Postural control deficit in acute QTF grade II whiplash injuries.
METHODS
Experimental in vivo study.


OBJECTIVE
The objective was to investigate the balance control in patients with acute QTF grade II whiplash injuries of the cervical spine.


BACKGROUND
Tetra-ataxiametric posturography in chronic pain patients after whiplash injuries of the cervical spine has revealed an impaired regulation of balance. However, so far it is unclear if this is caused by the accident or other factors that are associated with the pain chronification process.


METHODS
40 patients with acute QTF grade II whiplash injuries and 40 healthy matched controls were examined on a posturography platform. The stability index ST(Sigma) and the Fourier analysis FA(Sigma) (0.10-1.00Hz) were established for eight standing positions and sum scores were calculated. The pain index was established using a visual analog scale ranging from 0 to 100. A follow-up examination was conducted for the patients after 2 months.


RESULTS
The patients with acute whiplash injuries of the cervical spine achieved significantly poorer results for both ST(Sigma) and FA(Sigma) than the healthy controls. There were no differences between the eight standing positions for both ST(Sigma) and FA(Sigma). After 2 months, 17 patients had no change in the pain development, 21 patients showed an improvement in pain intensity and 2 patients had deteriorated. The subgroup of patients with improvement in pain intensity showed a significant improvement in balance control concerning the FA(Sigma) compared to patients with unchanged pain intensity.


CONCLUSIONS
Patients with acute whiplash injuries have a reduced balance control as compared to matched controls. This study gives an indication that post-traumatic neck pain is associated with impairments of postural control.
Dehner
Christoph
C
Department for Trauma Surgery, Hand, Plastic and Reconstructive Surgery, University of Ulm, Steinhövelstrasse 9, Germany. christoph.dehner@uniklinik-ulm.de
Heym
Birgit
B
Maier
Dirk
D
Sander
Silvia
S
Arand
Markus
M
Elbel
Martin
M
Hartwig
Erich
E
Kramer
Michael
M
D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000503:physiopathology; D004856:Postural Balance / Q000502:physiology; D011187:Posture / Q000502:physiology*; D014911:Whiplash Injuries / Q000503:physiopathology*