title: Potential associations between chronic whiplash and incomplete spinal cord injury.
abstract: METHODS
  This research utilized a cross-sectional design with control group inclusion.
  
  
  OBJECTIVE
  Preliminary evidence suggests that a portion of the patient population with chronic whiplash may have sustained spinal cord damage. Our hypothesis is that in some cases of chronic whiplash-associated disorders (WAD), observed muscle weakness in the legs will be associated with local signs of a partial spinal cord injury of the cervical spine.
  
  
  METHODS
  University based laboratory in Chicago, IL, USA.
  
  
  METHODS
  Five participants with chronic WAD were compared with five gender/age/height/weight/body mass index (BMI) control participants. For a secondary investigation, the chronic WAD group was compared with five unmatched participants with motor incomplete spinal cord injury (iSCI). Spinal cord motor tract integrity was assessed using magnetization transfer imaging. Muscle fat infiltration (MFI) was quantified using fat/water separation magnetic resonance imaging. Central volitional muscle activation of the plantarflexors was assessed using a burst superimposition technique.
  
  
  RESULTS
  We found reduced spinal cord motor tract integrity, increased MFI of the neck and lower extremity muscles and significantly impaired voluntary plantarflexor muscle activation in five participants with chronic WAD. The lower extremity structural changes and volitional weakness in chronic WAD were comparable to participants with iSCI.
  
  
  CONCLUSIONS
  The results support the position that a subset of the chronic whiplash population may have sustained partial damage to the spinal cord.
  
  
  BACKGROUND
  NIH R01HD079076-01A1, NIH T32 HD057845 and the Foundation for Physical Therapy Promotion of Doctoral Studies program.
authors.affiliation: Northwestern University Interdepartmental Neuroscience Program, Chicago, IL USA; Northwestern University Department of Physical Therapy and Human Movement Sciences, Chicago, IL USA.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Smith
authors.affiliation: Northwestern University Department of Radiology, Chicago, IL USA.
authors.forename: Todd B
authors.initials: TB
authors.lastname: Parrish
authors.affiliation: Northwestern University Department of Physical Therapy and Human Movement Sciences, Chicago, IL USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hoggarth
authors.affiliation: Florida International University Department of Biomedical Engineering, Miami, FL USA.
authors.forename: Jacob G
authors.initials: JG
authors.lastname: McPherson
authors.affiliation: Northwestern University Department of Physical Therapy and Human Movement Sciences, Chicago, IL USA.
authors.forename: Vicki M
authors.initials: VM
authors.lastname: Tysseling
authors.affiliation: Northwestern University Department of Physical Therapy and Human Movement Sciences, Chicago, IL USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Wasielewski
authors.affiliation: Rehabilitation Institute of Chicago, Chicago, IL USA.
authors.forename: Hyosub E
authors.initials: HE
authors.lastname: Kim
authors.affiliation: Rehabilitation Institute of Chicago, Chicago, IL USA.
authors.forename: T George
authors.initials: TG
authors.lastname: Hornby
authors.affiliation: Northwestern University Department of Physical Therapy and Human Movement Sciences, Chicago, IL USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Elliott
keywords: central activation; chronic WAD; magnetic resonance imaging; muscle fat infiltration; spinal cord injury; whiplash