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Objective: The Buffalo Concussion Treadmill Test (BCTT) was developed to identify potential physiological system impairment (PSI) underlying persistent symptoms post-mild traumatic brain injury (mTBI). This study evaluates PSI in individuals 4 weeks to 6 months post-mTBI using the BCTT "failure" criteria, and additional exploratory measures of test duration and heart rate (HR) response. Setting: Tertiary hospital and university. Participants: Participants included 73 individuals 4 weeks to 6 months post-mTBI and a comparison group of 39 healthy controls (HCs). The mTBI group was further subgrouped at screening into those considering themselves asymptomatic (Asymp mTBI) (n = 35) or symptomatic (Symp mTBI) (n = 36). Design: Observational cohort study. Main Measures: BCTT; failure rate (%), test duration (minutes), HR responses. Results: : Thirty percent of the mTBI group (including 50% of the Symp and 9% of the Asymp subgroups) failed the BCTT. BCTT duration and associated overall HR change was significantly lower in the mTBI group and Symp subgroup compared with HCs. Compared with HCs maximal HR percentage was higher for the first 4 minutes of the test in the mTBI group, and for the first 2 minutes of the test for the Symp subgroup. Conclusions: Individuals post-mTBI demonstrated PSI impairment subacutely. In some individuals this was despite an initially reported absence of symptoms. The study also showed some preliminary evidence that BCTT duration and HR responses may be additionally informative post-mTBI. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Individuals with chronic whiplash-associated disorders (WADs) often note driving as a difficult task. This study's aims were to (1) compare, while driving, neck motor performance, mental effort, and fatigue in individuals with chronic WAD against healthy controls and (2) investigate the relationships of these variables and neck pain to self-reported driving difficulty in the WAD group. DESIGN: This study involved 14 participants in each group (WAD and control). Measures included self-reported driving difficulty and measures of neck pain intensity, overall fatigue, mental effort, and neck motor performance (head rotation and upper trapezius activity) while driving a simulator. RESULTS: The WAD group had greater absolute path of head rotation in a simulated city area and used greater mental effort (P = 0.04), but there were no differences in other measures while driving compared with the controls (all P ≥ 0.05). Self-reported driving difficulty correlated moderately with neck pain intensity, fatigue level, and maximum velocity of head rotation while driving in the WAD group (all P < 0.05). CONCLUSIONS: Individuals with chronic WAD do not seem to have impaired neck motor performance while driving yet use greater mental effort. Neck pain, fatigue, and maximum head rotation velocity could be potential contributors to self-reported driving difficulty in this group. [ABSTRACT FROM AUTHOR]

Study Design. Cross-sectional. Objective. To conduct a preliminary analysis of the physical, cognitive, and psychological domains contributing to self-reported driving difficulty after adjusting for neck pain, dizziness, and relevant demographics in chronic whiplash-associated disorders (WAD) using hierarchical regression modeling. Summary of Background Data. Pain is a risk factor for car crashes, and dizziness may affect fitness to drive. Both symptoms are common in chronic WAD and difficulty driving is a common complaint in this group. Chronic WAD is often accompanied by physical, cognitive, and psychological impairments. These impairments may contribute to self-reported driving difficulty beyond neck pain, dizziness, and relevant demographics. Methods. Forty individuals with chronic WAD participated. Dependent variables were the magnitude of self-reported driving difficulty assessed in the strategic, tactical, and operational levels of the Neck Pain Driving Index. Three models were developed to assess the contributions of independent variables (physical, cognitive, and psychological domains) to each of the 3 dependent variables after adjusting for neck pain intensity, dizziness, and driving demographics. The measures included were: physical domain--range and maximum speed of head rotation, performances during gaze stability, eye-head coordination, and visual dependency tests; cognitive domain--self-reported cognitive symptoms including fatigue and the trail making tests; and psychological domain--general stress, traumatic stress, depression, and fear of neck movements and driving. Results. Symptom duration was relevant to driving difficulty in the strategic and tactical levels. The cognitive domain increased statistical power to estimate the strategic and operational levels (P < 0.1 ) beyond other contributors. The physical domain increased statistical power to estimate the tactical level (P < 0.1 ) beyond other contributors. Conclusion. Physical and cognitive impairments independently contributed to self-reported driving difficulty in chronic WAD beyond neck pain, dizziness, and symptom duration. [ABSTRACT FROM AUTHOR]

The article discusses a study on symptoms that cause postural control disturbance after suffering from a whiplash injury. The study was performed by evaluating an existing study which describes the symptoms, treatment and connections of symptoms of the postural control disturbance towards a whiplash injury. Results of the study revealed that symptoms including pain sensitivity, postural deficits, and dizziness contribute to development of postural control disturbance.

