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Khosravi, F., Peolsson, A., Karimi, N. & Rahnama, L. (2019). Scapular Upward Rotator Morphologic Characteristics in Individuals With and Without Forward Head Posture: A Case-Control Study. Journal of ultrasound in medicine, 38(2), 337-345
Open this publication in new window or tab >>Scapular Upward Rotator Morphologic Characteristics in Individuals With and Without Forward Head Posture: A Case-Control Study
2019 (English)In: Journal of ultrasound in medicine, ISSN 0278-4297, E-ISSN 1550-9613, Vol. 38, no 2, p. 337-345Article in journal (Refereed) Published
Abstract [en]

Objectives There are several reports suggesting that forward head posture contributes to alterations in scapular kinematics and muscle activity, leading to the development of shoulder problems. Currently, it is unknown whether forward head posture alters the thickness of the scapular muscles. The aim of this study was to compare the thickness of the serratus anterior and upper and lower trapezius muscles at rest and during loaded isometric contractions in individuals with and without forward head posture. Methods Twenty individuals with forward head posture and 20 individuals with normal head posture participated in this case-control study. Three separate ultrasound images of the serratus anterior and upper and lower trapezius muscles were captured under 2 randomized conditions: at rest and during a loaded isometric contraction. Results The thickness of each muscle significantly increased from rest to the loaded isometric contraction (P?<?.001). The only difference between the groups was that the thickness of the serratus anterior muscle at rest in the normal-posture group was larger than that in the forward-posture group (P?=?.01). Conclusions Forward head posture appears to be related to atrophy of the serratus anterior muscle, which may contribute to the development of shoulder problems. Further research is required to identify more about the association of forward head posture with the imbalance of shoulder girdle muscles and the impact of head posture on upper quadrant pain.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
musculoskeletal, scapular muscles, serratus anterior, thickness, trapezius, ultrasound
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-154050 (URN)10.1002/jum.14693 (DOI)000456851600007 ()
Note

Funding agencies: University of Social Welfare and Rehabilitation Sciences

Available from: 2019-01-24 Created: 2019-01-24 Last updated: 2019-03-06
Landén Ludvigsson, M., Peterson, G. & Peolsson, A. (2019). The effect of three exercise approaches on health-related quality of life, and factors associated with its improvement in chronic whiplash-associated disorders: analysis of a randomized controlled trial.. Quality of Life Research, 28(2), 357-368
Open this publication in new window or tab >>The effect of three exercise approaches on health-related quality of life, and factors associated with its improvement in chronic whiplash-associated disorders: analysis of a randomized controlled trial.
2019 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 28, no 2, p. 357-368Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aim was to evaluate whether neck-specific exercise, with (NSEB) or without (NSE) a behavioural approach, improves health-related quality of life (HRQoL) compared to physical activity prescription (PPA) in chronic whiplash-associated disorders (WAD) grades 2 and 3. A secondary aim was to identify factors associated with HRQoL and HRQoL improvement following exercise interventions.

METHODS: This is a secondary analysis of a multicentre randomized clinical trial. Participants (n = 216) with chronic WAD grades 2 and 3 were randomized to 12 weeks of PPA or physiotherapist-led NSE or NSEB. The EQ-5D 3L/EQ-VAS and SF-36v2 physical (PCS) and mental (MCS) component summaries were collected together with several neck-related and psychosocial outcomes at baseline, after 3, 6 and 12 months, and were analysed with linear mixed models (all time points) and multivariate linear regressions (baseline, 6 months).

RESULTS: NSE/NSEB resulted in better outcomes than PPA (EQ-VAS and SF-36 PCS, both groups, p < 0.01) but not in a higher EQ-5D score. Improvement over time was seen in EQ-5D/EQ-VAS for the NSEB group (p < 0.01), and for NSE/NSEB as measured with the PCS (p < 0.01). Factors associated with baseline HRQoL and change to 6 months in HRQoL (R2 = 0.38-0.59) were both neck-related and psychosocial (e.g. depression, work ability).

CONCLUSION: Neck-specific exercise, particularly with a behavioural approach, may have a more positive impact on HRQoL than physical activity prescription in chronic WAD grades 2 and 3. HRQoL is however complex, and other factors also need to be considered. Factors associated with HRQL and improvements in HRQoL following exercise are multidimensional.

TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, No. NCT01528579.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Chronic, Exercise, Physiotherapy, Quality of life, Spine, Whiplash
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-154060 (URN)10.1007/s11136-018-2004-3 (DOI)000457880300006 ()30225786 (PubMedID)
Note

Funding agencies: Vetenskapsradet [521-2014-2982]; Swedish Government through the REHSAM Foundation [RS2010/009]; Swedish Research Council; County Council of Ostergotland [LIO-533041, LIO-439541, LIO-197631, IO-276151, LIO-354241]; Centre for Clinical Research Sormland at 

Available from: 2019-01-24 Created: 2019-01-24 Last updated: 2019-03-07
Lo, H. K., Johnston, V., Landén Ludvigsson, M., Peterson, G., Overmeer, T., David, M. & Peolsson, A. (2018). Factors associated with work ability following exercise interventions for people with chronic whiplash-associated disorders: Secondary analysis of a randomized controlled trial.. Journal of Rehabilitation Medicine, 50
Open this publication in new window or tab >>Factors associated with work ability following exercise interventions for people with chronic whiplash-associated disorders: Secondary analysis of a randomized controlled trial.
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2018 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate the efficacy of exercise interventions and factors associated with changes in work ability for people with chronic whiplash-associated disorders.

DESIGN: Secondary analysis of a single-blind, randomized multi-centre controlled trial.

SETTING: Interventions were conducted in Swedish primary care settings.

PATIENTS: A total of 165 individuals with chronic whiplash-associated disorders grade II-III.

METHODS: Participants were randomly allocated to neck-specific exercise, neck-specific exercise with a behavioural approach, or prescribed physical activity interventions. Work ability was evaluated with the Work Ability Index at baseline, 3, 6 and 12 months.

RESULTS: The neck-specific exercise with a behavioural approach intervention significantly improved work ability compared with the prescribed physical activity intervention (3 months, p = 0.03; 6 months, p = 0.01; 12 months, p = 0.01), and neck-specific exercise at 12 months (p = 0.01). Neck-specific exercise was better than the prescribed physical activity intervention at 6 months (p = 0.05). An increase in work ability from baseline to one year for the neck-specific exercise with a behavioural approach group (p < 0.01) was the only significant within-group difference. Higher self-rated physical demands at work, greater disability, greater depression and poorer financial situation were associated with poorer work ability (p < 0.01).

CONCLUSION: This study found that neck-specific exercise with a behavioural approach intervention was better at improving self-reported work ability than neck-specific exercise or prescribed physical activity. Improvement in work ability is associated with a variety of factors.

Place, publisher, year, edition, pages
FOUNDATION REHABILITATION INFORMATION, 2018
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-150587 (URN)10.2340/16501977-2374 (DOI)000447771700008 ()30132011 (PubMedID)
Note

Funding agencies: Swedish government through the Swedish Research Council; Swedish Social Insurance Agency through the REHSAM Foundation Stockholm, Sweden; regional Center for Clinical Research of Ostergotland, Linkoping, Sweden; regional Center for Clinical Research of So

Available from: 2018-08-28 Created: 2018-08-28 Last updated: 2018-11-09
Amiri Arimi, S., Mohseni Bandpei, M. A., Rezasoltani, A., Peolsson, A. & Mohammadi, M. (2018). Multifidus muscle size changes at different directions of head and neck movements in females with unilateral chronic non-specific neck pain and healthy subjects using ultrasonography. Journal of Bodywork & Movement Therapies, 22(3), 560-565
Open this publication in new window or tab >>Multifidus muscle size changes at different directions of head and neck movements in females with unilateral chronic non-specific neck pain and healthy subjects using ultrasonography
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2018 (English)In: Journal of Bodywork & Movement Therapies, ISSN 1360-8592, E-ISSN 1532-9283, Vol. 22, no 3, p. 560-565Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aim of the study was to compare the dimensions of cervical multifidus muscle (CMM) in different conditions.

METHODS: Twenty five women with neck pain and 25 healthy subjects participated in this study. The dimensions of the CMM were measured at rest, 50% and 100% maximum isometric voluntary contraction (MIVC) at six directions of neck movements, using ultrasonography.

