Abstract
Madeleine P, Prietzel H, Svarrer H, Arendt-Nielsen L. Quantitative posturography in
altered sensory conditions: a way to assess balance instability in patients with chronic
whiplash injury. Arch Phys Med Rehabil 2004;85: 432–8.
Objectives
To quantify neck mobility and posture with and without various postural perturbations.
Design
A multivariable 2-group study with repeated measures and treatments.
Setting
A human performance laboratory.
Participants
Eleven patients with chronic whiplash injury (mean age, 33.3±6.7y; weight, 73.4±11.4kg;
height, 173.3±7.2cm) with a sex- and age-matched control group (mean age, 33.1±6.8y;
weight, 68±12.5kg; height, 171.5±6.3cm).
Interventions
Neck mobility and the effects of postural perturbations affecting the visual, vestibular,
cutaneous, proprioceptive, and nociceptive systems were measured.
Main outcome measures
Active range of motion, neck position sense, and postural activity.
Results
We found significantly reduced neck mobility and increased postural activity in the
patient group compared with the control group. In patients, there was significantly
greater postural activity with eyes closed, eyes open and speaking, and eyes closed
with Achilles’ tendons vibrations compared with eyes open with no vibrations. In the
controls, there was no significant effect of experimental muscle pain on postural
activity.
Conclusions
Patients with chronic whiplash injury had a protective response to neck movement and
different tuning, sequencing, and execution of the postural synergies probably because
of excessive reliance on visual input despite a possible deficit and altered vestibular
and/or proprioceptive activity. In healthy volunteers, the pain induced by a single
bolus injection of hypertonic saline was probably too limited in intensity and spreading
to decrease postural stability.
Keywords
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Article info
Footnotes
☆Supported by the Danish National Research Foundation.
Identification
Copyright
© 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
