Comparison of the Neck Extensor Muscles Dimensions and Echo Intensities between Patients with Whiplash Injury and Healthy Controls

Document Type : Original article

Authors

1 Professor of Physical therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Student Research Committee. MSc Student of Physical Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background and Aims: Whiplash injury occurs due to acceleration-deceleration in neck following the accidents. Since neck extensor muscles play a crucial role in mobility and stabilization of neck, their injury might significantly affect continuation and progress of complications. The objective of the present study was to investigate the variations of size and echo intensity of neck extensor muscles in patients suffering from whiplash injury and healthy individuals.
Materials and Methods: An analytical-sectional study was carried out on 10 healthy persons and 10 patients suffering from whiplash injury whose disease had been confirmed by neurologists and/or orthopedists. Pain severity, neck disability index (NDI) questionnaire score, anterior-posterior diameter, and echo intensities of oblique capitis, posterior rectus capitis, semi-spinalis capitis, splenius capitis, levator scapula, and upper trapezius were measured and recorded.
Results: The present study indicated that thicknesses of rectus capitis and oblique capitis muscles in the patients were smaller as compared with those of the healthy individuals (p<0.05). Normalized echo intensity of the rectus capitis muscle was significantly lower in patients compared with the healthy individuals (p<0.05).
Discussion and Conclusion: The present study demonstrated that extensor muscles of the upper part of neck in the patients suffering from whiplash injury are narrower in terms of thickness and less severe in terms of echo intensity as compared with those of the healthy individuals. The abovementioned muscular alterations are effectively among the reasons associated with continuation of weakness and reduction in tolerance threshold of neck structures in the patients suffering from whiplash injuries.

Keywords

Main Subjects

References

1) Naumann R , Dellinger A , Zaloshnja E , Lawrence B , Miller T . Incidence and total lifetime costs of motor vehicle-related fatal and nonfatal injury by road user type, United States, 2005. Traffic Inj Prev 2010; 11: 353–360.##
2) Sterling M , Hendrikz J , Kenardy J , Kristjansson E , Dumas JP , Niere K et al. Assessment and validation of prognostic models for poor functional recovery 12 months after whiplash injury: a multicentre inception cohort study. Pain 2012; 153: 1727–1734. ##
3) Riley LH, Long D, Riley Jr LH. The science of whiplash. Medicine. 1995 Sep 1;74(5):298-9. ##
4) Pearce J (1989) Whiplash injury: a reappraisal. J Neurol Neurosurg Psychiatry 52(12):1329–1331##
5) Pastakia K, Kumar S (2011) Acute whiplash associated disorders (WAD). Open Access Emerg Med 3:29–32##
6) Malleson A (1994) Chronic whiplash syndrome. Psychosocial epidemic. Can Fam Phys 40:1906–1909##
7) Livingston M (2000) Whiplash injury: why are we achieving so little? J R Soc Med 93(10):526–528##
8) Arthur A.Rodriquez, Karen P.Barr, Stephen P.Burns. Whiplash: Pathophysiology, diagnosis, treatment, and prognosis. Muscle Nerve 29: 768-781, 2004. ##
9) Chen Hai-bin, King H YANG, WANG Zheng-guo. Biomechanics of whiplash injury. Chinese Journal of Traumatology 2009; 12(5): 305-314. ##
10) Spitzer WO, Skovron ML, Salmi LR, et al. Scientific monograph of the Quebec Task Force on Whiplash – associated Dis-orders: redefining "whiplash" and its management. Spine 1995; 20: 1S-73S. ##
11) Carroll LJ, Holm LW, Hogg-Johnson S, Côtè P, Cassidy JD, Haldeman S, Nordin M, Hurwitz EL, Carragee EJ, van der Velde G, Peloso PM. Course and prognostic factors for neck pain in whiplash-associated disorders (WAD): results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Journal of manipulative and physiological therapeutics. 2009 Feb 28;32(2):S97-107##
12) Elliot JM, Kerry R, Flynn T, Parrish TB. Cnotent not quantity is a better measure of muscle degeneration in whiplash. Man Ther. 2013: 18(6): 578-82. ##
13) Kyhlbäck M, Thierfelder T, Söderlund A. Prognostic factors in whiplash associated disorders. Int J Rehabil Res 2002;25:181–7. ##
14) Biering-Sørensen S, Møller A, Stoltenberg C, et al. The return-to-work process of individuals sick-listed because of whiplash-associated disorder: a three-year follow-up study in a Danish cohort of long-term sickness absentees. BMC Public Health 2014;14:113##
15) Ivancic PC, Panjabi MM, Ito S, et al. Biofidilic whole cervical spine model with muscle force  replication for whiplash simulation. Eur spine J. 2015: 14(4): 346-55. ##
16) Versteegen GJ, Kingma J, Meijler WJ, ten Duis HJ: Neck sprain in patients injured in car accidents: a retrospective study covering the period 1970- 1994. Eur Spine J 1998, 7(3): 195-200. ##
17) Insurance Bureau of Canada: Submission to the Superintendent, Financial Services, FSCO: Submitted for the review of Part VI of the Insurance Act. A submission by the Insurance Bureau of Canada 2008. ##
 