RESULTS: The size of multifidus was smaller in patients than healthy individuals at rest state (P < 0.05). A significant smaller CMM dimension was found in the affected side compared with unaffected side in patients group (P < 0.05). The result of ANOVA for MLD showed a significant difference for contraction levels (P < 0.001) and neck movements (P < 0.001) in both groups. The MLD of the CMM was significantly different between CMM at rest and 50%, and 100% MIVC (P < 0.001). No significant differences were found between the groups at 50% and 100% MIVC (P > 0.05 in both instances). The most prominent CMM size change was observed during neck extension, flexion, ipsilateral lateral-flexion, and ipsilateral rotation, respectively (P < 0.05).

CONCLUSIONS: Results of the present study indicate that the size of CMM was decreased in patients with neck pain in rest state. The size of CMM changes in all directions of neck movements, although the most prominent was during neck extension. This points out CMM stabilization role's in different directions of neck movements.

Place, publisher, year, edition, pages
Churchill Livingstone, 2018
Keywords
Cervical muscles, Multifidus, Neck pain, Size, Ultrasonography
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-154059 (URN)10.1016/j.jbmt.2017.09.011 (DOI)30100277 (PubMedID)
Available from: 2019-01-24 Created: 2019-01-24 Last updated: 2019-01-24
Peterson, G., Nilsson, D., Trygg, J. & Peolsson, A. (2018). Neck-specific exercise improves impaired interactions between ventral neck muscles in chronic whiplash: A randomized controlled ultrasound study. Scientific Reports, 8, Article ID 9649.
Open this publication in new window or tab >>Neck-specific exercise improves impaired interactions between ventral neck muscles in chronic whiplash: A randomized controlled ultrasound study
2018 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 8, article id 9649Article in journal (Refereed) Published
Abstract [en]

Chronic pain and disability is common in whiplash-associated disorders (WAD), leading to personal suffering, sick leave, and social cost. The cervical spine is heavily dependent on muscular support and whiplash injury can cause damage to the neck muscles, but diagnostic tools to measure neck muscle impairment and evaluate exercise interventions are lacking. Therefore, the present study investigated ventral neck muscle interactions in 26 individuals with chronic WAD randomized to neck-specific exercise (NSE) or remaining on a waiting list (WL) in 3 months. We performed real-time, non-invasive ultrasound measurements with speckle tracking analysis and calculated the deformation area and deformation rate in three ventral neck muscles. Multivariate statistics were used to analyse interactions between the muscles. After 3 months of NSE, significant improvements were observed in neck muscle interactions and pain intensity in the NSE group compared to the WL group. Thus, this study demonstrates that non-invasive ultrasound can be a diagnostic tool for muscle impairment and used to evaluate exercise interventions in WAD and stands to make a breakthrough for better management in chronic WAD.

Place, publisher, year, edition, pages
NATURE PUBLISHING GROUP, 2018
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-149713 (URN)10.1038/s41598-018-27685-7 (DOI)000436078500012 ()29941911 (PubMedID)
Note

Funding Agencies|Swedish government; Swedish Social Insurance Agency through the REHSAM foundation; Swedish Research Council; Centre for Clinical Research Sormland at Uppsala University Sweden; Uppsala-Orebro Regional Research Council Sweden

Available from: 2018-07-24 Created: 2018-07-24 Last updated: 2018-08-14
Landén Ludvigsson, M., Peterson, G. & Peolsson, A. (2018). Neck-specific exercise may reduce radiating pain and signs of neurological deficits in chronic whiplash - Analyses of a randomized clinical trial. Scientific Reports, 8(1), Article ID 12409.
Open this publication in new window or tab >>Neck-specific exercise may reduce radiating pain and signs of neurological deficits in chronic whiplash - Analyses of a randomized clinical trial
2018 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 8, no 1, article id 12409Article in journal (Refereed) Published
Abstract [en]

Up to 90% of people with neurological deficits following a whiplash injury do not recover and cervical muscle dysfunction is common. The aim of this multicentre, randomized controlled trial was to examine whether two versions of neck-specific exercise or prescription of physical activity (PPA) can improve radiating arm pain and clinical signs that can be associated with neurological deficits in people with chronic whiplash associated disorders (WAD). Participants with chronic WAD, arm symptoms and signs associated with neurological deficits (n = 171) were randomized to: 12 weeks of neck-specific exercise without (NSE) or with a behavioural approach (NSEB), or PPA. Pain/bothersomeness frequency, six measures of arm pain/paraesthesia (VAS scales), and four clinical neurological tests were evaluated after 3 months. The NSE group reported the lowest frequency and lowest levels of arm pain, the highest proportion of participants with at least 50% pain reduction and the highest proportion of normal arm muscle force. The NSEB group reported increased normal tendon reflexes. No improvements were recorded for the PPA group. Neck-specific exercise may improve arm pain and decrease signs of neurological deficits, but the addition of a behavioural approach does not seem to be of additional benefit. © 2018, The Author(s).

