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• W1556554501 abstract "Dizziness and unsteadiness associated with reports of visual disturbances and loss of balancenare common complaints in those with persistent whiplash associated disorders (WAD). Annumber of causes for these symptoms have been suggested, but it is feasible that dizziness is anconsequence of abnormal afferent input to the postural control system due either to damage tonthe central nervous system, the peripheral vestibular system and or abnormal cervical afferentninput. n The aim of this thesis was to identify, more precisely, the nature and possible aetiology of thensymptoms of dizziness and unsteadiness in subjects with whiplash as well as investigate anynphysical impairments of postural control, particularly with respect to abnormal cervicalnafferent input. A better understanding of the causes and relationships of such persistentnproblems was considered vital to guide physiotherapists towards suitable diagnostic measuresnand relevant rehabilitation.n n The series of studies in this thesis investigated the symptom of dizziness and disturbances tonpostural control in subjects with persistent WAD and for the first time, took into considerationnsuch factors as medication, anxiety, age and compensation status. Three tests which werenlikely to reflect disordered cervical afferent input were examined: cervical joint position errorn(JPE), an eye movement control measure, the smooth pursuit neck torsion test (SPNT) andnmeasurement of dynamic balance control via computerised dynamic posturography.nComparison was made between subjects with whiplash complaining of dizziness and those notncomplaining of these symptoms. Relationships between cervical JPE, balance and SPNT wereninvestigated. A final study was conducted in which subjects with known pure peripheralnunilateral vestibular loss were examined to assess the potential of these tests to differentiatenbetween cervical and vestibular involvement. The results of the studies demonstrated that impairments identified in cervical JPE, balance andnSPNT are common in subjects with persistent WAD who both do, and do not, complain ofnspecific symptoms such as loss of balance or dizziness. Deficits in all three measures were greater in subjects with the symptomatic complaints of dizziness or unsteaduiess. Thencomplaint of dizziness and the deficits in postural control could not be attributed tonmedications, compensation, anxiety or age. Only weak relationships were observed betweenncervical JPE, balance and SPNT, implying a need to assess all three measures to identify andnmanage disturbances in the postural control system in subjects following a whiplash injury.nFurther the SPNT and selected balance tests were shown to effectively differentiate betweennsubjects with whiplash and subjects with discreet unilateral vestibular loss. Tests of cervicalnjoint position error did not differentiate between the groups.n n The results suggest that the reported characteristics of dizziness and causes of postural controlndisturbances in subjects with WAD are different to those with discreet vestibular pathology.nThe most plausible primary cause of the disturbances in subjects with WAD is abnormalncervical afferent to the postural control system.n n This series of studies has been the first comprehensive investigation of factors associated withnthe symptom of dizziness and disturbances to postural control in subjects with persistent WAD.nThis research is a vital step towards early identification of the most appropriate assessment andnmanagement strategies for patients with complaints of dizziness and/or disturbances in posturalncontrol following a whiplash injury. Early recognition of these disturbances may ultimatelynassist in the prevention of some of the persistent complaints and physical impairmentsnfollowing a whiplash injury.n" @default.
• W1556554501 created "2016-06-24" @default.
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• W1556554501 date "2005-01-01" @default.
• W1556554501 modified "2023-09-26" @default.
• W1556554501 title "Dizziness and unsteadiness in persistent whiplash associated disorders : the role of cervical afferent dysfunction" @default.
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