Can measuring passive neck muscle stiffness in whiplash injury patients help detect false whiplash claims?
Elastography
Neck pain
Shear wave
Trapezius
Ultrasound
Journal
Wiener klinische Wochenschrift
ISSN: 1613-7671
Titre abrégé: Wien Klin Wochenschr
Pays: Austria
ID NLM: 21620870R
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
04
07
2019
accepted:
03
03
2020
pubmed:
20
3
2020
medline:
20
11
2020
entrez:
20
3
2020
Statut:
ppublish
Résumé
Whiplash injury of the cervical spine is the most common injury after a car accident and in 25% of patients it progresses into chronic neck pain. To investigate the difference in neck muscle stiffness using shear wave ultrasound elastography between subjects who suffered an uncomplicated whiplash injury and a control group. Possible recognition of patients who insist on physical therapy in order to support their false whiplash injury claims. This study included 75 whiplash injury patients and 75 control subjects. Trapezius, splenius capitis and sternocleidomastoid muscles were examined by ultrasound shear wave elastography. Increased muscle stiffness was noticed in trapezius muscle bilaterally in the whiplash group when compared to the control group (p < 0.001; right 57.47 ± 13.82 kPa vs. 87.84 ± 23.23 kPa; left 54.4 ± 12.68 kPa vs. 87.21 ± 26.47 kPa). Muscle stiffness in splenius capitis and sternocleidomastoid muscles was not suitable for analysis because of asymmetrical data distribution. Patients with less than 76 kPa of muscle stiffness in trapezius muscle are unlikely to belong in whiplash injury group (sensitivity 90% for right and 97% for left trapezius muscle, specificity 72% and 73%, respectively). Patients measuring below 76 kPa of muscle stiffness in the trapezius muscle might have no whiplash injury. Further follow-up of the patients measuring higher than cut-off value might be beneficial for detecting patients with prolonged neck muscle spasm that can lead to chronic cervical pain syndrome.
Sections du résumé
BACKGROUND
BACKGROUND
Whiplash injury of the cervical spine is the most common injury after a car accident and in 25% of patients it progresses into chronic neck pain.
AIM OF THE STUDY
OBJECTIVE
To investigate the difference in neck muscle stiffness using shear wave ultrasound elastography between subjects who suffered an uncomplicated whiplash injury and a control group. Possible recognition of patients who insist on physical therapy in order to support their false whiplash injury claims.
METHODS
METHODS
This study included 75 whiplash injury patients and 75 control subjects. Trapezius, splenius capitis and sternocleidomastoid muscles were examined by ultrasound shear wave elastography.
RESULTS
RESULTS
Increased muscle stiffness was noticed in trapezius muscle bilaterally in the whiplash group when compared to the control group (p < 0.001; right 57.47 ± 13.82 kPa vs. 87.84 ± 23.23 kPa; left 54.4 ± 12.68 kPa vs. 87.21 ± 26.47 kPa). Muscle stiffness in splenius capitis and sternocleidomastoid muscles was not suitable for analysis because of asymmetrical data distribution. Patients with less than 76 kPa of muscle stiffness in trapezius muscle are unlikely to belong in whiplash injury group (sensitivity 90% for right and 97% for left trapezius muscle, specificity 72% and 73%, respectively).
CONCLUSION
CONCLUSIONS
Patients measuring below 76 kPa of muscle stiffness in the trapezius muscle might have no whiplash injury. Further follow-up of the patients measuring higher than cut-off value might be beneficial for detecting patients with prolonged neck muscle spasm that can lead to chronic cervical pain syndrome.
Identifiants
pubmed: 32189119
doi: 10.1007/s00508-020-01631-y
pii: 10.1007/s00508-020-01631-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
506-514Références
Connelly LB, Supangan R. The economic costs of road traffic crashes: Australia, states and territories. Accid Anal Prev. 2006;38(6):1087–93.
pubmed: 16797462
Ritchie C, Sterling M. Recovery pathways and prognosis after whiplash injury. J Orthop Sports Phys Ther. 2016;46(10):851–61.
pubmed: 27594661
Sterling M. Whiplash-associated disorder: musculoskeletal pain and related clinical findings. J Man Manip Ther. 2011;19(4):194–200.
pubmed: 23115472
pmcid: 3201650
Koren L, Peled E, Trogan R, Norman D, Berkovich Y, Israelit S. Gender, age and ethnicity influence on pain levels and analgesic use in the acute whiplash injury. Eur J Trauma Emerg Surg. 2015;41(3):287–91.
