Maximal voluntary isometric neck strength deficits in adults with whiplash-associated disorders and association with pain and fear of movement.

摘要

STUDY DESIGN: Controlled laboratory study using a cross-sectional, repeated-measures design. OBJECTIVES: To quantify maximal voluntary isometric neck forces in healthy subjects and individuals with whiplash-associated disorder (WAD), using an objective measurement system to evaluate the test-retest properties of these strength measurements and to assess the links between neck strength, pain, kinesiophobia, and catastrophizing in patients with WAD. BACKGROUND: The prognosis of WAD is difficult to predict due to a lack of objective measurement methods and to our limited understanding of the role of psychological factors in the development of chronic WAD symptoms. METHODS AND MEASURES: Fourteen subjects with chronic WAD grade I or II and an age-matched, healthy group (n = 28) participated in this study. Cervical strength was measured with the Multi-Cervical Unit (MCU) in 6 directions, and pain was measured with a visual analog scale. Individuals in the WAD group completed the Neck Disability Index (NDI), the Tampa Scale for Kinesiophobia (TSK), and the Pain Catastrophizing Scale (PCS). RESULTS: Significant deficits in strength were observed for the individuals in the WAD group compared to the healthy group, particularly in extension, retraction, and left lateral flexion (P<.05). The MCU demonstrated good intratester reliability for the healthy group (ICC = 0.80-0.92) and the WAD group (ICC = 0.85-0.98), and small standard errors of measurement for both groups. No significant association was found between neck strength and NDI, TSK, and PCS. CONCLUSION: The MCU demonstrated good test-retest properties for healthy subjects and individuals with WAD. Cervical strength was lower in individuals with WAD; however, the strength deficits were not clearly linked with psychological factors. J Orthop Sports Phys Ther 2009;39(3):179-187, Epub 17 December 2008. doi:10.2519/jospt.2009.2950.