Place, publisher, year, edition, pages
Nature Publishing Group, 2018
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-150588 (URN)10.1038/s41598-018-30556-w (DOI)000441876700112 ()30120313 (PubMedID)2-s2.0-85051714527 (Scopus ID)
Note

Funding agencies: Swedish government through the REHSAM Foundation [RS2010/009]; Swedish Research Council [521-2014-2982]; regional Center for Clinical Research; County Council of Ostergotland [LIO-533041, LIO-439541, LIO-197631, LIO-276151, LIO-354241]; Centre for Clinica

Available from: 2018-08-28 Created: 2018-08-28 Last updated: 2018-09-21
Wibault, J., Öberg, B., Dedring, Å., Löfgren, H., Zsigmond, P. & Peolsson, A. (2018). Structured postoperative physiotherapy in patients with cervical radiculopathy: 6-month outcomes of a randomized clinical trial. Journal of Neurosurgery: Spine, 28(1), 1-9
Open this publication in new window or tab >>Structured postoperative physiotherapy in patients with cervical radiculopathy: 6-month outcomes of a randomized clinical trial
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2018 (English)In: Journal of Neurosurgery: Spine, ISSN 1547-5654, Vol. 28, no 1, p. 1-9Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate the additional benefit of structured postoperative physiotherapy combining neck-specific exercises with a behavioral approach to standard postoperative approach in patients with cervical radiculopathy (CR) at 6 months after surgery.

Design: A prospective multi-center randomized clinical trial.

Subjects: Patients with CR (n=202, mean age 50.0, SD 8.4) who were scheduled for surgery.

Methods: Patients were randomized pre-operatively to structured postoperative physiotherapy (n=101) or standard approach (n=101) which in accordance with Swedish usual care may have included pragmatic physiotherapy after surgery when needed. Outcome measures at baseline and at 3 and 6 months follow-up included the Neck Disability Index (NDI), pain intensity in the neck and arm measured with a visual analogue scale (VAS) and global outcome of treatment. Between-group differences were investigated using complete case and per-protocol approaches.

Results: No between-group difference was found in NDI, VAS, or global outcome at 6 months after surgery (p> 0.18). The NDI and VAS neck and arm pain were improved in both groups from before surgery to 6 months after surgery (p< 0.001). Sixty-one percent of the patients who received SA reported additional use of postoperative physiotherapy. Global outcome improved during the postoperative period in patients who received structured postoperative physiotherapy only (p< 0.01).

Conclusions: No additional benefit of structured postoperative physiotherapy compared to standard postoperative approach was found at 6 months of follow-up based on patientreported measures of pain, neck disability and global outcome. However, many patients with CR perceived a need for additional treatments after surgery; and the results may suggest a benefit from combining surgery with structured postoperative physiotherapy in patients with CR. Moreover, the results confirm that neck-specific exercises are tolerated by patients with CR after surgery.

Place, publisher, year, edition, pages
American Association of Neurological Surgeons, 2018
Keywords
Cervical radiculopathy; Postoperative physiotherapy; Neck Disability Index; Global outcome
National Category
Neurology Physiotherapy
Identifiers
urn:nbn:se:liu:diva-122692 (URN)10.3171/2017.5.SPINE16736 (DOI)000418927300001 ()29087809 (PubMedID)
Available from: 2015-11-16 Created: 2015-11-16 Last updated: 2019-05-02Bibliographically approved
Landén Ludvigsson, M., Peolsson, A., Peterson, G., Dedering, Å., Johansson, G. & Bernfort, L. (2017). Cost-effectiveness of neck-specific exercise with or without a behavioral approach versus physical activity prescription in the treatment of chronic whiplash-associated disorders Analyses of a randomized clinical trial. Medicine (Baltimore, Md.), 96(25), Article ID e7274.
Open this publication in new window or tab >>Cost-effectiveness of neck-specific exercise with or without a behavioral approach versus physical activity prescription in the treatment of chronic whiplash-associated disorders Analyses of a randomized clinical trial
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2017 (English)In: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 96, no 25, article id e7274Article in journal (Refereed) Published
Abstract [en]

