Performance of cervical motion in chronic whiplash patients and healthy subjects: the case of atypical patients.

摘要

STUDY DESIGN: A comparative study of cervical motion performance in chronic whiplash (CW) patients and healthy subjects. OBJECTIVES: To examine the efficiency of total cervical range of motion (TCROM), which consists of the combined score of all six primary movements and their mean coefficient of variation (MCV), in differentiating CW patients from healthy subjects as well as typical from atypical patients. Additionally to explore in the patients possible relationships between their cervical motion profile and functional and personality traits. SUMMARY OF BACKGROUND DATA: Previous studies revealed that cervical motion was an efficient discriminator between healthy and CW patients. However, none of these studies provided either guidelines regarding cutoff scores or insight as to what should be considered typical compared with atypical patient with respect to cervical motion performance. METHODS: Cervical motion was measured in 75 healthy subjects and 101 CW patients in each of the six primary movements.In addition, patients filled the functional neck disability index (NDI) and personality symptom check list (SCL-R-90) questionnaire. RESULTS: Total CROM was significantly lower and the MCV was significantly higher in patients compared with healthy subjects. Age and gender affected TCROM significantly in both groups while MCV remained unaffected, respectively. Atypical patients were identified by having a TCROM < 58 degrees and or MCV > 22%, both scores corresponding to 2 SDs below and above group means, respectively. These benchmarks resulted in classifying as atypical 6% of the CW group who also scored drastically higher in the NDI and SCL-R-90 questioners. CONCLUSIONS: Using MCV and TCROM adds new insight regarding what should be considered as atypical cervical motion profile in CW patients. Several aspects of this complex clinical entity are discussed.