Headache production during physical examination in patients with and without headache attributed to a whiplash injury: A case-control study.
Intra-rater test-retest reliability
Neuromusculoskeletal disorders
Physical testing
Whiplash-associated disorders
Whiplash-associated headache
Journal
Musculoskeletal science & practice
ISSN: 2468-7812
Titre abrégé: Musculoskelet Sci Pract
Pays: Netherlands
ID NLM: 101692753
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
14
03
2023
revised:
16
05
2023
accepted:
20
05
2023
medline:
28
8
2023
pubmed:
5
6
2023
entrez:
4
6
2023
Statut:
ppublish
Résumé
Provocation of headache on physical examination of the neck may reflect a role of cervical structures in the presence of acute whiplash-associated headache (WAH). To determine differences in headache provocation during physical tests in people with and without WAH after a whiplash injury. Case-control study. Forty-seven people with acute whiplash-associated disorders participated, 28 with WAH. Passive accessory intervertebral movement over the tubercle of C1, the spinous processes of C2-C3 and facet joints of C0-C4, the flexion-rotation test (FRT), manual palpation of cranio-cervical muscles and the upper limb neurodynamic test + cranio-cervical flexion were assessed bilaterally twice by a blinded examiner; headache provocation was determined. Cohen's kappa and Chi-squared were determined to evaluate the intra-rater reliability of test results and differences between groups, respectively. A logistic regression model was also performed. Intra-rater reliability of headache provocation was good or excellent for most tests. Significant differences between groups were found with higher positive tests in WAH for the assessment of C2 (68%), the most painful side of C0-C1 (57%), C1-C2 (75%) and C2-C3 (53%), most (79%) and least (25%) restricted sides of the FRT, and manual palpation of the most painful side for the trapezius (53%), masseter (50%) and temporalis (46%) muscles. Provocation of headache during the assessment of C2 and C1-C2 on the most painful side demonstrated the highest association with WAH. Mechanical provocation of headache is more frequent in people with WAH than in those without headache soon after a whiplash injury.
Sections du résumé
BACKGROUND
BACKGROUND
Provocation of headache on physical examination of the neck may reflect a role of cervical structures in the presence of acute whiplash-associated headache (WAH).
OBJECTIVE
OBJECTIVE
To determine differences in headache provocation during physical tests in people with and without WAH after a whiplash injury.
DESIGN
METHODS
Case-control study.
METHODS
METHODS
Forty-seven people with acute whiplash-associated disorders participated, 28 with WAH. Passive accessory intervertebral movement over the tubercle of C1, the spinous processes of C2-C3 and facet joints of C0-C4, the flexion-rotation test (FRT), manual palpation of cranio-cervical muscles and the upper limb neurodynamic test + cranio-cervical flexion were assessed bilaterally twice by a blinded examiner; headache provocation was determined. Cohen's kappa and Chi-squared were determined to evaluate the intra-rater reliability of test results and differences between groups, respectively. A logistic regression model was also performed.
RESULTS
RESULTS
Intra-rater reliability of headache provocation was good or excellent for most tests. Significant differences between groups were found with higher positive tests in WAH for the assessment of C2 (68%), the most painful side of C0-C1 (57%), C1-C2 (75%) and C2-C3 (53%), most (79%) and least (25%) restricted sides of the FRT, and manual palpation of the most painful side for the trapezius (53%), masseter (50%) and temporalis (46%) muscles. Provocation of headache during the assessment of C2 and C1-C2 on the most painful side demonstrated the highest association with WAH.
CONCLUSION
CONCLUSIONS
Mechanical provocation of headache is more frequent in people with WAH than in those without headache soon after a whiplash injury.
Identifiants
pubmed: 37271677
pii: S2468-7812(23)00064-4
doi: 10.1016/j.msksp.2023.102779
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
102779Informations de copyright
Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest Authors declare no conflict of interest.