Clinical trial NCT01547624: Neck Muscle Activation in Patients With Long Standing Problems After a Whiplash Trauma Registered With Ultrasound With Speckle Tracking
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Whiplash Associated Disorder
Keywords: Neck
Spine
Muscles
Activity
Coordination
Lead sponsor: Linkoeping University
Sponsor class: OTHER_GOV
First posted: 2012-03-08
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Maximum age (years): 63
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: DIAGNOSTIC

Brief summary: Today there is evidence for that neck specific exercises reduce neck pain problems in patients with mechanical neck pain. However, there is a lack of consensus on how to optimize neck exercises and dosages in neck rehabilitation. More knowledge is needed to determine which and how muscles are activated in exercises thought to be neck-specific. There is neither enough knowledge of differences in neck muscle activation between patients with long standing neck problems after a whiplash trauma and healthy controls nor if the neck muscle function improved with specific neck exercises. One approach would be a real time study of deformation and deformation rate in different layers of neck muscles in patients with residual long-term neck pain and disability after a whiplash trauma. The purpose of the present study was to investigate deformation and deformation rate in different layers of dorsal and ventral neck muscles (including upper and middle part of trapezius muscle) during rest and during different exercises; arm flexion until 120 degrees, repeated arm flexion until 90 degrees, low loaded neck extension, low loaded neck muscle endurance test, shoulder elevation. Forty patients with long standing (more than 6 months but less than 3 years)patients and 40 controls matched for age and gender will be included for comparisons between patients and healthy in neck muscle activation. The investigators also include 60 patients with whiplash trauma, of those 30 patients will be randomized to A. neck specific exercises in a 3 months period and B. will 30 be on a waiting list for 3 months. Measurements are performed at baseline and at 3 months follow-up. Those patients who fulfilled the 3 months period of neck specific exercises will also be asked for a 6 months follow-up.


Eligibility criteria: Inclusion Criteria:

* WAD II and III
* Age 18-63 years
* Remaining problems
* Right handed
* Pain on right or on both sides.

Exclusion Criteria:

* Myelopathy
* Earlier fracture or luxation of the cervical column, earlier neck injury
* Spinal tumour
* Spinal infection
* Surgery in the cervical column
* Malignity
* Systemic disease or other disease or another injury contraindicated to perform the treatment program or the measurements
* Diagnosed severe psychiatric disorder
* Unconscious in connection to the trauma
* Known drug abuse
* Lack of familiarity with the Swedish language

Primary outcomes:
measure: Speckle tracking analysis of muscle function
timeFrame: Baseline and at 3 and 6 months follow-up. The outcome measure is going to report a change over time.
Secondary outcomes:
measure: Background data
timeFrame: Baseline
measure: Symptom satisfaction
timeFrame: Baseline and at 3 months follow-up. The outcome measure is going to report a change over time.
measure: Pain intensity on visual analogue scale (VAS)
timeFrame: Baseline and at 3 months follow-up. The outcome measure is going to report a change over time.
measure: Dizziness/ unsteadiness on visual analogue scale
timeFrame: Baseline and at 3 month follow-up. The outcome measure is going to report a change over time.
measure: Pain distribution on drawing
timeFrame: Baseline and at 3 months follow-up. The outcome measure is going to report a change over time.
measure: Pain Disability Index
timeFrame: Baseline and at 3 months follow-up. The outcome measure is going to report a change over time
measure: Neck Disability Index
timeFrame: Baseline and at 3 month follow-up. The outcome measure is going to report a change over time.
measure: Tampa Scale of Kinesiophobia (TSK-11 short version)
timeFrame: Baseline and at 3 month follow-up. The outcome measure is going to report a change over time.
measure: Pain Catastrophizing Scale
timeFrame: Baseline and at 3 month follow-up. The outcome measure is going to report a change over time.
measure: Hospital Anxiety and Depression Scale
timeFrame: Baseline and at 3 month follow-up. The outcome measure is going to report a change over time.
measure: Euroquol
timeFrame: Baseline and at 3 month follow-up. The outcome measure is going to report a change over time.
measure: Exercise Self-Efficacy Scale
timeFrame: Baseline and at 3 month follow-up. The outcome measure is going to report a change over time.
measure: Self-Efficacy Scale
timeFrame: Baseline and at 3 month follow-up. The outcome measure is going to report a change over time.
measure: Work Ability Index
timeFrame: Baseline and at 3 month follow-up. The outcome is going to report a change over time.
measure: Physical Activity level
timeFrame: Baseline and at 3 month follow-up. The outcome measure is going to report a change over time.
measure: Physical Outcome Measures
timeFrame: Baseline and at 3 month follow-up. The outcome is going to report a change over time.
measure: SF-36
timeFrame: Baseline and at 3 month follow-up. The outcome measure is going to report a change over time.
Other outcomes:
Locations:
city: Linköping
country: Sweden
facility: Anneli Peolsson
state: Östergötland
Study officials:
affiliation: Linkoeping University
name: Anneli Peolsson, Assoc. Prof.
role: STUDY_CHAIR
References:
citation: Peolsson A, Landen Ludvigsson M, Tigerfors AM, Peterson G. Effects of Neck-Specific Exercises Compared to Waiting List for Individuals With Chronic Whiplash-Associated Disorders: A Prospective, Randomized Controlled Study. Arch Phys Med Rehabil. 2016 Feb;97(2):189-95. doi: 10.1016/j.apmr.2015.10.087. Epub 2015 Oct 26.
citation: Landen Ludvigsson M, Peterson G, Jull G, Trygg J, Peolsson A. Mechanical properties of the trapezius during scapular elevation in people with chronic whiplash associated disorders--A case-control ultrasound speckle tracking analysis. Man Ther. 2016 Feb;21:177-82. doi: 10.1016/j.math.2015.07.009. Epub 2015 Aug 5.