Motor impairment in patients with chronic neck pain: does the traumatic event play a significant role? A case-control study

BACKGROUND CONTEXT: Motor impairment is a key sign in patients with traumatic (whiplash-associated disorder [WAD]) and non-traumatic (idiopathic neck pain [INP]) neck pain. PURPOSE: This study aimed to analyze differences in motor impairment between two patient groups and to assess the association between motor performance and self-reported symptoms. STUDY DESIGN: This is a case-control study. PATIENT SAMPLE: A total of 38 patients with chronic INP, 35 patients with chronic WAD. and 30 healthy pain-free controls were included in the study. OUTCOME MEASUR: Outcome measures used in this study were mobility (degrees), strength (N), repositioning accuracy (degrees), endurance (seconds), sway velocity (cm/s). sway area (cm(2)), and neuromuscular control. METHODS: Group differences of motor impairment, together with questionnaires to evaluate pain intensity, fear avoidance, pain catastrophizing. symptoms of central sensitization, and disability, were analyzed with analysis of covariance, including age as a covariate. RESULTS: Motor impairment was observed in both patient groups with a higher degree in patients with chronic WAD. These impairments were moderately linked to self-reported disability and were in most cases associated with pain, fear avoidance, and symptoms of central sensitization (vertical bar rho vertical bar ranging from 0.28 to 0.59). CONCLUSIONS: Motor impairment should be addressed when treating both groups of patients, keeping in mind the association with self-reported pain and disability, fear-avoidance, and central sensitization. (C) 2018 Elsevier Inc. All rights reserved.