Biofeedback treatment for acute whiplash patients

Main Article Content

Carmen Lizette Gálvez-Hernández
Ma. Dolores Rodríguez-Ortiz
Yolanda Del Río-Portilla

Keywords

Neurofeedback, Relaxation therapy, Cervical vertebrae, Whiplash injuries

Abstract

Background: The aim of this study is to evaluate the physiological and psychological effect after an electromyographic biofeedback treatment in combination with progressive muscular relaxation training in patients with acute whiplash. 

Methods: Twelve patients with acute whiplash volunteered to participate in a quasi-experimental design and a control group. Inclusion criteria: Two months maximum after car accident, severity levels II and I. Exclusion criteria: previous history of persistent pain or serious previous injury. The groups were randomly divided in two (treatment and waiting list groups). We used electromyographic measures of the trapezius muscles with psychometric tests: Beck Anxiety and Depression Inventory; Oswestry Pain Disability Questionnaire; Visual Analog Scale of Pain; TAMPA Scale for Kinesiophobia. The treatment consisted in electromyographic biofeedback after progressive muscular relaxation training. 

Results: There were significant intra-group differences before and after treatment in muscular symmetry and subjective pain perception in the treatment group. 

Conclusions: We achieved a significant change (clinical and statistical) in subjective pain perception and muscular symmetry. This study highlights the importance of multidisciplinary work in acute pain patients and the effectiveness of clinical psychophysiological strategies with acute whiplash patients.

Abstract 1454 | PDF (Spanish) Downloads 314 HTML (Spanish) Downloads 2309 PubMed (Spanish) Downloads 0 HTML Downloads 533

References

Middaugh S, Thomas KJ, Smith AR, McFall TL, Klingmueller J. EMG Biofeedback and Exercise for Treatment of Cervical and Shoulder Pain in Individuals with a Spinal Cord Injury: A Pilot Study. Top Spinal Cord Inj Rehabil. Fall 2013;19(4):311-323.

 

Wang TJ, Chang CF, Lou MF, et al. Biofeedback relaxation for pain associated with continuous passive motion in Taiwanese patients after total knee arthroplasty. Res Nurs Health. Feb 2015;38(1):39-50.

 

Lee KE, Thinnes, J.H., Gokhin, D.S & Winkelstein, B.A. A novel rodent neck pain model of facet-mediated behavioral hypersensitivity: implications for persistent pain and whiplash injury. Journal of Neuroscience Methods. 2004;137(2):151-159.

 

Holm LW, Carroll LJ, Cassidy JD, et al. The burden and determinants of neck pain in whiplash-associated disorders after traffic collisions: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976). Feb 15 2008;33(4 Suppl):S52-59.

 

Styrke J, Stalnacke BM, Bylund PO, Sojka P, Bjornstig U. A 10-year incidence of acute whiplash injuries after road traffic crashes in a defined population in northern Sweden. PM R. Oct 2012;4(10):739-747.

 

Ferrari R, Russell AS, Carroll LJ, Cassidy JD. A re-examination of the whiplash associated disorders (WAD) as a systemic illness. Ann Rheum Dis. Sep 2005;64(9):1337-1342.

 

Phillips LA, Carroll LJ, Cassidy JD, Cote P. Whiplash-associated disorders: who gets depressed? Who stays depressed? Eur Spine J. Jun 2010;19(6): 945-956.

 

Hincapie CA, Cassidy JD, Cote P, Carroll LJ, Guzman J. Whiplash injury is more than neck pain: a population-based study of pain localization after traffic injury. J Occup Environ Med. Apr 2010;52(4): 434-440.

 

Dehner C, Kraus M, Scholl H, Schneider F, Richter P, Kramer M. Therapy recommendation “act as usual” in patients with whiplash injuries QTF I degrees. Glob J Health Sci. Nov 2012;4(6):36-42.

 

Nijs J, Ickmans K. Chronic whiplash-associated disorders: to exercise or not? The Lancet. 2014;384 (9938):109-111.

 

Gross A KF, Huang S, Khan M, Santaguida L, Carlesso L, et al. . Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain: An Systematic Overview Update as Part of the ICON§ Project. . Open Ortho J. 2013; 7(4:M12):530-561.