Background: Fifty percent of people injured by whiplash still report neck pain after 1 year and costs associated with whiplash associated disorders (WAD) are mostly attributed to health service and sick-leave costs in chronic conditions. With increasing health care expenditures the economic impact of interventions needs to be considered. Objective: To analyze the cost-effectiveness of physiotherapist-led neck-specific exercise without (NSE) or with a behavioral approach (NSEB), or prescription of physical activity (PPA) in chronic WAD, grade 2 to 3. Methods: This is a secondary cost-effectiveness analysis of a multicenter randomized clinical trial of 216 participants with chronic WAD grade 2 to 3. The interventions were physiotherapist-led neck-specific exercise without or with a behavioral approach, or prescription of physical activity for 12 weeks. Incremental cost-effectiveness ratios (ICERs) were determined after 1 year and bootstrapped cost-effectiveness planes and sensitivity analyses of physiotherapy visits were performed. Health care and production loss costs were included and quality-adjusted life years (QALYs) were estimated, using the Euroqol-5D questionnaire. Comparisons with the Short Form-6D, and neck disability index (NDI) were also made. Results: The 1-year follow-up was completed by 170 participants (79%). Both physiotherapist-led groups improved in health related quality of life. The intervention cost alone, per quality-adjusted life year (QALY) gain in the NSE group was US$12,067. A trend for higher QALY gains were observed in the NSEB group but the costs were also higher. The ICERs varied depending on questionnaire used, but the addition of a behavioral approach to neck-specific exercise alone was not cost-effective from a societal perspective (ICER primary outcome $127,800 [95% confidence interval [CI], 37,816-711,302]). The sensitivity analyses confirmed the results. The prescription of physical activity did not result in any QALY gain and the societal costs were not lower. Conclusion: Neck-specific exercise was cost-effective from a societal perspective in the treatment of chronic WAD compared with the other exercise interventions. ICERS varied depending on health-related quality of life questionnaires used, but the addition of a behavioral approach was not cost-effective from a societal perspective. The prescription of physical activity did not result in any QALY gain and was thus not considered a relevant option.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS, 2017
Keywords
chronic; cost; cost-effectiveness; exercise; physiotherapy; rehabilitation; whiplash
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-139409 (URN)10.1097/MD.0000000000007274 (DOI)000404116900065 ()28640136 (PubMedID)
Note

Funding Agencies|Swedish Research Council; Swedish government through the REHSAM foundation; Medical Research Council of Southeast Sweden; County Council of Ostergotland; regional Center for Clinical Research; Centre for Clinical Research Sormland at Uppsala University; Uppsala-Orebro Regional Research Council, Sweden

Available from: 2017-08-07 Created: 2017-08-07 Last updated: 2019-01-24
Wibault, J., Öberg, B., Dedring, Å., Löfgren, H., Zsigmond, P., Persson, L., . . . Peolsson, A. (2017). Neck-related physical function, self-efficacy and coping strategies in patients with cervical radiculopathy: a randomized clinical trial of postoperative physiotherapy. Journal of Manipulative and Physiological Therapeutics, 40(5), 330-339
Open this publication in new window or tab >>Neck-related physical function, self-efficacy and coping strategies in patients with cervical radiculopathy: a randomized clinical trial of postoperative physiotherapy
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2017 (English)In: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 40, no 5, p. 330-339Article in journal (Refereed) Published
Abstract [en]

Objective: To compare postoperative rehabilitation with structured physiotherapy to standard approach in patients with cervical radiculopathy (CR) based on measures of neck-related physical function, self-efficacy and coping strategies at 6 months follow-up.

Design: A randomized clinical trial of postoperative physiotherapy in patients with CR.

Subjects: Patients (n= 202) with persistent CR who were scheduled for surgery.

Methods: Patients were preoperatively randomized to receive structured postoperative physiotherapy (SPT, n=101) or standard postoperative approach (SA, n=101). SPT combined neck-specific exercises with a behavioral approach. Baseline, 3-month, and 6-month evaluations included questionnaires and clinical examinations. Neck muscle endurance, active cervical range of motion, self-efficacy, pain catastrophizing (CSQ_CAT), perceived control over pain, and ability to decrease pain were analyzed for between-group differences using complete case and per-protocol approaches.