pubmed: 26037975
Carriere JS, Thibault P, Milioto M, Sullivan MJL. Expectancies mediate the relations among pain catastrophizing, fear of movement, and return to work outcomes after whiplash injury. J Pain. 2015;16(12):1280–7.
pubmed: 26409116
Carstensen TB. The influence of psychosocial factors on recovery following acute whiplash trauma. Dan Med J. 2012;59(12):B4560.
pubmed: 23290295
Paluch L, Nawrocka-Laskus E, Wieczorek J, Mruk B, Frel M, Walecki J. Use of ultrasound elastography in the assessment of the musculoskeletal system. Pol J Radiol. 2016;81:240–6.
pubmed: 27279926
pmcid: 4880311
Brandenburg JE, Eby SF, Song P, Zhao H, Brault JS, Chen S, et al. Ultrasound elastography: the new frontier in direct measurement of muscle stiffness. Arch Phys Med Rehabil. 2014;95(11):2207–19.
pubmed: 25064780
pmcid: 4254343
Brandenburg JE, Eby SF, Song P, Zhao H, Landry BW, Kingsley-Berg S, et al. Feasibility and reliability of quantifying passive muscle stiffness in young children by using shear wave ultrasound elastography. J Ultrasound Med. 2015;34(4):663–70.
pubmed: 25792582
pmcid: 4369795
Leong HT, Ng GY, Leung VY, Fu SN. Quantitative estimation of muscle shear elastic modulus of the upper trapezius with supersonic shear imaging during arm positioning. Plos One. 2013;8(6):e67199.
pubmed: 23825641
pmcid: 3692441
Xie Y, Thomas L, Hug F, Johnston V, Coombes BK. Quantifying cervical and axioscapular muscle stiffness using shear wave elastography. J Electromyogr Kinesiol. 2019;48:94–102.
pubmed: 31272075
Spitzer WO, Skovron ML, Salmi LR, Cassidy JD, Duranceau J, Suissa S, et al. Scientific monograph of the Quebec task force on whiplash-associated disorders: redefining “whiplash” and its management. Spine. 1995;20(8 Suppl):1S–73S.
pubmed: 7604354
Dhyani M, Grajo JR, Bhan AK, Corey K, Chung R, Samir AE. Validation of shear wave elastography cutoff values on the supersonic Aixplorer for practical clinical use in liver fibrosis staging. Ultrasound Med Biol. 2017;43(6):1125–33.
pubmed: 28341490
pmcid: 5610928
Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420–8.
pubmed: 18839484
McClune T, Burton AK, Waddell G. Whiplash associated disorders: a review of the literature to guide patient information and advice. Emerg Med J. 2002;19(6):499–506.
pubmed: 12421771
pmcid: 1756324
Walton DM, Macdermid JC, Giorgianni AA, Mascarenhas JC, West SC, Zammit CA. Risk factors for persistent problems following acute whiplash injury: update of a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2013;43(2):31–43.
pubmed: 23322093
Curatolo M. Pharmacological and interventional management of pain after whiplash injury. J Orthop Sports Phys Ther. 2016;46(10):845–50.
pubmed: 27594660
Nikles J, Yelland M, Bayram C, Miller G, Sterling M. Management of whiplash associated disorders in Australian general practice. BMC Musculoskelet Disord. 2017;18(1):551.
pubmed: 29284446
pmcid: 5747169
Helliwell PS, Evans PF, Wright V. The straight cervical spine: does it indicate muscle spasm? J Bone Joint Surg Br. 1994;76(1):103–6.
pubmed: 8300650
Beltsios M, Savvidou O, Mitsiokapa EA, Mavrogenis AF, Kaspiris A, Efstathopoulos N, et al. Sagittal alignment of the cervical spine after neck injury. Eur J Orthop Surg Traumatol. 2013;23(Suppl 1):47–51.
Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. Eur Spine J. 2007;16(5):669–78.
pubmed: 17115202
Matsui T, Iwata M, Endo Y, Shitara N, Hojo S, Fukuoka H, et al. Effect of intensive inpatient physical therapy on whole-body indefinite symptoms in patients with whiplash-associated disorders. BMC Musculoskelet Disord. 2019;20(1):251.
pubmed: 31164107
pmcid: 6549292
Michaleff ZA, Maher CG, Lin CW, Rebbeck T, Jull G, Latimer J, et al. Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial. Lancet. 2014;384(9938):133–41.
pubmed: 24703832
Sterling M. Physiotherapy management of whiplash-associated disorders (WAD). J Physiother. 2014;60(1):5–12.
pubmed: 24856935