Eulogio Pleguezuelos Cobo

What factors have influence on persistence of neck pain after a whiplash

Study Design. Prospective longitudinal study. Objective. To identify prognosis factors that allow us to identify patients with risk of developing chronic symptoms and disabilities after a whiplash injury. Summary of Background Data. The prognosis factors for poor recovery in acute whiplash are not conclusive. Methods. We included 557 patients who suffered whiplash injury after road traffic accident and visited the Department of Physical Medicine and Rehabilitation of Mataró Hospital (Spain) for medical evaluation and rehabilitation treatment. The variables were collected following a protocol designed for the study, and all patients were assessed through the Visual Analogue Scale (VAS) for the intensity of neck pain, the Goldberg Depression and Anxiety Scale and the Northwick Park Neck Pain Questionnaire (NPH) for cervical column functionality at initial evaluation and 6 months later. Results. Factors related with VAS 6 months after the whiplash injury were women, age, number of days of cervical column immobilization, previous neck pain, self-employed workers, housewives, pensioners, students, presence of headache or dizziness, and VAS, Goldberg Depression and Anxiety scale, and NPH scores at initial evaluation. In multivaried analysis, it had been found that the variables that had influence on VAS 6 months after the whiplash injury were statistically significant for age, presence of dizziness, self-employed workers, and VAS and NPH scores at initial evaluation. Conclusion. Our findings indicate that factors that allow us to identify patients at risk for poor recovery are age, dizziness, and initial evaluation of neck pain with VAS and cervical column functionality with NPH.

The anterior mini-open approach for femeroacetabular impingement: Gait and functional assessment at one year post-surgery.

OBJECTIVE This study aimed to evaluate the outcome of the anterior mini-open approach of the hip for femoroacetabular impingement (FAI) at one year post-surgery by use of questionnaires, functional capacity tests and biomechanical studies. DESIGN This is a case series prospective study. A total of 14 patients diagnosed of FAI were included. Patients were classified according to Tönnis scale. Hip joint mobility, Faber distance, pain levels (assessed on a visual analogic scale [VAS]), 6-minute walking test (6MWT), Timed up & go test (TUGT), Stairs climbing test, Lequesne functional index, and gait analysis were assessed prior to and 12 months after surgery. RESULTS Pain significantly improved following surgery. An improvement of 80% or more was found in 6 patients (42.85% of cases). Improvements were also seen in time support of the affected limb and in the braking force of the contralateral limb, although these are not clinically significant. No statistically significant changes were seen in functional capacity tests. At 12 months after surgery, meralgia paraesthetica presented in 3 patients (21.4%), and a total hip arthroplasty was performed in 1 patient. CONCLUSIONS There was significant reduction in pain intensity 12 months following mini-open approach for FAI compared to preoperatively. Improvement in gait analysis and functional capacity was also seen, although not statistically significant.

Alteraciones del control postural en fases iniciales del latigazo cervical

BACKGROUND AND OBJECTIVE Dizziness of variable intensity is a frequent complaint in patients who suffered whiplash and largely documented balance disturbances. The objective of the study was to identify balance disorders in early stage of whiplash after road traffic accidents. PATIENTS AND METHOD Ninety nine women were included in the study. Fifty four women had suffered whiplash within two weeks and 45 were included in a healthy control group. Static posturography on a force platform was carried out in all study participants, by means of the Romberg test in four sequential phases, using the postural sway area (SA) as a dependent variable. Visual Analogic Scale (VAS) and Northwick Park Neck Pain Questionnaire (NPH) were used to evaluate pain and function. RESULTS Postural sway area increased significantly in each of the consecutive phases in both groups. The differences of the means of the postural sway area were statistically significant in all Romberg phases (p=.009 to P=.000). No correlation was found between SA and VAS or NPH scores. There was a positive correlation between the postural sway area standing on a thick foam cushion placed over the plate with closed eyes and the number of days of transitory incapacity (r=0.414; P=.009). CONCLUSIONS Patients with recent whiplash show a postural control disturbance revealed trough a sequential static posturography analysis. This suggests that the balance disorder is not only a consequence of late whiplash syndrome evolution. Therefore, we should promote early instauration of a specific therapeutic approach if and when the patient refers dizziness and related symptoms.

OriginalAlteraciones del control postural en fases iniciales del latigazo cervicalPostural control disorders in initial phases of whiplash

BACKGROUND AND OBJECTIVE Dizziness of variable intensity is a frequent complaint in patients who suffered whiplash and largely documented balance disturbances. The objective of the study was to identify balance disorders in early stage of whiplash after road traffic accidents. PATIENTS AND METHOD Ninety nine women were included in the study. Fifty four women had suffered whiplash within two weeks and 45 were included in a healthy control group. Static posturography on a force platform was carried out in all study participants, by means of the Romberg test in four sequential phases, using the postural sway area (SA) as a dependent variable. Visual Analogic Scale (VAS) and Northwick Park Neck Pain Questionnaire (NPH) were used to evaluate pain and function. RESULTS Postural sway area increased significantly in each of the consecutive phases in both groups. The differences of the means of the postural sway area were statistically significant in all Romberg phases (p=.009 to P=.000). No correlation was found between SA and VAS or NPH scores. There was a positive correlation between the postural sway area standing on a thick foam cushion placed over the plate with closed eyes and the number of days of transitory incapacity (r=0.414; P=.009). CONCLUSIONS Patients with recent whiplash show a postural control disturbance revealed trough a sequential static posturography analysis. This suggests that the balance disorder is not only a consequence of late whiplash syndrome evolution. Therefore, we should promote early instauration of a specific therapeutic approach if and when the patient refers dizziness and related symptoms.