Pathophysiology behind prolonged whiplash associated disorders: study protocol for an experimental study

Peolsson, Anneli; Karlsson, Anette; Ghafouri, Bijar; Ebbers, Tino; Engström, Maria; Jönsson, Margaretha; Wåhlén, Karin; Romu, Thobias; Borga, Magnus; Kristjansson, Eythor; Bahat, Hilla; German, Dmitry; Zsigmond, Peter; Peterson, Gunnel

doi:10.1186/s12891-019-2433-3

Cited by 9 publications

(8 citation statements)

References 31 publications

(63 reference statements)

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“…61 In a similar fashion, high baseline modularity has been used to predict larger cognitive gains in response to an exercise intervention in healthy older adults. 62 In light of these findings and with an ongoing trial investigating the effects of exercise on WAD (which includes fMRI), 63 network modularity presents a promising marker for treatment prediction.…”

Section: Discussionmentioning

confidence: 99%

Brain Network Disruption in Whiplash

Higgins

Elliott

Parrish

2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Whiplash-associated disorders frequently develop following motor vehicle collisions and often involve a range of cognitive and affective symptoms, though the neural correlates of the disorder are largely unknown. In this study, a sample of participants with chronic whiplash injuries were scanned by using resting-state fMRI to assess brain network changes associated with long-term outcome metrics. MATERIALS AND METHODS:Resting-state fMRI was collected for 23 participants and used to calculate network modularity, a quantitative measure of the functional segregation of brain region communities. This was analyzed for associations with whiplash-associated disorder outcome metrics, including scales of neck disability, traumatic distress, depression, and pain. In addition to these clinical scales, cervical muscle fat infiltration was quantified by using Dixon fat-water imaging, which has shown promise as a biomarker for assessing disorder severity and predicting recovery in chronic whiplash.RESULTS: An association was found between brain network structure and muscle fat infiltration, wherein lower network modularity was associated with larger amounts of cervical muscle fat infiltration after controlling for age, sex, body mass index, and scan motion (t ¼ À4.02, partial R 2 ¼ 0.49, P , .001).CONCLUSIONS: This work contributes to the existing whiplash literature by examining a sample of participants with whiplash-associated disorder by using resting-state fMRI. Less modular brain networks were found to be associated with greater amounts of cervical muscle fat infiltration suggesting a connection between disorder severity and neurologic changes, and a potential role for neuroimaging in understanding the pathophysiology of chronic whiplash-associated disorders.

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Section: Discussionmentioning

confidence: 99%

Brain Network Disruption in Whiplash

Higgins

Elliott

Parrish

2020

AJNR Am J Neuroradiol

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“…(The first visit was a 60-minute examination, including information and the first exercise session, and the remaining sessions were 30-minute exercise sessions.) The neck specific internet-based exercise (NSEIT) group ( n = 24) had four PT visits only, combined with a web-based system [ 37 ]. (The first PT visit was the same as for the NSE group, and the remaining three PT visits were 30-minute sessions at weeks 2, 3 and 7 for follow-up and progression/adjustment of exercises.)…”

Section: Methodsmentioning

confidence: 99%

The effect of a neck-specific exercise program on cervical kinesthesia for patients with chronic whiplash-associated disorders: a case-control study

Ragnarsdottir,

Peterson,

Gislason

et al. 2024

BMC Musculoskelet Disord

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Introduction Cervical kinesthesia is an important part of movement control and of great importance for daily function. Previous research on kinesthesia in whiplash-associated disorders (WAD) has focused on grades I-II. More research is needed on WAD grade III. The aim of this study was to investigate cervical kinesthesia in individuals with WAD grades II-III before and after a neck-specific exercise intervention and compare them to healthy controls. Methods A prospective, case-control study with a treatment arm (n = 30) and a healthy control arm (n = 30) was conducted in Sweden. The WAD group received a neck-specific exercise program for 12 weeks. The primary outcome to evaluate kinesthesia was neck movement control (the Fly test). Secondary outcomes were neck disability, dizziness and neck pain intensity before and after the Fly test. Outcomes were measured at baseline and post-treatment. The control arm underwent measurements at baseline except for the dizziness questionnaire. A linear mixed model was used to evaluate difference between groups (WAD and control) and over time, with difficulty level in the Fly test and gender as factors. Results Between-group analysis showed statistically significant differences in three out of five kinesthetic metrics (p = 0.002 to 0.008), but not for the WAD-group follow-up versus healthy control baseline measurements. Results showed significant improvements for the WAD-group over time for three out of five kinaesthesia metrics (p < 0.001 to 0.008) and for neck disability (p < 0.001) and pain (p = 0.005), but not for dizziness (p = 0.70). Conclusions The exercise program shows promising results in improving kinesthesia and reducing neck pain and disability in the chronic WAD phase. Future research might benefit from focusing on adding kinesthetic exercises to the exercise protocol and evaluating its beneficial effects on dizziness or further improvement in kinesthesia. Impact statement Kinesthesia can be improved in chronic WAD patients without the use of specific kinesthetic exercises. Trial registration ClinicalTrials.gov (NCT03664934), first registration approved 11/09/2018.

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“…Data is stored at the Medical Faculty at Linköping University, Sweden (for 10 years after publication of data, according to law), and is accessible for the researchers. The trial was registered before data collection started (Clinicaltrial.gov Protocol ID: NCT03664934, initial release 09/11/2018) and the protocol was published 40 , 41 . All experiments were performed in accordance with the Declaration of Helsinki and Swedish law.…”

Section: Methodsmentioning

confidence: 99%

Results of neck-specific exercise for altered postural sway in individuals with chronic whiplash-associated disorders: a longitudinal case–control study

Peolsson,

Bahat,

German

et al. 2024

Sci Rep

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Postural sway has not been investigated before or after a neck exercise intervention in individuals with chronic whiplash-associated disorders (WAD). The aim of the study was to investigate postural sway in individuals with chronic WAD grades 2 and 3: (a) compared with healthy matched controls at baseline; (b) after three months of neck-specific exercise and (c) to investigate the correlation between postural sway with self-reported dizziness during motion and balance problems/unsteadiness. This is a longitudinal prospective experimental case–control intervention study. Individuals with WAD (n = 30) and age- and gender-matched healthy volunteers (n = 30) participated. Postural sway was assessed using an iPhone application. Measurements were carried out at baseline, and for those with WAD a second measurement was performed at the three-month follow-up when neck-specific exercise intervention ended. The WAD group performed significantly worse than the healthy group in both pathway and ellipse area double stance eyes closed at baseline (main outcome), but not at the three-month follow-up. The WAD group significantly improved after rehabilitation in both pathway double stance eyes closed and pathway single stance eyes open. The correlation between postural sway and self-rated dizziness during motion and balance problems was low to moderate. One may conclude that postural sway was improved after a neck-specific exercise programme. The study results strengthen earlier findings that individuals with WAD have worse balance outcome when they have to rely on neck proprioception (eyes closed). The study results may be important for the development of improved rehabilitation methods for WAD.

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Pathophysiology behind prolonged whiplash associated disorders: study protocol for an experimental study

Cited by 9 publications

References 31 publications

Brain Network Disruption in Whiplash

Brain Network Disruption in Whiplash

The effect of a neck-specific exercise program on cervical kinesthesia for patients with chronic whiplash-associated disorders: a case-control study

Results of neck-specific exercise for altered postural sway in individuals with chronic whiplash-associated disorders: a longitudinal case–control study

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