Results: No between-group difference was reported at the 6-month follow-up (p = 0.05 to 0.99), but all outcomes had improved from baseline (p<0.001). Patients in the SPT group with ≥50% attendance to treatment sessions showed larger improvements in CSQ_CAT (p= 0.04) during the rehabilitation period from 3 to 6 months after surgery compared to the patients who received SA.

Conclusion: No between-group difference in outcomes was found at 6 months after surgery based on measures of neck-related physical function, self-efficacy and coping strategies. However, the results confirm that neck-specific exercises are tolerated by patients with CR after surgery, and that there may be a benefit from combining surgery with structured postoperative physiotherapy in patients with CR.

Keywords
Cervical radiculopathy, Postoperative physiotherapy, Randomized clinical trial, Physical function, Coping strategies
National Category
Neurology Physiotherapy
Identifiers
urn:nbn:se:liu:diva-122694 (URN)10.1016/j.jmpt.2017.02.012 (DOI)000404024700003 ()
Note

Funding agencies: Swedish Research Council; Swedish Society of Medicine; Medical Research Council of Southeast Sweden; Region Ostergotland; Lions; Futurum (Academy of Health and Care, Region Jonkoping County)

Available from: 2015-11-16 Created: 2015-11-16 Last updated: 2017-08-21Bibliographically approved
Treleaven, J., Peterson, G., Landén Ludvigsson, M., Kammerlind, A.-S. & Peolsson, A. (2016). Balance, dizziness and proprioception in patients with chronic whiplash associated disorders complaining of dizziness: A prospective randomized study comparing three exercise programs. Manual Therapy, 22, 122-130
Open this publication in new window or tab >>Balance, dizziness and proprioception in patients with chronic whiplash associated disorders complaining of dizziness: A prospective randomized study comparing three exercise programs
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2016 (English)In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 22, p. 122-130Article in journal (Refereed) Published
Abstract [en]

Background: Dizziness and unsteadiness are common symptoms following a whiplash injury. Objective: To compare the effect of 3 exercise programs on balance, dizziness, proprioception and pain in patients with chronic whiplash complaining of dizziness. Design: A sub-analysis of a randomized study. Methods: One hundred and forty subjects were randomized to either a physiotherapist-guided neck-specific exercise (NSE), physiotherapist-guided neck-specific exercise, with a behavioural approach (NSEB) or prescription of general physical activity (PPA) group. Pre intervention, 3, 6 and 12 months post baseline they completed the University of California Los Angeles Dizziness Questionnaire (UCLA-DQ), Visual Analogue Scales (VAS) for, dizziness at rest and during activity and physical measures (static and dynamic clinical balance tests and head repositioning accuracy (HRA)). Results: There were significant time by group differences with respect to dizziness during activity and UCLA-Q favouring the physiotherapy led neck specific exercise group with a behavioural approach. Within group analysis of changes over time also revealed significant changes in most variables apart from static balance. Conclusion: Between and within group comparisons suggest that physiotherapist led neck exercise groups including a behavioural approach had advantages in improving measures of dizziness compared with the general physical activity group, although many still complained of dizziness and balance impairment. Future studies should consider exercises specifically designed to address balance, dizziness and cervical proprioception in those with persistent whiplash. Crown Copyright (C) 2015 Published by Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
CHURCHILL LIVINGSTONE, 2016
Keywords
Dizziness; Balance; Proprioception; Whiplash
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-127561 (URN)10.1016/j.math.2015.10.017 (DOI)000373615700021 ()26678652 (PubMedID)
Note

Funding Agencies|Swedish government through the REHSAM foundation; regional Centres for Clinical Research of Ostergotland and Sormland County Councils; Medical Research Council of Southeast Sweden; Swedish government; Swedish Social Insurance Agency through the REHSAM foundation; Centre for Clinical Research Sormland at Uppsala University Sweden; Uppsala-Orebro Regional Research Council Sweden; Swedish Research Council; County Council of Ostergotland; County Council of Jonkoping

Available from: 2016-05-04 Created: 2016-05-03 Last updated: 2017-11-30
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6075-4432

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