Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “WHIPLASH INJURY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2005

The cervico-ocular reflex is increased in whiplash injury patients.

Whiplash-associated disorders (WAD) are a major problem in the Western world, which put a formidable financial burden on modern society and which evoke an emerging debate on the true nature of their origin. To date there is no generally accepted test that allows us to diagnose WAD objectively. Because whiplash injury causes dysfunction of proprioception in the neck, we investigated the characteristics of the cervico-ocular reflex (COR) of presumptive WAD patients. These patients and age-matched healthy controls were rotated at different stimulus peak velocities in the dark while their head was fixed in space. The gain values of the COR were significantly increased in the patient population at a wide range of stimulus peak velocities with maximum difference at the lower frequencies (p = 0.037, ANOVA). Hence, although larger numbers of patients should be measured, the COR gain appears to be a parameter that may permit an objective diagnosis of WAD.

Adult↗
PubMed2005

Physical and psychological factors predict outcome following whiplash injury.

Predictors of outcome following whiplash injury are limited to socio-demographic and symptomatic factors, which are not readily amenable to secondary and tertiary intervention. This prospective study investigated the predictive capacity of early measures of physical and psychological impairment on pain and disability 6 months following whiplash injury. Motor function (ROM; kinaesthetic sense; activity of the superficial neck flexors (EMG) during cranio-cervical flexion), quantitative sensory testing (pressure, thermal pain thresholds, brachial plexus provocation test), sympathetic vasoconstrictor responses and psychological distress (GHQ-28, TSK, IES) were measured in 76 acute whiplash participants. The outcome measure was Neck Disability Index scores at 6 months. Stepwise regression analysis was used to predict the final NDI score. Logistic regression analyses predicted membership to one of the three groups based on final NDI scores (<8 recovered, 10-28 mild pain and disability, >30 moderate/severe pain and disability). Higher initial NDI score (1.007-1.12), older age (1.03-1.23), cold hyperalgesia (1.05-1.58), and acute post-traumatic stress (1.03-1.2) predicted membership to the moderate/severe group. Additional variables associated with higher NDI scores at 6 months on stepwise regression analysis were: ROM loss and diminished sympathetic reactivity. Higher initial NDI score (1.03-1.28), greater psychological distress (GHQ-28) (1.04-1.28) and decreased ROM (1.03-1.25) predicted subjects with persistent milder symptoms from those who fully recovered. These results demonstrate that both physical and psychological factors play a role in recovery or non-recovery from whiplash injury. This may assist in the development of more relevant treatment methods for acute whiplash.

Adult↗
PubMed2002

Cervicogenic headache (CEH) after whiplash injury.

The main objective of the present investigation was to search for cervicogenic headache (CEH) after whiplash injury. Whiplash patients (n= 587), were followed for a year after their emergency service consultation. A total of 222 patients with headache after 1 month went through interview and examinations at 6 weeks, 6 months and 1 year. All included persons received a questionnaire after 1 year. De novo CEH seemed to be present in 8% at 6 weeks and in 3% at 1 year. Previous car accidents, pre-existing headache and neck pain were more frequent in chronic CEH individuals than in those in the cohort without CEH. Range of motion in the neck was reduced in 65% of chronic CEH individuals hours after the accident, compared with 41% in the cohort. Cybex inclinometer, at 6 weeks and 1 year, demonstrated reduced extension in the neck. CEH seems to be present after whiplash injury, particularly in the early phase. It seems similar to, but probably not identical to, non-whiplash CEH.

Adolescent↗
PubMed1999

Whiplash Injuries.

The term "whiplash" is not a medical diagnosis, but is the result of soft-tissue trauma to the neck. A whiplash injury occurs as a result of a sudden acceleration or deceleration of the head and neck with respect to the body. This article recommends that patient treatment be individualized.

Journal Article↗
PubMed2005

Prospective PC-interactive pressure algesimetry of post-traumatic neck pain after whiplash injury.

