title: Cervical muscle dysfunction in chronic whiplash-associated disorder grade 2: the relevance of the trauma.
abstract: METHODS
  Surface electromyography measurements of the upper trapezius muscles were performed in patients with a chronic whiplash-associated disorder Grade 2 and those with nonspecific neck pain.
  
  
  OBJECTIVE
  To determine the etiologic relation between acceleration-deceleration trauma and the presence of cervical muscle dysfunction in the chronic stage of whiplash-associated disorder.
  
  
  BACKGROUND
  From a biopsychosocial perspective, the acceleration-deceleration trauma in patients with whiplash-associated disorder is not regarded as a cause of chronicity of neck pain, but rather as a risk factor triggering response systems that contribute to the maintenance of neck pain. One of the contributing factors is dysfunction of the cervical muscles. Considering the limited etiologic significance of the trauma, it is hypothesized that in patients with neck pain, there are no differences in muscle activation patterns between those with and those without a history of an acceleration-deceleration trauma.
  
  
  METHODS
  Muscle activation patterns, expressed in normalized smooth rectified electromyography levels of the upper trapezius muscles, in patients with whiplash-associated disorder Grade 2 were compared with those of patients with nonspecific neck pain. The outcome parameters were the mean level of muscle activity before and after a physical exercise, the muscle reactivity in response to the exercise, and the time-dependent behavior of muscle activity after the exercise.
  
  
  RESULTS
  There were no statistical significant differences in any of the outcome parameters between patients with whiplash-associated disorder Grade 2 and those with nonspecific neck pain. There was only a tendency of higher muscle reactivity in patients with whiplash-associated disorder Grade 2.
  
  
  CONCLUSIONS
  It appears that the cervical muscle dysfunction in patients with chronic whiplash-associated disorder Grade 2 is not related to the specific trauma mechanism. Rather, cervical muscle dysfunction appears to be a general sign in diverse chronic neck pain syndromes.
authors: Roessingh, Research and Development, Enschede, The Netherlands. m.nederhand@rrd.nl
authors: Marc J
authors: MJ
authors: Nederhand
authors: Hermie J
authors: HJ
authors: Hermens
authors: Maarten J
authors: MJ
authors: IJzerman
authors: Dennis C
authors: DC
authors: Turk
authors: Gerrit
authors: G
authors: Zilvold
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae; D002908:Chronic Disease; D004576:Electromyography; D015444:Exercise / Q000502:physiology; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D019547:Neck Pain / Q000503:physiopathology*; D014911:Whiplash Injuries / Q000503:physiopathology*