Adding motor imagery to motor control training can improve neck sensorimotor function

Neck pain is one of the most common musculoskeletal disorders with a global annual prevalence of 37% [1]. People with neck pain show neck-specific motor control dysfunction including impaired proprioception [2] and sensorimotor function, altered movement patterns [3-5], and reduced maximal voluntary isometric contraction of deep cervical muscles … [Read more...]

Seeing your pain site – continued

Some time ago we reported here about the effect of visual induced analgesia on experimental pain in chronic back pain patients. In short to remind you: we used real-time video feedback; a video camera filmed the back and presented the video in real-time on a monitor in front of the subjects, and that was compared to watching a plain hand video. We … [Read more...]

Text neck is not a pain in the neck

In recent years there has been a sharp increase in the use of mobile phones, especially among young people. Over the same period, there has been a growing prevalence of neck pain [1, 2–4]. There is evidence that, compared to neutral standing, subjects viewing a mobile phone screen display a more forward head posture [5, 6]. Furthermore, a forward … [Read more...]

Assessment of movement control impairments of the neck

In a study on patients with and without neck pain we set out to evaluate a battery of ten movement control tests for the neck using a Rasch analysis (Sattelmayer, Hilfiker, Luomajoki, & Elsig, 2017). The aim was to establish whether all movement control tests measure the construct “movement control impairments of the neck”, to establish the … [Read more...]

Exercise for chronic whiplash – the road to Nullville.

It seems like only yesterday I was blogging about an important trial of targeted care for acute whiplash, which like other such trials returned a convincingly negative result. It seems that our best efforts at improving outcomes in the early stages after whiplash injury do not achieve their goals. But what about when we intervene with a group of … [Read more...]

Subgrouping patients with chronic whiplash on the basis of symptoms of sensory hypersensitivity and PTSD

A significant proportion of people (up to 50%) who develop neck pain following a car accident continue to report neck pain at long term follow up. It's not clear why these patients don't recover and unfortunately current evidence seems to indicate that usual rehabilitative management is not very effective for patients with chronic whiplash. The … [Read more...]

Effectiveness of conservative therapy for cervical radiculopathy – rooting out what works

Cervical radiculopathy is severe arm pain originating from a pinched nerve in your neck. It is different from non-specific neck pain and treatment guidelines should be different also. Surgery has proven to be very unsuccessful, so our systematic review focused on which conservative therapy would be most effective. The “blinding” of patient, … [Read more...]

The role of Range of Motion in recovery from Whiplash Associated Disorders

Summary My PhD research investigated the role of cervical spine Range of Motion in the recovery from Whiplash Associated Disorders (WAD). This formed part of my work on a large RCT investigating conservative treatments for WAD [2]. In clinical practice, Health Care Professionals attach value to measurements of cervical spine Range of Motion … [Read more...]

Findings on imaging for whiplash? It’s a miracle! What does it actually mean?

Whiplash is one of those conditions that often strikes fear into the hearts of clinicians, mainly because chronic whiplash is very hard to treat. This not helped by the fact that there is scepticism regarding the condition itself due to its lack of objective findings. Whiplash associated disorders (WAD) are largely diagnosed based on mechanism of … [Read more...]

What happens when systematic reviews tell us different things?

Conventional wisdom tells us that when we want an answer to a clinical question, such as what is the evidence for treatment ‘X’, we should look to systematic reviews because they collate all the available evidence on that topic. Problematically though, sometimes systematic reviews on the same topic don’t all give us the same conclusions. This … [Read more...]