Whiplash: assessing the validity of diagnostic tests in a cervical sensory disturbance.
OBJECTIVE
To determine the ability of two diagnostic tests that examine sensory disturbance in whiplash patients to discriminate between 'extreme' groups.


BACKGROUND
The neuromuscular theories have been accepted as explanations of the symptoms after a whiplash injury. Dutch manual therapists often use the diagnostic tests under study to diagnose and treat sensory disturbances after such an injury. The validity of a test needs to be assessed before its efficacy as a treatment in whiplash patients can be tested. The aim of this study was to validate two diagnostic tests and to initiate further research on the efficacy of a treatment of a sensory disturbance in whiplash patients.


METHODS
Twelve subjects with chronic symptoms (> 3 months) after a whiplash injury (patient group) and 18 subjects without any head or neck problems (control group) were studied. The tests under study were the extension test and the coordination test. All researchers were blind to the characteristics of the subjects.


RESULTS
The extension test and the coordination test were able to discriminate adequately between subjects with symptoms after a whiplash injury (patients) and subjects without any head or neck complaints (control subjects). Patients clearly show a smaller degree of extension compared with the control subjects and an increase of extension movement with external fixation. The sensitivity as well as the specificity of the coordination test were good (both > .80).


CONCLUSIONS
These diagnostic tests seemed to be valid instruments for discriminating between whiplash patients with symptoms and healthy people.
Verhagen
A P
AP
Department of Epidemiology, University of Maastricht, The Netherlands.
Lanser
K
K
de Bie
R A
RA
de Vet
H C
HC
D000328:Adult; D002574:Cervical Vertebrae / Q000502:physiology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D026741:Physical Therapy Modalities / Q000379:methods; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012399:Rotation; D014911:Whiplash Injuries / Q000150:complications / Q000175:diagnosis*