Cervical motor dysfunction and its predictive value for long-term recovery in patients with acute whiplash-associated disorders: a systematic review.

OBJECTIVE To study the presence of cervical motor dysfunctions in acute whiplash-associated disorders, evaluate their course and assess their predictive value for long-term recovery. DESIGN Systematic literature review. METHODS PubMed and Web of Science databases were used to select studies of the presence of cervical motor dysfunctions within the acute stage (< 6 weeks) after whiplash trauma and/or their predictive value for the development of chronic whiplash-associated disorders. RESULTS The presence of cervical motor dysfunctions in the acute stage after whiplash trauma was investigated in 4 cohorts. The course of cervical motor dysfunctions in whiplash-associated disorders was examined in 4 cohorts, and the predictive value on outcome 1 year post-whiplash trauma was assessed in 3 cohorts. Reduced cervical mobility, disturbed kinaesthesia, and altered muscle activity were found in the acute stage, and these persisted over time in the moderate/severe group. The predictive value of examining the presence of cervical motor dysfunctions was doubtful. The course and predictive value of initial reduced cervical mobility was inconsistent. CONCLUSION Cervical motor dysfunctions are present soon after whiplash trauma persisting in those with moderate/severe symptoms. However, these dysfunctions have limited predictive value, and hence may not explain the complex clinical picture of whiplash-associated disorders. This systematic review highlights the need for differentiating between patients with acute whiplash-associated disorders taking into account the biopsychological framework.