title: Balance, dizziness and proprioception in patients with chronic whiplash associated disorders complaining of dizziness: A prospective randomized study comparing three exercise programs.
abstract: BACKGROUND
  Dizziness and unsteadiness are common symptoms following a whiplash injury.
  
  
  OBJECTIVE
  To compare the effect of 3 exercise programs on balance, dizziness, proprioception and pain in patients with chronic whiplash complaining of dizziness.
  
  
  METHODS
  A sub-analysis of a randomized study.
  
  
  METHODS
  One hundred and forty subjects were randomized to either a physiotherapist-guided neck-specific exercise (NSE), physiotherapist-guided neck-specific exercise, with a behavioural approach (NSEB) or prescription of general physical activity (PPA) group. Pre intervention, 3, 6 and 12 months post baseline they completed the University of California Los Angeles Dizziness Questionnaire (UCLA-DQ), Visual Analogue Scales (VAS) for, dizziness at rest and during activity and physical measures (static and dynamic clinical balance tests and head repositioning accuracy (HRA)).
  
  
  RESULTS
  There were significant time by group differences with respect to dizziness during activity and UCLA-Q favouring the physiotherapy led neck specific exercise group with a behavioural approach. Within group analysis of changes over time also revealed significant changes in most variables apart from static balance.
  
  
  CONCLUSIONS
  Between and within group comparisons suggest that physiotherapist led neck exercise groups including a behavioural approach had advantages in improving measures of dizziness compared with the general physical activity group, although many still complained of dizziness and balance impairment. Future studies should consider exercises specifically designed to address balance, dizziness and cervical proprioception in those with persistent whiplash.
authors.affiliation: NHMRC CCRE (Spinal Pain, Injury and Health), The University of Queensland, Brisbane, Australia. Electronic address: j.treleaven@uq.edu.au.
authors.forename: Julia
authors.initials: J
authors.lastname: Treleaven
authors.affiliation: Department of Medical and Health Sciences, Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Sweden.
authors.forename: Gunnel
authors.initials: G
authors.lastname: Peterson
authors.affiliation: Department of Medical and Health Sciences, Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping, Sweden; Rehab Väst, County Council of Östergötland, Sweden.
authors.forename: Maria Landén
authors.initials: ML
authors.lastname: Ludvigsson
authors.affiliation: Department of Medical and Health Sciences, Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping, Sweden; Futurum the Academy for Healthcare, County Council Jönköping, Sweden.
authors.forename: Ann-Sofi
authors.initials: AS
authors.lastname: Kammerlind
authors.affiliation: Department of Medical and Health Sciences, Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Anneli
authors.initials: A
authors.lastname: Peolsson
mesh_terms: D000293:Adolescent; D000328:Adult; D004185:Disability Evaluation; D004244:Dizziness / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology*; D011434:Proprioception / Q000502:physiology*; D011446:Prospective Studies; D014911:Whiplash Injuries / Q000150:complications* / Q000534:rehabilitation*; D055815:Young Adult
keywords: Balance; Dizziness; Proprioception; Whiplash