Cervical pain is a prominent symptom in both acute whiplash injury and late whiplash syndrome. However, no systematic analysis of post-traumatic pain development covering several weeks has yet been performed in whiplash patients. It was the aim of the present study to analyse the duration and course of post-traumatic muscle pain due to whiplash injury in a prospective follow-up examination with short investigation intervals. A recovery of initially increased muscle pain after whiplash injury within 1 month was hypothesized. Pressure pain of the splenius and trapezius muscles was recorded using PC-interactive pressure algesimetry. Whiplash patients were investigated during the acute injury stage and after 3, 4, and 6 weeks and compared with matched controls. We found significantly increased pressure pain of the splenius and trapezius muscles in the acute stage of whiplash injury. After 4 weeks patients' scores of pain parameters were comparable to those of healthy control subjects. Within the patient group the first changes of pressure pain were observed within 3 (splenius) and 4 weeks (trapezius). For most patients the recovery dynamics lasted 4-6 weeks. A minority of patients did not show any improvement after 6 weeks. The present study shows that the dynamics of pressure pain due to whiplash injury can be quantified by means of PC-interactive pressure algesimetry. Our results confirm the clinical experience that the acute post-traumatic cervical syndrome normally subsides within weeks.

Adult↗
PubMed2001

Systemic immune response in whiplash injury and ankle sprain: elevated IL-6 and IL-10.

Whiplash injury and whiplash-associated disorders (WAD) are significant problems of modern society. Numerous attempts have been made to characterize the nature of whiplash injury. Whether the immune system is involved during the disease process is not known. In a prospective study, using enzyme-linked immunospot (ELISPOT) assays, we examined numbers of blood mononuclear cells (MNC) secreting pro- (IFN-gamma, TNF-alpha, IL-6) and anti-inflammatory (IL-10) cytokines in patients with WAD and, for reference, patients with ankle sprain and multiple sclerosis and healthy subjects. An immune response reflected by elevated numbers of TNF-alpha- and IL-10-secreting blood MNC was observed in patients with WAD examined within 3 days compared to 14 days after the whiplash injury. The patients with WAD examined within 3 days after the injury had also higher numbers of IL-6 and IL-10 secreting blood MNC compared to healthy subjects. The alterations of cytokine profiles observed in WAD were also observed in patients with ankle sprain when examined within 3 days after trauma. In contrast, there were no differences for cytokine profiles between patients with WAD examined 14 days after the whiplash injury and healthy subjects. Relatively minor trauma like WAD and ankle sprain are associated with a systemic dysregulation in numbers of cells secreting pro- as well as anti-inflammatory cytokines.

Adolescent↗
PubMed1995

[Clinical aspects and neurologic expert assessment in sequelae of whiplash injury to the cervical spine].

Whiplash injury to the cervical spine and its possible long-term sequelae, the late (or chronic) whiplash syndrome, are analysed based on a clearly defined accident mechanism and an initial battery of investigations to exclude lesions other than those affecting the soft tissue of the neck region (i.e. the consequences of strain and sprain). Predictors are discussed that may point to a delayed and complicated recovery, with development of a complex array of symptoms. The pattern of this symptomatology, as reviewed on the basis of different neuropsychological investigations, appears inhomogeneous. Comparison with other non-traumatic conditions, such as the chronic fatigue syndrome, the fibromyalgia syndrome and chronic daily headache, as well as with chronic disturbances of cervical origin, reveals striking similarities. In cases of litigation, these circumstances require careful assessment of the patient's previous history and an extensive differential diagnosis. Whiplash injury to the cervical spine rarely results in disability and, if so, is only minor.

Cervical Vertebrae↗
PubMed2005

A cross-cultural comparison between Canada and Germany of symptom expectation for whiplash injury.

OBJECTIVE: Symptom expectation for whiplash injury has been shown to be low in countries with low rates of chronic whiplash when compared with countries like Canada, where chronic whiplash is common. The objective of the current study is to compare the frequency and nature of expected "whiplash" symptoms in Germany with that in Canada. METHODS: A symptom checklist was administered to two subject groups selected from local companies in Germany and Canada. Subjects were asked to imagine having suffered a neck sprain (whiplash injury) with no loss of consciousness in a motor vehicle collision and to check which, of a variety of symptoms, they would expect might arise from the injury. For symptoms they anticipated, they were asked to select the period of time they expected those symptoms to persist. RESULTS: In both groups, the pattern of acute symptoms anticipated closely resembled the symptoms of acute whiplash victims, but 50% of Canadians also anticipated symptoms to last months or years, whereas few German subjects selected any symptoms as likely to persist. CONCLUSIONS: In Germany, despite the documented occurrence of neck sprain symptoms in individuals following motor vehicle collisions, there is a very low rate of expectation of any sequelae from this injury. The current or previous aspects of society that underlie this remain uncertain. This lack of expectation of chronicity in Germany may, in part, determine the low prevalence of the chronic whiplash syndrome there. Further studies of symptom expectation as an etiologic factor in the chronic whiplash syndrome are needed.

