SENSORIMOTOR INTEGRATION,SENSORIMOTOR CONTROL, AND COST OF DUAL TASKING: ARE THERE DIFFERENCES BETWEEN CHRONIC WHIPLASH-ASSOCIATED DISORDERS AND CHRONIC IDIOPATHIC NECK PAIN?

I. Moustafa¹, A. Diab², T. Shousha¹, V. Raigangar¹, D. Harrison³

¹University of Sharjah, Physiotherapy, Sharjah, United Arab Emirates, ²Cairo University, Basic Sciences, Giza, Egypt, ³CBP Nonprofit (a Spine Research Foundation), Chiropractic, Eagle, United States

Background: It remains a matter of debate whether whiplash-associated disorders(WAD) represent a different diagnostic entity from idiopathic neck pain. In particular, only a limited number of studies have directly compared the pre­sentation and outcome in patients with WAD and those with nonspecific neck pain gathered from the same clinical setting.

Purpose: The current investigation aimed to compare the sensorimotor integration,sensorimotor control, and cost of cognitive motor dual task during walking, in persons with chronic WAD as compared to matched chronic idiopathic neck pain and normal healthy controls.

Methods: A cross-sectional, case control design comparing 30 participants in each of two study groups (chronic WAD and chronic idiopathic neck pain) to a matched control group was conducted. Measurements included:
1) the cranio-vertebral angle (CVA),
2) left and right rotation head repositioning accuracy (HRA),
3) frontal N30 amplitudes to assess sensorimotor integration,
4) dual cognitive gait cost (DCGC).

Results: A statistically significant difference for the CVA was found between groups: WAD 36.8° ± 3.4, chronic pain 44.5° ± 1.5, and controls 47.1° ± 4; p < 0.05. MANOVA revealed significant group differences for the N30 amplitude (p<0.05), where the WAD group had the greatest amplitude. Statistically significant differences among the three groups were found for HRA left and right where the WAD group had the greatest error, (p<0.05). Post hoc tests revealed that the WAD group had the highest dual-task cost during walking, (p<0.05). Significant linear correlations between the CVA and N30 amplitude, HRA, and DCGC were identified in all 3 groups, (p<0.05).

Conclusions: Compared to both a matched control group and chronic neck pain group, whiplash injured persons have greater forward head posture, greater error in sensorimotor control, and an altered ability to perform a motor task with a simultaneous cognitive task.

Implications: Because our investigation was not an interventional trial we cannot, with certainty, comment on how our findings translate directly into patient outcomes. However, since the CVA showed increased forward head posture (FHP) in the WAD group, we recommend that interventions designed to improve FHP should be implemented as part of a multi-modal treatment approach. These interventions should include proper evidence-based exercises and sustained loading into the reversed position such as extension traction devices. Furthermore, due to the increased cost of the cognitive task challenge in the WAD group, interventions designed to improve real-world cognitive and motor task activities and conditions.

Funding acknowledgements: This study is self-funded

Keywords:
Whiplash-associated disorders
Forward head posture
Chronic idiopathic neck pain

Topics:
Musculoskeletal: spine
Pain & pain management

Did this work require ethics approval? Yes

Institution: University of Sharjah

Committee: University of Sharjah Research Ethics Committee

Ethics number: REC-22-04-22-S