@article{00bb1382f4a24d259b7d43f4cfcaf7d5,
title = "Biopsychosocial sequelae and recovery trajectories from whiplash injury following a motor vehicle collision",
abstract = "BACKGROUND CONTEXT: Five out of 10 injured in a motor vehicle collision (MVC) will develop persistent pain and disability. It is unclear if prolonged symptoms are related to peritraumatic pain/disability, psychological distress, muscle fat, lower extremity weakness. PURPOSE: To test if widespread muscle fat infiltration (MFI) was (1) unique to those with poor recovery, (2) present in the peritraumatic stage, (3) related to known risk factors. STUDY DESIGN/SETTING: A cohort study, single-center academic hospital. PATIENT SAMPLES: A total of 97 men and women (age 18–65) presenting to an urban academic emergency medicine department following MVC, but not requiring inpatient hospitalization. PRIMARY OUTCOME MEASURE: Neck disability at 12-months. METHODS: Participants underwent magnetic resonance imaging (MRI) to quantify neck and lower extremity MFI, completed questionnaires on pain/disability and psychological distress (< 1-week, 2-weeks, 3-, and 12-months) and underwent maximum volitional torque testing of their lower extremities (2-weeks, 3-, and 12-months). Percentage score on the Neck Disability Index at 12-months was used for a model of (1) Recovered (0%–8%), (2) Mild (10%–28%), and (3) Moderate/Severe (≥ 30%). This model was adjusted for BMI and age. RESULTS: Significant differences for neck MFI were revealed, with the Recovered group having significantly lower neck MFI than the Mild and Moderate/Severe groups at all time points. The Mild group had significantly more leg MFI at 12-months (p=.02) than the Recovered group. There were no other significant differences at any other time point. Lower extremity torques revealed no group differences. The Traumatic Injury Distress Scale (TIDS) and MFI of the neck at 1-week postinjury significantly predicted NDI score at 12-months. CONCLUSIONS: Higher neck MFI and distress may represent a risk factor though it is unclear whether this is a pre-existing phenotype or result of the trauma. Trial Registration: ClinicalTrials.gov Identifier: NCT02157038.",
keywords = "Distress, MRI, Muscle, Pain, Trauma, Whiplash",
author = "Elliott, {J. M.} and Walton, {D. M.} and Albin, {S. R.} and Courtney, {D. M.} and Siegmund, {G. P.} and Carroll, {L. J.} and Weber, {K. A.} and Smith, {A. C.}",
note = "Funding Information: This work was supported by the National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD079076-01A1). ACS was supported by NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development (K01HD106928) and the Boettcher Foundation's Webb-Waring Biomedical Research Program. We would like to thank the participants for their time and efforts. We also wish to thank Professor Todd B. Parrish, Northwestern University (Departments of Biomedical Engineering and Radiology) for his insights, expertise, and time in turning concept into reality with regards to our advanced imaging acquisition, analyses, and interpretation. We would also like to express our thanks to Professor George Hornby and Dr Hyosub Kim for their expertise in spinal cord injury and in designing and collecting data for maximal volitional torque generation. Author disclosures: JME: Grant: NIH (H, paid directly to institution); Royalties: Handspring Publishing (A); Consulting: Orofacial Therapeutics (B); Grants: NSW Spinal Cord Injury Research Awards (H, paid directly to institution). DMW: Royalties: Handspring Publishing (A); Consulting: Pain Assessment and Prediction (B). SRA: Nothing to disclose. DMC: Grant: NIH (H, paid directly to institution). GPS: Consulting fee or honorarium: NIH (B, paid directly to institution); Stock Ownership: MEA Forensic (10% ownership) LJC: Nothing to disclose. KW: Grant: NIH (G, paid directly to institution); Fees for participation in review activities such as data monitoring boards, statistical analysis, end point committees, and the like: Norwegian Chiropractors Research Foundation (A); Speaking and/or Teaching Arrangements: Parker University (C). ACS: Grant: NIH (NIH NICHD K01 Award, paid directly to institution) (E). Funding Information: This work was supported by the National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development ( R01 HD079076-01A1 ). ACS was supported by NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development ( K01HD106928 ) and the Boettcher Foundation's Webb-Waring Biomedical Research Program . Funding Information: Author disclosures: JME: Grant: NIH (H, paid directly to institution); Royalties: Handspring Publishing (A); Consulting: Orofacial Therapeutics (B); Grants: NSW Spinal Cord Injury Research Awards (H, paid directly to institution). DMW: Royalties: Handspring Publishing (A); Consulting: Pain Assessment and Prediction (B). SRA: Nothing to disclose. DMC: Grant: NIH (H, paid directly to institution). GPS: Consulting fee or honorarium: NIH (B, paid directly to institution); Stock Ownership: MEA Forensic (10% ownership) LJC: Nothing to disclose. KW: Grant: NIH (G, paid directly to institution); Fees for participation in review activities such as data monitoring boards, statistical analysis, end point committees, and the like: Norwegian Chiropractors Research Foundation (A); Speaking and/or Teaching Arrangements: Parker University (C). ACS: Grant: NIH (NIH NICHD K01 Award, paid directly to institution) (E). Publisher Copyright: {\textcopyright} 2023 Elsevier Inc.",
year = "2023",
month = jul,
doi = "10.1016/j.spinee.2023.03.005",
language = "English (US)",
volume = "23",
pages = "1028--1036",
journal = "Spine Journal",
issn = "1529-9430",
publisher = "Elsevier Inc.",
number = "7",
}