Cervical Muscle Dysfunction in the Chronic Whiplash Associated Disorder Grade II (WAD-II)

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Abstract

Study Design: In a cross-sectional study, surface electromyography measurements of the upper trapezius muscles were obtained during different functional tasks in patients with a chronic whiplash associated disorder Grade II and healthy control subjects.

Objectives: To investigate whether muscle dysfunctionof the upper trapezius muscles, as assessed by surface electromyography, can be used to distinguish patients with whiplash associated disorder Grade II from healthy control subjects.

Summary of Background Information: In the whiplash associated disorder, there is need to improve the diagnostic tools. Whiplash associated disorder Grade II is characterized by the presence of “musculoskeletal signs. ”Surface electromyography to assess these musculoskeletal signs objectively may be a useful tool.

Methods: Normalized smoothed rectified electromyography levels of the upper trapezius muscles of patients with whiplash associated disorder Grade II (n=18) andhealthy control subjects (n=19) were compared duringthree static postures, during a unilateral dynamic manual exercise, and during relaxation after the manual exercise. Coefficients of variation were computed to identify the measurement condition that discriminated best between the two groups.

Results: The most pronounced differences between patients with whiplash associated disorder Grade II and healthy control subjects were found particularly in situations in which the biomechanical load was low. Patients showed higher coactivation levels during physical exercise and a decreased ability to relax muscles after physical exercise.

Conclusions: Patients with whiplash associated disorder Grade II can be distinguished from healthy control subjects according to the presence of cervical muscledysfunction, as assessed by surface electromyography of the upper trapezius muscles. Particularly the decreasedability to relax the trapezius muscles seems to be a promising feature to identify patients with whiplash associated disorder Grade II. Assessment of the muscle (dys)functionby surface electromyography offers a refinement of the whiplash associated disorder classification and providesan indication to a suitable therapeutic approach.
Original languageEnglish
Pages (from-to)1938-1943
JournalSpine
Volume25
Issue number15
DOIs
Publication statusPublished - 2000

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