Headache production during physical examination in patients with and without headache attributed to a whiplash injury: A case-control study
Background Provocation of headache on physical examination of the neck may reflect a role of cervical structures in the presence of acute whiplash-associated headache (WAH). Objective To determine differences in headache provocation during physical tests in people with and without WAH after a whipla...
| Autores: | , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2023 |
| País: | España |
| Institución: | Universidad de Sevilla (US) |
| Repositorio: | idUS. Depósito de Investigación de la Universidad de Sevilla |
| OAI Identifier: | oai:idus.us.es:11441/160262 |
| Acceso en línea: | https://hdl.handle.net/11441/160262 https://doi.org/10.1016/j.msksp.2023.102779 |
| Access Level: | acceso abierto |
| Palabra clave: | Whiplash-associated disorders Whiplash-associated headache Physical testing Intra-rater test-retest reliability Neuromusculoskeletal disorders |
| Sumario: | Background Provocation of headache on physical examination of the neck may reflect a role of cervical structures in the presence of acute whiplash-associated headache (WAH). Objective To determine differences in headache provocation during physical tests in people with and without WAH after a whiplash injury. Design Case-control study. Methods Forty-seven people with acute whiplash-associated disorders participated, 28 with WAH. Passive accessory intervertebral movement over the tubercle of C1, the spinous processes of C2-C3 and facet joints of C0-C4, the flexion-rotation test (FRT), manual palpation of cranio-cervical muscles and the upper limb neurodynamic test + cranio-cervical flexion were assessed bilaterally twice by a blinded examiner; headache provocation was determined. Cohen's kappa and Chi-squared were determined to evaluate the intra-rater reliability of test results and differences between groups, respectively. A logistic regression model was also performed. Results Intra-rater reliability of headache provocation was good or excellent for most tests. Significant differences between groups were found with higher positive tests in WAH for the assessment of C2 (68%), the most painful side of C0-C1 (57%), C1-C2 (75%) and C2-C3 (53%), most (79%) and least (25%) restricted sides of the FRT, and manual palpation of the most painful side for the trapezius (53%), masseter (50%) and temporalis (46%) muscles. Provocation of headache during the assessment of C2 and C1-C2 on the most painful side demonstrated the highest association with WAH. Conclusion Mechanical provocation of headache is more frequent in people with WAH than in those without headache soon after a whiplash injury. |
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