Biopsychosocial sequelae and recovery trajectories from whiplash injury following a motor vehicle collision.
Distress
MRI
Muscle
Pain
Trauma
Whiplash
Journal
The spine journal : official journal of the North American Spine Society
ISSN: 1878-1632
Titre abrégé: Spine J
Pays: United States
ID NLM: 101130732
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
16
11
2022
revised:
17
02
2023
accepted:
10
03
2023
pmc-release:
01
07
2024
medline:
26
6
2023
pubmed:
24
3
2023
entrez:
23
3
2023
Statut:
ppublish
Résumé
Five out of 10 injured in a motor vehicle collision (MVC) will develop persistent pain and disability. It is unclear if prolonged symptoms are related to peritraumatic pain/disability, psychological distress, muscle fat, lower extremity weakness. To test if widespread muscle fat infiltration (MFI) was (1) unique to those with poor recovery, (2) present in the peritraumatic stage, (3) related to known risk factors. A cohort study, single-center academic hospital. A total of 97 men and women (age 18-65) presenting to an urban academic emergency medicine department following MVC, but not requiring inpatient hospitalization. Neck disability at 12-months. Participants underwent magnetic resonance imaging (MRI) to quantify neck and lower extremity MFI, completed questionnaires on pain/disability and psychological distress (< 1-week, 2-weeks, 3-, and 12-months) and underwent maximum volitional torque testing of their lower extremities (2-weeks, 3-, and 12-months). Percentage score on the Neck Disability Index at 12-months was used for a model of (1) Recovered (0%-8%), (2) Mild (10%-28%), and (3) Moderate/Severe (≥ 30%). This model was adjusted for BMI and age. Significant differences for neck MFI were revealed, with the Recovered group having significantly lower neck MFI than the Mild and Moderate/Severe groups at all time points. The Mild group had significantly more leg MFI at 12-months (p=.02) than the Recovered group. There were no other significant differences at any other time point. Lower extremity torques revealed no group differences. The Traumatic Injury Distress Scale (TIDS) and MFI of the neck at 1-week postinjury significantly predicted NDI score at 12-months. Higher neck MFI and distress may represent a risk factor though it is unclear whether this is a pre-existing phenotype or result of the trauma. ClinicalTrials.gov Identifier: NCT02157038.
Sections du résumé
BACKGROUND CONTEXT
BACKGROUND
Five out of 10 injured in a motor vehicle collision (MVC) will develop persistent pain and disability. It is unclear if prolonged symptoms are related to peritraumatic pain/disability, psychological distress, muscle fat, lower extremity weakness.
PURPOSE
OBJECTIVE
To test if widespread muscle fat infiltration (MFI) was (1) unique to those with poor recovery, (2) present in the peritraumatic stage, (3) related to known risk factors.
STUDY DESIGN/SETTING
METHODS
A cohort study, single-center academic hospital.
PATIENT SAMPLES
METHODS
A total of 97 men and women (age 18-65) presenting to an urban academic emergency medicine department following MVC, but not requiring inpatient hospitalization.
PRIMARY OUTCOME MEASURE
METHODS
Neck disability at 12-months.
METHODS
METHODS
Participants underwent magnetic resonance imaging (MRI) to quantify neck and lower extremity MFI, completed questionnaires on pain/disability and psychological distress (< 1-week, 2-weeks, 3-, and 12-months) and underwent maximum volitional torque testing of their lower extremities (2-weeks, 3-, and 12-months). Percentage score on the Neck Disability Index at 12-months was used for a model of (1) Recovered (0%-8%), (2) Mild (10%-28%), and (3) Moderate/Severe (≥ 30%). This model was adjusted for BMI and age.
RESULTS
RESULTS
Significant differences for neck MFI were revealed, with the Recovered group having significantly lower neck MFI than the Mild and Moderate/Severe groups at all time points. The Mild group had significantly more leg MFI at 12-months (p=.02) than the Recovered group. There were no other significant differences at any other time point. Lower extremity torques revealed no group differences. The Traumatic Injury Distress Scale (TIDS) and MFI of the neck at 1-week postinjury significantly predicted NDI score at 12-months.
CONCLUSIONS
CONCLUSIONS
Higher neck MFI and distress may represent a risk factor though it is unclear whether this is a pre-existing phenotype or result of the trauma.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov Identifier: NCT02157038.
Identifiants
pubmed: 36958668
pii: S1529-9430(23)00108-0
doi: 10.1016/j.spinee.2023.03.005
pmc: PMC10330498
mid: NIHMS1904378
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT02157038']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1028-1036Subventions
Organisme : NICHD NIH HHS
ID : K01 HD106928
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD079076
Pays : United States
Informations de copyright
Copyright © 2023 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest One or more of the authors declare financial or professional relationships on ICMJE-TSJ disclosure forms.
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