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Considerations in the Physical Rehabilitation of Patients with Whiplash Associated Disorders.
MedLine Citation:
PMID:  22020596     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ABSTRACT: Study Design. Review of research identifying physical impairments in the neuromuscular system in subjects with whiplash associated disorders.Objective. Review the impairments in movement and neuromuscular function towards constructing research informed exercise programs.Summary of Background Data. Pain and injury to the musculoskeletal system result in loss of motion and impaired neuromuscular function which impacts on functional activities, work and quality of life. Therapeutic exercise is a mainstay of rehabilitation, but the nature of the exercises prescribed are currently various and the effect sizes of current programs for patients with whiplash associated disorders are modest at best.Methods. A review was undertaken of research investigating the changes in cervical motion and neuromuscular function to better inform exercise prescription and identify areas for future research.Results. Reduced range of movement as well as pathological movement patterns (reduced acceleration and velocity, reduced smoothness and irregular axes of neck movement) have been documented in subjects with whiplash associated disorders. In relation to neuromuscular control, changes have been demonstrated in neck muscles' spatial and temporal relationships as well as in their strength and endurance. The presence or not and the extent of changes is highly variable between individuals and appears to have some relationship to pain intensity. It appears that there is a need for specificity in exercise prescription to address particular impairments rather than the use of generic programs. High pain intensity can modify effects of a therapeutic exercise program.Conclusion. Pain and injury result in re-organization of the motor control strategies of neck muscles and movement. Further research is required to determine if outcomes following a whiplash injury can be improved by using research informed, individually prescribed exercise programs matched to the individual's presentation. Research into best methods of pain management is also required to facilitate physical rehabilitation.
Authors:
Gwendolen A Jull
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-20
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
CCRE Spinal Pain, Injury and Health, Division of Physiotherapy, The University of Queensland, Australia.
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