Impaired neck motor control in chronic whiplash and tension‐type headache

Abstract

Objectives The purpose of this study is twofold, first to present a new method based on head laser tracking designed to measure head or hand movements and second to further investigate if patients suffering from chronic whiplash or tension‐type headache have impaired motor control of neck muscles. Material and Methods A new laser tracking instrument was designed to measure the ability of a test person to track a reference point moving on the wall by a laser fixed to the forehead or held in the hand. The reference point to be tracked moves in runs of a circle or a square at three different speeds 10, 20, or 30 cm/s. We used a 1 × 1 ×1 m setup geometry to provide head movements well below pain release. Groups of 22 patients diagnosed with chronic whiplash‐associated disorder grade 2, 19 patients diagnosed with chronic tension‐type headache, and 37 control persons were compared. Results A small but highly significant dyscoordination of head movements was observed in both patient groups and in whiplash also of the hand. Conclusions Our study presents a new method based on laser tracking for precision quantitative measurements of head or hand movements during standardized conditions. The results confirm that motor control of head movements is impaired in both chronic whiplash and tension‐type headache, and in whiplash also of the hand. This suggests involvement of the central nervous system in the pathology of these diseases.

Tension-type headache and low back pain reconsidered

“…In the present context of a possible central cause of this condition, it is of particular interest that tension-type headache patients display discoordination of head movements and discoordination of adjacent muscle groups. The discoordination of head movements was first observed by Woodhouse and Vasseljen (3) and Kristjansson and Oddsdottir (4) using 'the fly method' and recently confirmed by Astrup et al (5) using the laser tracking technique. This evidence indicates impaired neuromotor control by the central nervous system.…”

Cervical Motor and Nociceptive Dysfunction After an Acute Whiplash Injury and the Association With Long-Term Non-Recovery: Revisiting a One-Year Prospective Cohort With Ankle Injured Controls

“…In more recent studies, it has been suggested that chronic WAD (I–II) is a non-specific neck pain condition, a “ de novo ” tension-type headache, as clinical features are similar to non-specific low-back pain conditions ( 24 ). Shared mechanisms for so-called spinal dyssynergia might underlie the basis for motor disability, non-recovery, and poor treatment results when applying known physical rehabilitation methods.…”

The Whiplash Disease Reconsidered

“…Several studies have observed subclinical but significant dyscoordination of head movements in whiplash as measured by “the fly method” ( 22 , 23 ) and recently by laser tracking ( 24 ). Other muscular systems adjacent to the neck musculature are also affected.…”

“…Other muscular systems adjacent to the neck musculature are also affected. This is indicated by dyscoordination of eye movements ( 25 , 26 ) and the upper extremity ( 24 , 27 , 28 ). The dyscoordination of head movements probably is indicative of neuromotor hyperactivity and altered activation patterns as observed in the EMG studies.…”