Objective: Individuals with chronic whiplash-associated disorders (WADs) often note driving as a difficult task. This study's aims were to (1) compare, while driving, neck motor performance, mental effort, and fatigue in individuals with chronic WAD against healthy controls and (2) investigate the relationships of these variables and neck pain to self-reported driving difficulty in the WAD group., Design: This study involved 14 participants in each group (WAD and control). Measures included self-reported driving difficulty and measures of neck pain intensity, overall fatigue, mental effort, and neck motor performance (head rotation and upper trapezius activity) while driving a simulator., Results: The WAD group had greater absolute path of head rotation in a simulated city area and used greater mental effort (P = 0.04), but there were no differences in other measures while driving compared with the controls (all P ≥ 0.05). Self-reported driving difficulty correlated moderately with neck pain intensity, fatigue level, and maximum velocity of head rotation while driving in the WAD group (all P < 0.05)., Conclusions: Individuals with chronic WAD do not seem to have impaired neck motor performance while driving yet use greater mental effort. Neck pain, fatigue, and maximum head rotation velocity could be potential contributors to self-reported driving difficulty in this group.

Study Design: Cross-sectional., Objective: To conduct a preliminary analysis of the physical, cognitive, and psychological domains contributing to self-reported driving difficulty after adjusting for neck pain, dizziness, and relevant demographics in chronic whiplash-associated disorders (WAD) using hierarchical regression modeling., Summary of Background Data: Pain is a risk factor for car crashes, and dizziness may affect fitness to drive. Both symptoms are common in chronic WAD and difficulty driving is a common complaint in this group. Chronic WAD is often accompanied by physical, cognitive, and psychological impairments. These impairments may contribute to self-reported driving difficulty beyond neck pain, dizziness, and relevant demographics., Methods: Forty individuals with chronic WAD participated. Dependent variables were the magnitude of self-reported driving difficulty assessed in the strategic, tactical, and operational levels of the Neck Pain Driving Index. Three models were developed to assess the contributions of independent variables (physical, cognitive, and psychological domains) to each of the 3 dependent variables after adjusting for neck pain intensity, dizziness, and driving demographics. The measures included were: physical domain-range and maximum speed of head rotation, performances during gaze stability, eye-head coordination, and visual dependency tests; cognitive domain-self-reported cognitive symptoms including fatigue and the trail making tests; and psychological domain-general stress, traumatic stress, depression, and fear of neck movements and driving., Results: Symptom duration was relevant to driving difficulty in the strategic and tactical levels. The cognitive domain increased statistical power to estimate the strategic and operational levels (P < 0.1) beyond other contributors. The physical domain increased statistical power to estimate the tactical level (P < 0.1) beyond other contributors., Conclusion: Physical and cognitive impairments independently contributed to self-reported driving difficulty in chronic WAD beyond neck pain, dizziness, and symptom duration., Level of Evidence: 3.

Background: It has been shown that perception of elbow joint position is affected by changes in head and neck position. Further, people with whiplash-associated disorders (WAD) present with deficits in upper limb coordination and movement., Objectives: This study is aimed to determine whether the effect of changes in head position on elbow joint position error (JPE) is more pronounced in people with WAD, and to determine whether this is related to the participant's pain and anxiety levels., Methods: Nine people with chronic and disabling WAD and 11 healthy people participated in this experiment. The ability to reproduce a position at the elbow joint was assessed after changes in the position of the head and neck to 30 degrees , and with the head in the midline. Pain was monitored in WAD participants., Results: Absolute elbow JPE with the head in neutral was not different between WAD and control participants (P=0.5). Changes in the head and neck position increased absolute elbow JPE in the WAD group (P<0.05), but did not affect elbow JPE in the control group (P=0.4). There was a connection between pain during testing and the effect of changes in head position on elbow JPE (P<0.05)., Discussion: Elbow JPE is affected by movement of the head and neck, with smaller angles of neck rotation in people with WAD than in healthy individuals. This observation may explain deficits in upper limb coordination in people with WAD, which may be due to the presence of pain or reduced range of motion in this population.