18) O’Leary S, Cagnie B, Reeve A, Jull G, Elliott JM. Is there altered activity of the extensor muscles in chronic mechanical neck pain? A functional magnetic resonance imaging study. Archives of Physical Medicine and Rehabilitation 2011a; 92:929e34. (Abstract) ##
19) Schomacher J, Farina D, Lindstroem R, Falla D. Chronic trauma-induced neck pain impairs the neural control of the deep semispinalis cervicis muscle. Clinical Neurophysiology 2012b; 123(7):1403e8. ##
20) Uhlig Y, Weber BR, Grob D, Muntener M. Fiber composition and fibre transformations in neck muscles of patients with dysfunction of the cervical spine. Journal of Orthopaedic Research 1995; 13:240e9. ##
21) Elliott JM, Jull G, Noteboom JT, Darnell R, Galloway G, Gibbon WW. Fatty infiltration in the cervical extensor muscles in persistent whiplash-associated disorders: a magnetic resonance imaging analysis. Spine 2006; 31:E847e55. ##
22) Andary MT, Hallgren RC, Greenman PE, Rechtien JJ. Neurogenic atrophy of suboccipital muscles after a cervical injury: a case study. American Journal of Physical Medicine & Rehabilitation 1998; 77(6):545e9. ##
23)  Elliott JM, Jull G, Noteboom JT, Galloway G. MRI study of the cross-sectional area for the cervical extensor musculature in patients with persistent whiplash associated disorders (WAD). Manual Therapy 2008a; 13:258e65. ##
24) Jochen Schomacher, Deborah Falla. Function and structure of the deep cervical extensor muscles in patients with neck pain. Manual Therapy 18 (2013) 360e366. ##
25) Johnston V, Jull G, Souvlis T, Jimmieson N. Neck movement and muscle activity characteristics in female office workers with neck pain. Spine 2008; 33(5): 555e63. ##
26) Kumar S, Narayan Y, Prasad N, Shuaib A, Siddiqui ZA. Cervical electromyogram profile differences between patients of neck pain and control. Spine 2007; 32(8):E246e53. ##
27) Lindstrøm R, Schomacher J, Farina D, Rechter L, Falla D. Association between neck muscle coactivation, pain, and strength in women with neck pain. Manual Therapy 2011; 16(1):80e6. ##
28) Szeto GPY, Straker LM, O’Sullivan PB. A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work e 1: neck and shoulder muscle recruitment patterns. Manual Therapy 2005; 10:270e80. ##
29) Johnston V, Jull G, Souvlis T, Jimmieson N. Neck movement and muscle activity characteristics in female office workers with neck pain. Spine 2008; 33(5): 555e63. ##
30)  Elliott J, Pedler A, Kenardy J, Galloway G, Jull G, Sterling M. The temporal development of fatty infiltrates in the neck muscles following whiplash injury: an association with pain and posttraumatic stress. PLoS One 2011; 6:e21194. ##
31) Woodhouse A, Vasseljen O. Altered motor control patterns in whiplash and chronic neck pain. BMC Musculoskelet Disord 2008; 9:90. ##
32) Juul-Kristensen B, Clausen B, Ris I, et al. Increased neck muscle activity and impaired balance among  females with whiplash-related chronic neck pain: a cross-sectional study. J Rehabil Med. 2013 Apr: 45(4): 376-84. ##
33) Murphy WA, Totty WG, Carroll JE. MRI of normal and pathologic skeletal muscle. Am J Roentgenol 1986; 146: 565-74. ##
34) Sigrid Pillen. Skeletal muscle ultrasound. European Journal Translational Myology 2010; 1 (4): 145-155. ##
35)  Cady EB, Gardener JE, Edwards RH. Ultrasonic tissue characterisation of skeletal muscle. Eur J Clin Invest 1983; 13: 469-473. ##
36) Mayoux-Benhamou MA, Revel M, Vallee C. Selective electromyography of dorsal neck muscles in humans. Exp Brain Res 1997; 113:353-60. ##
37) Gunnel Peterson, David Nilsson, Simon Peterson, et al. Changes in dorsal neck muscle function in individuals with chronic whiplash – associated disorders: A Real-time ultrasound case – control study. Ultrasound in Med. & Biol., Vol. -, No. -, pp. 1–13, 2016. ##
38)Cady EB, Gardener JE, Edwards RH. Ultrasonic tissue characterisation of skeletal muscle. Eur J Clin Invest 1983; 13: 469-473. ##
39) Jo-Ping Leea, Wen-Yih I. Tsengb, Yio-Wha Shau, et al. Measurement of segmentl cervical multifidus contraction by ultrasonography in asymptomatic adults. Manual Therapy 12 (2007) 286–294. ##
40) Anneli Peolsson, Lars-Ake Brodin, Michael Peolsson. A tissue velocity ultrasound imaging investigation of the dorsal neck muscles during resisted isometric extension. Manual Therapy 15 (2010) 567-573. ##
