2016;Li et al, 2021;Masaki et al, 2017;Valera-Calero et al, 2021;Wang, Cui, et al, 2022;Zhang et al, 2022).…”

Section: Critical Appraisal Of Swe Methods (Supplementary Items)mentioning

confidence: 99%

“…No difference or higher stiffness in symptomatic individuals was identified in eleven studies (36.6%) that investigated chronic neck pain (Taş et al, 2018), migraine (Hvedstrup et al, 2020), cervicogenic headache (Sedlackova et al, 2021), myofascial pain syndrome in the neck region (Valera-Calero et al, 2021), rotator cuff tendinopathy (Leong et al, 2016), posterior shoulder pain (Itoigawa et al, 2022), low back pain (Masaki et al, 2017;Masaki et al, 2019;Murillo et al, 2019), patellofemoral pain syndrome (Botanlıoğlu et al, 2019) and medial tibial stress syndrome (Zhang et al, 2022). Higher stiffness in the symptomatic group was reported by nine studies (30.0%) that investigated whiplash injury (Aljinović et al, 2020), cervicogenic headache (Lin et al, 2022), temporomandibular disorder (Takashima et al, 2017), myofascial pain syndrome in the neck region (Ertekin et al, 2021), low back pain (Gao et al, 2020;Koppenhaver et al, 2020;Wang, Liu, et al, 2022), piriformis syndrome (Hashimoto et al, 2022) and knee osteoarthritis (Li et al, 2021).…”

Section: Evidence Map and Map Of Muscle Stiffnessmentioning

confidence: 99%

Is musculoskeletal pain associated with increased muscle stiffness? Evidence map and critical appraisal of muscle measurements using shear wave elastography

Haueise,

Le Sant,

Eisele‐Metzger

et al. 2024

Clin Physio Funct Imaging

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SummaryIntroduction and aimsApproximately 21% of the world's population suffers from musculoskeletal conditions, often associated with sensations of stiff muscles. Targeted therapy requires knowing whether typically involved muscles are objectively stiffer compared to asymptomatic individuals. Muscle stiffness is quantified using ultrasound shear wave elastography (SWE). Publications on SWE‐based comparisons of muscle stiffness between individuals with and without musculoskeletal pain are increasing rapidly. This work reviewed and mapped the existing evidence regarding objectively measured muscle stiffness in musculoskeletal pain conditions, and surveyed current methods of applying SWE to measure muscle stiffness.MethodsA systematic search was conducted in PubMed and CINAHL using the keywords “muscle stiffness”, “shear wave elastography”, “pain”, “asymptomatic controls”, and synonyms. The search was supplemented by a hand search using Google Scholar. Included articles were critically appraised with the AXIS tool, supplemented by items related to SWE methods. Results were visually mapped and narratively described.ResultsThirty of 137 identified articles were included. High‐quality evidence was missing. The results comprise studies reporting lower stiffness in symptomatic participants, no differences between groups, and higher stiffness in symptomatic individuals. Results differed between pain conditions and muscles, and also between studies that examined the same muscle(s) and pathology. The methods of the application of SWE were inconsistent and the reporting was often incomplete.ConclusionsExisting evidence regarding the objective stiffness of muscles in musculoskeletal pain conditions is conflicting. Methodological differences may explain most of the inconsistencies between findings. Methodological standards for SWE measurements of muscles are urgently required.This article is protected by copyright. All rights reserved.

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Can measuring passive neck muscle stiffness in whiplash injury patients help detect false whiplash claims?

Cited by 10 publications

References 22 publications

Neck Disability Index Is Better in Classification of Recovery after Whiplash Injury in Comparison with Ultrasound Shear Wave Elastography of Trapezius Muscle

Neck Disability Index Is Better in Classification of Recovery after Whiplash Injury in Comparison with Ultrasound Shear Wave Elastography of Trapezius Muscle

Lack of Objective Measurement in the Initial Screening and Follow-Up of Patients Who Report Whiplash Injury—Is Elastography of the Trapezius Muscle an Answer?

Is musculoskeletal pain associated with increased muscle stiffness? Evidence map and critical appraisal of muscle measurements using shear wave elastography

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