Article

The influence of self-rated disability and fear-avoidance beliefs on
whiplash sufferers in their performance of active ranges of motion has not been
studied well. We undertook a cross-sectional study to determine this. METHODS:
Chronic whiplash subjects completed a standard clinical examination. They
completed the Neck Disability Index (NDI), the Tampa Scale for Kinesiophobia
(TSK) and pain visual analog scale (VAS). Active ranges of motion (goniometer)
and cervical nonorganic simulation signs (C-NOSS) were obtained by the examiner.
Univariate and multivariable analyses were conducted on these scores. RESULTS:
Sixty-four subjects (37 female) with a mean age of 41.4 (SD 16.1) years completed
all scores. NDI, pain VAS and C-NOSS correlated significantly with ROM. In a
multivariable model, only the NDI score contributed significantly to the variance
of the ROM scores (14%). CONCLUSION: As chronic whiplash sufferers perform ROM in
a clinical examination, these ranges are importantly influenced by their
self-perceived disability. Cervical nonorganic simulation signs can be helpful in
distinguishing high from very high levels of disability and motion restriction.
The lack of correlation with the TSK may present a challenge to the Fear
Avoidance Model in whiplash. Implications for Rehabilitation Self-ratings of
disability in chronic whiplash sufferers are influenced by their fear-avoidance
beliefs. While self-ratings of disability are known to predict chronicity of
whiplash, there is less known about how these ratings affect impairment
assessment during recovery. This study shows that self-ratings of disability
influence the presentation of impairment by chronic whiplash sufferers with
respect to their ranges of neck motion. Signs of nonorganic behavior also
influence ranges of motion and self-ratings of disability. These findings should
be incorporated into the interpretation of impairment findings in chronic
whiplash sufferers in order to improve management.

Langue : ANGLAIS