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A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Europa Medicophysica 1999 December;35(4):171-6

language: English

The seque­lae of cer­vi­cal whip­lash inju­ry. Static pos­tu­rog­ra­phy for eval­u­at­ing dis­abil­ity and the effi­ca­cy of reha­bil­i­ta­tion (meso­ther­a­py ver­sus phys­io­ther­a­py)

Florio A., Ceruti R., Sguazzini-Viscontini G., Cisari C.

Rehabilitation Unit, Azienda Ospedaliera “Maggiore del­la Carità”, Novara, Italy


BACKGROUND: There is an ­increase in the num­ber of ­patients pre­sent­ing at phy­siat­ric out-­patient clin­ics ­with the seque­lae of cerv­i­cal “whip­lash” inju­ries. The varie­ty of the symp­toms (diz­zi­ness in par­tic­u­lar) and the pau­ci­ty of clin­i­cal ­signs com­pli­cate the assess­ment of dis­abil­ity, of its nat­u­ral his­to­ry and of the med­i­cal-­legal ­aspects. Rehabilitative Medicine is cal­led­into ­play dur­ing the ­post-­acute ­stage. The ­real effi­ca­cy of the pre­vi­ous­ly pro­posed inter­ven­tions ­remains ­under debat­ed.
METHODS: In the ­present ­study, ­patients ­with the seque­lae of cer­vi­cal trau­ma under­went an objec­tive, repeat­able assess­ment ­with the aim of pro­vid­ing a ­basis on ­which to com­pare the out­comes of two dif­fer­ent ther­a­peu­tic approach­es: meso­ther­a­py and antal­gic instru­men­tal phys­io­ther­a­py. The inves­ti­ga­tion was con­duct­ed in 50 ­patients. Inclusion cri­te­ria ­were: no his­to­ry of pre­vi­ous cra­ni­al-cer­vi­cal trau­ma; no his­to­ry of pre­vi­ous ­major ves­tib­u­lar and vis­u­al pathol­o­gies; a per­sis­tent sub­jec­tive “feel­ing of instabil­ity”; no evi­dence of con­di­tions of the loco­mo­tor ­system affect­ing the ­upright pos­ture; the ­absence of ­focal ­lesions of the CNS, the pres­ence of at ­least one path­o­log­i­cal sta­bil­o­met­ric ­test ­result. Protocol: phy­siat­ric exam­ina­tion; sta­bil­o­met­ric ­test; ran­dom­ised pre­scrip­tion of ther­a­py ­based on two dif­fer­ent pro­to­cols; exam­ina­tion and sta­bil­o­met­ric ­test fol­low­ing treat­ment.
RESULTS: Comparison of the ­healthy/path­o­log­i­cal pos­tu­ro­graph­ic ­data (­track ­length and ­area) ­proved to be sta­tis­ti­cal­ly sig­nif­i­cant; ­thus, stat­ic pos­tu­rog­raghy is a val­id eval­u­a­tion meth­od. The com­par­i­son of ­patients ­before and ­after treat­ment was not sig­nif­i­cant.
CONCLUSIONS: Neither of the two ther­a­peu­tic modal­ities ­induced any sig­nif­i­cant objec­tive improve­ments, ­even ­though ­both had an extreme­ly pos­i­tive sub­jec­tive ­effect.

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