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Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici

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

lingua: Inglese

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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