Adult↗
PubMed2002

Temporomandibular joint arthroscopic findings in patients with cervical flexion-extension injury (whiplash): a preliminary study of 30 patients.

PURPOSE: To investigate arthroscopic findings for the temporomandibular joint (TMJ) in 30 patients with refractory TMJ symptoms who had suffered cervical flexion-extension injury (whiplash). METHODS: The clinical data and operative reports of all patients with a diagnosis of TMJ whiplash injury who underwent TMJ arthroscopic procedures from 1997 to 2002 were reviewed. All patients underwent preoperative clinical, panoramic, arthrographic, magnetic resonance imaging evaluation or computed tomography (or some combination). The same surgical team performed all diagnostic and therapeutic arthroscopic procedures in patients for whom conservative therapy had failed. Before the arthroscopic surgery, all of the patients had received at least 3 to 6 months of nonsurgical therapy consisting of anti-inflammatory medications, muscle relaxants, splint therapy, physiotherapy (specifically transcutaneous electrical nerve stimulation, moist heat, cold laser, and ultrasonography) and a soft diet. RESULTS: A spectrum of arthroscopic findings, ranging from chondromalacia (softening of the articular fibrocartilage) to moderate or severe synovitis and adhesions, was observed, as well as combinations of these abnormalities. CONCLUSION: The primary intracapsular pathologic changes observed during TMJ arthroscopic examination of 30 patients who suffered cervical whiplash injury appear to be nonspecific, varying along a wide spectrum of findings.

Adult↗
PubMed2004

Modulation of central hypersensitivity by nociceptive input in chronic pain after whiplash injury.

OBJECTIVE: Chronic pain after whiplash injury is associated with hypersensitivity of the central nervous system to peripheral stimulation. It is unclear whether central hypersensitivity is modulated by peripheral nociceptive input. We hypothesized that changes in nociceptive input would correlate with changes in magnitude of central hypersensitivity. DESIGN: Fifteen patients with chronic pain after whiplash injury were investigated. Changes in nociceptive input were induced by infiltration of painful and tender muscles with bupivacaine (0.25%). Such infiltrations produce either pain reduction or pain enhancement, the latter effect probably resulting from transient injection-induced trauma. We used this individual variability in correlation analyses. Changes in intensity of neck pain, as assessed by a visual analog scale (VAS), after infiltration were assumed to reflect changes in nociceptive input. Changes in pressure pain thresholds recorded at healthy tissues (nonpainful point of the neck and the second toe) were used to measure changes in central hypersensitivity. The correlations between the change in VAS score and changes in pressure pain thresholds 15 minutes after infiltration were analyzed. RESULTS: Statistically significant negative correlations were found between change in VAS score and changes in threshold measurements performed at the neck, but not at the toe. CONCLUSIONS: Different mechanisms underlie hyperalgesia localized at areas surrounding the site of pain and hyperalgesia generalized to distant body areas. Central hypersensitivity as a determinant of neck pain is probably a dynamic condition that is influenced by the presence and activity of a nociceptive focus.

Adult↗
PubMed1985

Vertigo due to whiplash injury: a neurotological approach.