41) Lamminen A, Jaaskelainen J, Rapola J, Suramo I. High-frequency ultrasonography of skeletal muscle in children with neuromuscular disease. J Ultrasound Med 1988; 7: 505-509. ##
42) Peetrons P. Ultrasound of muscles. Eur Radiol 2002; 12: 35-43. ##
43) Lopata RG, van Dijk JP, Pillen S, Nillesen MM, Maas H, Thijssen JM, et al. Dynamic imaging of skeletal muscle contraction in three orthogonal directions. J Appl Physiol 2010; 109:906e15. ##
44) Peolsson M, Lofstedt T, Vogt S, Stenlund H, Arndt A, Trygg J. Modelling human musculoskeletal functional movements using ultrasound imaging. BMC Med Imaging 2010; 10:9. ##
45) Khodabakhsh Javanshir, Mohammad Ali Mohseni-Bandpei, Asghar Rezasoltani, et al. Ultrasonography of longus colli muscle: A reliability study on healthy subjects and patients with chronic neck pain. Journal of Bodywork & Movement Therapies (2011) 15, 50e56. ##
46) Esformes R, Narici MV. Measurement of human muscle volume using ultrasonography. European Journal of Applied Physiology 2002; 87:90–2. ##
47) Kristjansson E. Reliability of ultrasonography for the cervical multifidus muscle in asymptomatic and symptomatic subjects. Manual Therapy 2004; 9:83–8. ##
48)  Mousavi SJ, Parnianpour M, Montazeri A, Mehdian H, Karimi A, Abedi M, et al. Translation and validation study of the Iranian versions of the Neck Disability Index and the Neck Pain and Disability Scale. Spine. 2007;32(26):E825-E31. ##
49) Nash L, Nicholson H, Lee AS, Johnson GM, Zhang M. Configuration of the connective tissue in the posterior atlanto-occipital interspace: a sheet plastination and confocal microscopy study. Spine. 2005 Jun 15;30(12):1359-66. ##
50)Elliott JM, Galloway GJ, Jull GA, Noteboom JT, Centeno CJ, Gibbon WW. Magnetic resonance imaging analysis of the upper cervical spine extensor musculature in an asymptomatic cohort: an index of fat within muscle. Clinical radiology. 2005 Mar 31;60(3):355-63. ##
51)  Fernández-de-las-Penas C, Cuadrado ML, Arendt-Nielsen L, Ge HY, Pareja JA. Association of cross-sectional area of the rectus capitis posterior minor muscle with active trigger points in chronic tension-type headache: a pilot study. American journal of physical medicine & rehabilitation. 2008 Mar 1;87(3):197-203. ##
52) McPartland JM, Brodeur RR. Rectus capitis posterior minor: a small but important suboccipital muscle. Journal of Bodywork and Movement Therapies. 1999 Jan 1;3(1):30-5. ##
53) Rix GD, Bagust J. Cervicocephalic kinesthetic sensibility in patients with chronic, nontraumatic cervical spine pain. Archives of physical medicine and rehabilitation. 2001 Jul 31;82(7):911-9. ##
54) Alix ME, Bates DK. A proposed etiology of cervicogenic headache: the neurophysiologic basis and anatomic relationship between the dura mater and the rectus posterior capitis minor muscle. Journal of manipulative and physiological therapeutics. 1999 Oct 31;22(8):534-9. ##
55) Blouin JS, Siegmund GP, Carpenter MG, Inglis JT. Neural control of superficial and deep neck muscles in humans. Journal of neurophysiology. 2007 Aug 1;98(2):920-8. ##
56) Bexander CS, Mellor R, Hodges PW. Effect of gaze direction on neck muscle activity during cervical rotation. Experimental brain research. 2005 Dec 1;167(3):422. ##
57)Elliott JM. Are there implications for morphological changes in neck muscles after whiplash injury?. Spine. 2011 Dec 1;36:S205-10. ##
58)Malmström EM, Karlberg M, Melander A, Magnusson M, Moritz U. Cervicogenic dizziness–musculoskeletal findings before and after treatment and long-term outcome. Disability and rehabilitation. 2007 Jan 1;29(15):1193-205. ##
59) Castaldo M, Catena A, Chiarotto A, Villafañe JH, Fernández-de-Las-Peñas C, Arendt-Nielsen L. Association between Clinical and Neurophysiological Outcomes in Patients with Mechanical Neck Pain and Whiplash-associated Disorders. The Clinical Journal of Pain. 2017 Oct 26. ##
60) Shah JP, Danoff JV, Desai MJ, Parikh S, Nakamura LY, Phillips TM, Gerber LH. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Archives of physical medicine and rehabilitation. 2008 Jan 31;89(1):16-23. ##
The Scientific Journal of Rehabilitation Medicine
Volume 8, Issue 2
July 2019
Pages 221-232

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History

  • Receive Date: 01 August 2017
  • Revise Date: 18 September 2017
  • Accept Date: 01 November 2019
  • First Publish Date: 01 November 2019

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