Cervical motor dysfunction and its predictive value for long-term recovery in patients with acute whiplash-associated disorders: a systematic review

J Rehabil Med. 2013 Feb;45(2):113-22. doi: 10.2340/16501977-1091.

Abstract

Objective: To study the presence of cervical motor dysfunctions in acute whiplash-associated disorders, evaluate their course and assess their predictive value for long-term recovery.

Design: Systematic literature review.

Methods: PubMed and Web of Science databases were used to select studies of the presence of cervical motor dysfunctions within the acute stage (< 6 weeks) after whiplash trauma and/or their predictive value for the development of chronic whiplash-associated disorders.

Results: The presence of cervical motor dysfunctions in the acute stage after whiplash trauma was investigated in 4 cohorts. The course of cervical motor dysfunctions in whiplash-associated disorders was examined in 4 cohorts, and the predictive value on outcome 1 year post-whiplash trauma was assessed in 3 cohorts. Reduced cervical mobility, disturbed kinaesthesia, and altered muscle activity were found in the acute stage, and these persisted over time in the moderate/severe group. The predictive value of examining the presence of cervical motor dysfunctions was doubtful. The course and predictive value of initial reduced cervical mobility was inconsistent.

Conclusion: Cervical motor dysfunctions are present soon after whiplash trauma persisting in those with moderate/severe symptoms. However, these dysfunctions have limited predictive value, and hence may not explain the complex clinical picture of whiplash-associated disorders. This systematic review highlights the need for differentiating between patients with acute whiplash-associated disorders taking into account the biopsychological framework.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Kinesthesis
  • Musculoskeletal Diseases / etiology
  • Musculoskeletal Diseases / physiopathology*
  • Neck / physiopathology*
  • Neck Muscles / physiopathology*
  • Nervous System Diseases / physiopathology
  • Prognosis
  • Range of Motion, Articular
  • Whiplash Injuries / complications
  • Whiplash Injuries / physiopathology*
  • Whiplash Injuries / rehabilitation