Abstract
Whiplash Associated Disorders (WAD) refers to the multifaceted and chronic burden that is common after a whiplash injury. Tools to assist in the diagnosis of WAD and an increased understanding of neck muscle behaviour are needed. We examined the multilayer dorsal neck muscle behaviour in nine women with chronic WAD versus healthy controls during the entire sequence of a dynamic low-loaded neck extension exercise, which was recorded using real-time ultrasound movies with high frame rates. Principal component analysis and orthogonal partial least squares were used to analyse mechanical muscle strain (deformation in elongation and shortening). The WAD group showed more shortening during the neck extension phase in the trapezius muscle and during both the neck extension and the return to neutral phase in the multifidus muscle. For the first time, a novel non-invasive method is presented that is capable of detecting altered dorsal muscle strain in women with WAD during an entire exercise sequence. This method may be a breakthrough for the future diagnosis and treatment of WAD.
Highlights
One year after whiplash injury, up to half of affected individuals have remaining neck pain due to whiplash associated disorders (WAD)[1]
principal component analysis (PCA) was here used as an unsupervised tool to illustrate differences between the observations, taking into account all variation found in the strain data and its 800 variables
It can be presumed that individuals with WAD are showing more shortening in the trapezius and multifidus muscles during the exercise as healthy controls correlated positively to the higher strain given by the loading plots
Summary
One year after whiplash injury, up to half of affected individuals have remaining neck pain due to whiplash associated disorders (WAD)[1]. Peolsson et al.[16] investigated multilayer dorsal neck muscles with ultrasonography during the range of standardised dynamic low-loaded neck extension in an upright seated position, where postural control is vital. The behaviour of the different dorsal neck muscle layers during dynamic neck extension has not been investigated in individuals with chronic WAD and no one has investigated multilayer muscle behaviour registered with ultrasound movies during the entire sequence of a neck movement. The aim of this study was to compare the strain (the degree of muscle deformation expressed as the percentage of longitudinal shortening or elongation during the entire exercise compared with the start of the exercise/“rest”) of dorsal multilayer neck muscles in individuals with chronic WAD and matched healthy controls, during a standardised dynamic resisted neck extension. Non-invasive ultrasonography movies, post-process speckle tracking, and advanced multivariate statistics were used to investigate the real time mechanical muscle behaviour during the entire sequence of neck extension
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