Head repositioning accuracy in patients with whiplash-associated disorders

Study Design. Controlled study, measuring head repositioning error (HRE) using an electrogoniometric device. Objective. To compare HRE in neutral position, axial rotation and complex postures of patients with whiplash-associated disorders ( WAD) to that of control subjects. Summary of Background Data. The presence of kinesthetic alterations in patients with WAD is controversial. Methods. In 26 control subjects and 29 patients with WAD ( aged 22 - 74 years), head kinematics was sampled using a 3-dimensional electrogoniometer mounted using a harness and a helmet. All tasks were realized in seated position. The repositioning tasks included neutral repositioning after maximal flexion-extension, eyes open and blindfolded, repositioning at 50 degrees of axial rotation, and repositioning at 50 degrees of axial rotation combined to 20 degrees of ipsilateral bending. The flexion-extension, ipsilateral bending, and axial rotation components of HRE were considered. A multiple-way repeated-measures analysis of variance was used to compare tasks and groups. Results. The WAD group displayed a reduced flexion-extension range ( P = 1.9 x 10(-4)), and larger HRE during flexion-extension and repositioning tasks ( P = 0.009) than controls. Neither group nor task affected maximal motion velocity. Neutral HRE of the flexion-extension component was larger in blindfolded condition ( P = 0.03). Ipsilateral bending and axial rotation HRE components were smaller than the flexion-extension component ( P = 7.1 x 10(-23)). For pure rotation repositioning, axial rotation HRE was significantly larger than flexion-extension and ipsilateral bending repositioning error ( P = 3.0 x 10(-23)). Ipsilateral bending component of HRE was significantly larger combined tasks than for pure rotation tasks ( P = 0.004). Conclusions. In patients with WAD, range of motion and head repositioning accuracy were reduced. However, the differences were small. Vision suppression and task type influenced HRE.