Standing balance in persistent whiplash: a comparison between subjects with and without dizziness

Abstract

Dizziness and unsteadiness, associated with altered balance, are frequent complaints in subjects suffering persistent whiplash associated disorders. Research has been inconclusive with respect to possible aetiology. This study assessed balance responses in subjects with whiplash associated disorders, taking into account several possible causes. A prospective, 3 group, observational design. 100 subjects with persistent whiplash associated disorders, 50 complaining of dizziness, 50 not complaining of dizziness and 50 healthy controls. The Clinical Test for Sensory Interaction in Balance was performed in both comfortable and tandem stance. The sway trace was analysed using wavelet analysis. The results indicated that the energy of the sway signal for comfortable stance tests was significantly greater in the group with dizziness compared with the group without dizziness. In the group without dizziness the energy was greater than controls for all tests, but significantly different on selected tests. In selected tandem stance tests, subjects with dizziness were significantly less able to complete the test than subjects without dizziness and controls. These deficits could not be attributed to medications, compensation, anxiety or age and are likely to be due to disturbances to the postural control system possibly originating from abnormal cervical afferent input.