Abstract
Up to 90% of people with neurological deficits following a whiplash injury do not recover and cervical muscle dysfunction is common. The aim of this multicentre, randomized controlled trial was to examine whether two versions of neck-specific exercise or prescription of physical activity (PPA) can improve radiating arm pain and clinical signs that can be associated with neurological deficits in people with chronic whiplash associated disorders (WAD). Participants with chronic WAD, arm symptoms and signs associated with neurological deficits (n = 171) were randomized to: 12 weeks of neck-specific exercise without (NSE) or with a behavioural approach (NSEB), or PPA. Pain/bothersomeness frequency, six measures of arm pain/paraesthesia (VAS scales), and four clinical neurological tests were evaluated after 3 months. The NSE group reported the lowest frequency and lowest levels of arm pain, the highest proportion of participants with at least 50% pain reduction and the highest proportion of normal arm muscle force. The NSEB group reported increased normal tendon reflexes. No improvements were recorded for the PPA group. Neck-specific exercise may improve arm pain and decrease signs of neurological deficits, but the addition of a behavioural approach does not seem to be of additional benefit.
Highlights
Up to 90% of people with neurological deficits following a whiplash injury, continue to report symptoms after 1 year[1,2]
In the absence of universally accepted criteria for the diagnosis of cervical radiculopathy[15], radiating arm pain and signs of neurological deficits may be present in other grades
Whether arm pain and clinical signs associated with neurological deficits can be improved remains unknown and has, to our knowledge, not been tested before in whiplash associated disorders (WAD)
Summary
Up to 90% of people with neurological deficits following a whiplash injury, continue to report symptoms after 1 year[1,2]. In the absence of universally accepted criteria for the diagnosis of cervical radiculopathy[15], radiating arm pain and signs of neurological deficits may be present in other grades. They are rarely considered in the literature. We hypothesized that neck-specific exercise would have a positive effect on these outcomes The aim of this analysis was to examine whether two versions of neck-specific exercise or prescription of physical activity can affect radiating arm pain and clinical signs, which can be associated with neurological deficits in people with chronic WAD
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