• Pascal Madeleine, Hanne Prietzel, Heine Svarrer, and Lars Arendt-Nielsen.
• Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark. pm@smi.auc.dk
• Arch Phys Med Rehabil. 2004 Mar 1;85(3):432-8.

ObjectivesTo quantify neck mobility and posture with and without various postural perturbations.DesignA multivariable 2-group study with repeated measures and treatments.SettingA human performance laboratory.ParticipantsEleven patients with chronic whiplash injury (mean age, 33.3+/-6.7 y; weight, 73.4+/-11.4 kg; height, 173.3+/-7.2 cm) with a sex- and age-matched control group (mean age, 33.1+/-6.8 y; weight, 68+/-12.5 kg; height, 171.5+/-6.3 cm).InterventionsNeck mobility and the effects of postural perturbations affecting the visual, vestibular, cutaneous, proprioceptive, and nociceptive systems were measured.Main Outcome MeasuresActive range of motion, neck position sense, and postural activity.ResultsWe found significantly reduced neck mobility and increased postural activity in the patient group compared with the control group. In patients, there was significantly greater postural activity with eyes closed, eyes open and speaking, and eyes closed with Achilles' tendons vibrations compared with eyes open with no vibrations. In the controls, there was no significant effect of experimental muscle pain on postural activity.ConclusionsPatients with chronic whiplash injury had a protective response to neck movement and different tuning, sequencing, and execution of the postural synergies probably because of excessive reliance on visual input despite a possible deficit and altered vestibular and/or proprioceptive activity. In healthy volunteers, the pain induced by a single bolus injection of hypertonic saline was probably too limited in intensity and spreading to decrease postural stability.

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