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The role of cervical spine range of motion in recovery from whiplash associated disorders

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Williams, Mark A. (2011) The role of cervical spine range of motion in recovery from whiplash associated disorders. PhD thesis, University of Warwick.

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Official URL: http://webcat.warwick.ac.uk:80/record=b2580969~S1

Abstract

This thesis investigates the role of cervical spine Range of Motion in the recovery from Whiplash Associated Disorders. In clinical practice, Health Care Professionals attach value to measurements of cervical spine Range of Motion for diagnostic, prognostic and treatment evaluation purposes. A systematic literature review found conflicting evidence as to whether cervical spine Range of Motion was a prognostic factor following a whiplash injury. Greater understanding of prognostic factors such as this may facilitate improvements in patient management. A second systematic literature review investigated the reliability and validity of methods for measuring cervical spine Range of Motion. The Cervical Range Of Motion (CROM) device was found to be the most rigorously tested and clinimetrically promising method and was subsequently investigated for intra- and inter-observer reliability in a group of whiplashinjured individuals and found to be substantially reliable. The CROM device was utilised in a longitudinal cohort study of 599 whiplash-injured patients to investigate the prognostic value of cervical spine Range of Motion for neck painrelated disability and patient-reported recovery at short, medium and long-term follow-up. A patient-reported version of cervical spine Range of Motion was also evaluated as a prognostic factor. Although useful for explaining disability at the time of measurement, active, passive and patient-reported forms of cervical spine Range of Motion were not significant prognostic factors for poor outcome when other physical and psychosocial factors were accounted for. The clinical implication of this research is that if patients are experiencing reduced cervical spine Range of Motion a few weeks after their whiplash injury they will not necessarily have a poor outcome in the longer term as is commonly believed at present.

Item Type: Thesis or Dissertation (PhD)
Subjects: R Medicine > RC Internal medicine
Library of Congress Subject Headings (LCSH): Whiplash injuries -- Prognosis, Cervical vertebrae, Joints -- Range of motion
Date: April 2011
Institution: University of Warwick
Theses Department: Warwick Medical School
Thesis Type: PhD
Publication Status: Unpublished
Supervisor(s)/Advisor: Cooke, Matthew, MB ChB ; Gates, Simon
Description: This is an abridged version for electronic use; please see the official URL for details on how to access the full version.
Extent: xxv, 504 leaves : ill., charts
Language: eng
URI: http://wrap.warwick.ac.uk/id/eprint/49214

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