A series of examinations were carried out to elucidate the characteristics of vertigo due to whiplash injury. In patients with whiplash injury, there are over-excitation of the cervical and/or the lumbar proprioceptors on one hand, and dysfunction of the central nervous system, such as the hypothalamus, the brain stem and the cerebellum, on the other hand. These two etiological factors induce disequilibrium by a trigger-and-target relationship in which the above proprioceptors act as a trigger and the central nervous system acts as a target. This postulate is applicable to the explanation of aural vertigo following whiplash injury. Autonomic reflexes in patients with whiplash injury can be explained not only as due to over-excitation of the cervical sympathetic nerves, but also to that of the cervical and lumbar proprioceptors. In other words, these reflexes are considered as being the proprio-autonomic reflexes. These reflexes are more evident in patients with cervical pain. Cerebellar symptoms can be manifested by over-excitation of the cervical and lumbar proprioceptors. These symptoms are more evident in patients with lumbar pain. The above differences in the autonomic reflexes and cerebellar symptoms of patients with cervical and/or lumbar pains can be explained on the basis of known fiber connections in the central nervous system. Hypertonicity of the cervical and lumbar erector muscles in patients with whiplash injury can be explained not only as due to over-excitation of gamma fibers, but also to that of sympathetic nerves in these muscles. This hypertonicity affects the central nervous system, causing disequilibrium following whiplash injury.

Adult↗
PubMed2003

A comparison of biomechanical mechanisms of whiplash injury from rear impacts.

Several hypotheses have been proposed to explain the mechanism of injury in whiplash including, pressure on nerve root ganglia, stretching of facet capsules, or damage to facet articular cartilage. These injury mechanisms have not been directly compared in the same study. A comparison could provide insight into the most likely mechanism of whiplash injury. Twenty eight volunteers underwent rear impacts with head and chest acceleration data collected. The same apparatus was used to test 11 cervico-thoracic human cadaveric spines with an instrumented headform attached. Head acceleration, individual vertebral kinematics from high speed video, local nerve root pressure, and facet joint contact pressures were collected during impacts. Each specimen was tested first at an impact acceleration similar to that of volunteers, who reported minimal or no symptoms after the test, then at double the acceleration. Head X (forward) and Z (upward) accelerations of cadaveric specimens were very similar in time sequence and magnitude to those of unprepared volunteers. Pressure around the lower cervical nerve roots ranged from 2.7kPa to 10kPa, and occurred generally after chest but before peak head acceleration. Facets at C4-5 and C5-6 had the highest probability (64% and 71% respectively) of pinching. Neither pressure rise nor pinching changed significantly with increased acceleration. Vertebral intersegmental extension rotations (4 ( o ) -9.5 ( o ) ) and posterior translations (3.7-8.9 mm) peaked near maximum head excursion into the head restraint, at the time of peak head acceleration. Vertebral shear translations showed the largest (and only significant) increases with increased impact acceleration. This data implies that facet shearing was most sensitive to the increased acceleration in this experiment and may be a primary mechanism of cervical spine injury in rear impacts.

Acceleration↗
PubMed1989

[Biomechanics of whiplash injuries of the cervical spine].

1. The whiplash injury of the cervical spine is a typical, but not very often observed injury of occupants of automotive vehicles involved in moderate collisions. 2. There still exist great uncertainties in the elaboration of expertises concerning the minor whiplash injury, so that the great part of the disturbances cannot be objectivated under a clinical point of view. And on the other hand, serious whiplash injuries often are superposed or veiled by secondary injuries. 3. Thus, the aim of the present paper was to point out injury mechanisms, to give a rough scaling of the whiplash severity under biomechanical aspects and finally to set these injury mechanisms in correlation to the following criteria of accident: a) vehicle velocity change (energy equivalent speed--EES); b) deformation of vehicles on the impact-exposed structure; c) loading of occupants by acceleration or deceleration. 4. The tolerance limit of the cervical spine generally decreases to a lower limit, if the cervical spine is changed in a pathological way, e.g. by preexisting diseases. 5. It is evident and important, that the difficult work of giving an expert's opinion on this field must be performed in an interdisciplinary collaboration of engineers for collision-analysis and physicians experienced in accident-traumatology.

Accidents, Traffic↗
PubMed1993

Whiplash injury and peer copying.

Whiplash injury has increased during the past 40 years. Peer copying has occurred both among patients and practitioners. The importance of understanding the common course of the injury is stressed and simpler and less costly management suggested. Also noted is the importance of digesting whole articles. Reliance upon abstracted material alone or parts of articles may prove to be misleading and may lead to perpetuating questionable information.