 

Ehrenborg C, Archenholtz B. Is surface EMG biofeedback an effective training method for persons with neck and shoulder complaints after whiplash-associated disorders concerning activities of daily living and pain -- a randomized controlled trial. Clin Rehabil. Aug 2010;24(8):715-726.

 

Sutton DA, Cote P, Wong JJ, et al. Is multimodal care effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Spine J. Jul 8 2014.

 

Robles R VR, Jurado S, Páez F. . Versión mexicana del inventario de ansiedad de Beck: propiedades psicométricas. Rev Mex Psic. 2001;18(2):211-218.

 

Andrade L. Propiedades psicométricas del Inventario de Depresión de Beck II (BDI-II) en residentes de la Ciudad de México México, D.F.: División de Estudios Profesionales Universidad Nacional Autónoma de México 2010.

 

S. M. Adaptación transcultural del cuestionario “Oswestry Disability Index 2.0” para la evaluación de incapacidad funcional de pacientes con dolor lumbar en México. México Universidad Nacional Autónoma de México; 2012.

 

Hendriks EJ, Scholten-Peeters GG, van der Windt DA, Neeleman-van der Steen CW, Oostendorp RA, Verhagen AP. Prognostic factors for poor recovery in acute whiplash patients. Pain. Apr 2005;114(3): 408-416.

 

Burwinkle T, Robinson JP, Turk DC. Fear of movement: factor structure of the tampa scale of kinesiophobia in patients with fibromyalgia syndrome. J Pain. Jun 2005;6(6):384-391.

 

Asociación Médica Mundial. Declaración de Helsinki de la AMM-Principios éticos para las investigaciones médicas en seres humanos. 2015; Recuperado de http://www.wma.net/es/30publications/10policies/b3/.

 

Criswell E. ram ́s Introduction to Surface Electromyography. USA: Jones and BarlettPublishers.; 2011.

 

Rodríguez D GJ, Pauda G. Asimetría debida a una mayor actividad en la hemicara derecha durante el movimiento facial deliberado no emocional. Rev Mex Psic. 2002;112:17-22.

 

M C. La medición de la calidad de vida. In: L CF, García H, ed. Epidemiología médica. México: : McGraw-Hill; 1994:189-199.

 

Mitani Y, Fukunaga M, Kanbara K, Takebayashi N, Ishino S, Nakai Y. Evaluation of psychophysiological asymmetry in patients with fibromyalgia syndrome. Appl Psychophysiol Biofeedback. Sep 2006;31(3): 217-225.

 

Gálvez L dR-PY. Esguince Cervical agudo: manejo psicofisiológico de la simetría muscular. Psic Salud. 2012;22(1):141-152.

 

Stohler C. The pain-adaptation Model: remembering James P. Lund. Journal of Orofacial Pain. 2009;24 (2):137-138.

 

Voerman GE, Vollenbroek-Hutten MM, Hermens HJ. Changes in pain, disability, and muscle activation patterns in chronic whiplash patients after ambulant myofeedback training. Clin J Pain. Sep 2006; 22(7):656-663.

 

Williams MA, Williamson, E., Gates. S., Mt-Isa, S., Castelnuovo, E., Ashby, D., Cooke. M., . A Randomised Controlled Trial Of Physiotherapy Treatments For Patients With Acute Whiplash Associated Disorders. A Randomised Controlled Trial Of Physiotherapy Treatments For Patients With Acute Whiplash Associated Disorders. Vol 101. WCTP Congress 2015 Physiotherapy 2015:eS633-eS832.

 

Sterling M. Physiotherapy management of whiplash-associated disorders (WAD). J Physiother. Mar 2014;60(1):5-12.

 

Angoules AG, Balakatounis KC, Panagiotopoulou KA, Mavrogenis AF, Mitsiokapa EA, Papagelopoulos PJ. Effectiveness of electromyographic biofeedback in the treatment of musculoskeletal pain. Orthopedics. Oct 2008;31(10).

 

Dunne RL, Kenardy J, Sterling M. A randomized controlled trial of cognitive-behavioral therapy for the treatment of PTSD in the context of chronic whiplash. Clin J Pain. Nov-Dec 2012;28(9):755-765.

 

Van Oosterwijck J, Nijs J, Meeus M, et al. Pain neurophysiology education improves cognitions, pain thresholds, and movement performance in people with chronic whiplash: A pilot study. The Journal of Rehabilitation Research and Development. 2011;48 (1):43.