Abstracting and Indexing↗
PubMed2005

The effect of collision pulse properties on seven proposed whiplash injury criteria.

Recent epidemiological and biomechanical studies have suggested that whiplash injury is related to a vehicle's average acceleration rather than its speed change during a rear-end collision. To further explore this phenomenon, the effect of various kinematic properties of the collision pulse on seven proposed whiplash injury criteria was quantified. A BioRID II rear-impact dummy was seated on a programmable sled and exposed six times to each of 15 different collision pulses. Five properties of the collision pulse were varied: peak acceleration (1.3-4.4 g), speed change (3-11 km/h), duration (52-180 ms), displacement (2-26 cm) and shape (square, sine and triangular). Linear and angular accelerations and displacements of the head, and linear accelerations of the T1 and pelvis were measured in the sagittal-plane. Upper neck loads in the sagittal-plane were also measured. Variations within the proposed injury criteria between the different pulses were compared using analyses of variance. Six criteria--peak upper neck shear force, peak upper neck moment, peak retraction, the neck injury criterion (NIC) and two normalized neck injury criteria (Nij and Nkm)--exhibited graded responses that were most sensitive to the average acceleration of the collision pulse. Peak extension angle between the head and T1 decreased with both increasing speed change and peak acceleration, and was, therefore, deemed unsuitable as a whiplash injury criterion for the BioRID dummy. Of the seven criteria, Nij and Nkm were best able to distinguish between the 15 pulses. If the six graded injury criteria are related to the risk of whiplash injury, then the results of this study indicate that the risk of whiplash injury can be reduced by bumper and seat designs that prolong the collision pulse and thereby reduce the average vehicle and occupant accelerations for a given speed change.

Acceleration↗
PubMed1996

Prolonged functional impairments after whiplash injury.

Thirty patients with whiplash injuries were examined 1 to 55 months after the accidents. Pain had appeared on the day of the accident in 24 (80%) of the patients and with different delays in the remainder. The mean pain intensity was 43 mm (SD 26) on a visual analogue scale (VAS). All patients had pain in the neck, 17-33% had headache and 6-17% had pain in various regions of the arms. Thirteen patients (43%) suffered from constant pain, while 17 (57%) had pain-free periods. Muscle tenderness was higher at all tested sites compared with controls. The tolerance level to pressure pain in the index finger as well as grip strength and neck mobility was reduced compared with controls. The whiplash patients showed poorer mental well-being compared with a reference group representing the general population and compared with a group of tension-type headache patients.

Adult↗
PubMed2003

[Relevant factors in medico-legal prognosis of whiplash injury].

BACKGROUND AND OBJECTIVE: Whiplash injury (WI) is commonly evaluated in medico-legal practice. With the aim of knowing the determining factors of WI's medico-legal prognosis, a prospective and observational study was carried out. PATIENTS AND METHOD: One hundred and twenty consecutive patients who were clinically observed and evaluated in the Medico-Legal Clinic of Barcelona were studied. Socio-demographic, clinical, radiographic and evolutive factors were analyzed. RESULTS: We included 120 patients with a mean age of 35.6 (14) years (range, 4-74), with a homogeneous male/female distribution. An earlier cervical pathology was detected in 10% of patients; none of them had previous psychiatric pathology. 95% corresponded to road-traffic accident cases and there were 5 aggression cases. Over 50% of cases involved a rear-end collision. All patients had neck pain, almost 25% had headache and 13% had paresthesia. According to the Whiplash Association Disorders clinical classification, distribution in grades (G) was: G I 51%, G II 32% and G III 17%. Patients reported recovery within a mean time of 71.6 (46) days (range, 4-244), with 51,2 (45) no working days (range, 0-180 days). The 52% of the patients rest with complains. According to the recovery time, the following medico-legal prognostic factors were identified: age (p < 0.001), being female (p = 0.001), clinical grade (p < 0.001) and abnormal cervical MRI exploration (p < 0.001). Patients with previous cervical pathology reported more complaints (p = 0.001). CONCLUSIONS: In our study, WI affected young people of both sex mainly during rear-end collision. Worst medico-legal prognostic factors were age, being females, severity of initial clinical symptoms, previous cervical pathology and abnormal cervical MRI/CT.

Adolescent↗