Lecture 9

Question 1

Neck pain with movement coordination impairments (wiplash)

associated w/ shoulder problems

Dizziness/nausea

Headache, concentration issues or memory difficluts

Confusioned

Heightened affective distress

Hypersensitivity to everything since they’re in that chronically sensitive state

Every little thing sets them off because they’re hypersneitive to everything (on high alert)
* thermal
* acoustic
* olfactory
* visual
* mechanical

Iritability very important to find

Question 2

Would someone with a wiplash injury have an increased or decreased pain sentivity?

Answer 2

Increased - they’re hypersensititve to everything

doesnt take as much to bring on their symptoms

Question 3

NOTE: Their neck pain is going to be present at mid range and end range (People w/ ROM issues only present w/ end range problems)

may have lots of trigger points

May look a lot like a cervicogenic HA except we have a MOI now

Question 4

KNOW: Wiplash pts would proably have neck endurance muscle loss

Question 5

KNOW: These pts would have proprioception problems. (swelling)

Question 6

KNOW: We don’t really do much physical stuff to an acute whip lash pt

Question 7

KNOW: Acute whiplash around 6 wks, subacute = 6-12

Question 8

What does nociplastic mean?

Answer 8

Nociception (pain) despite no clear evidence of actual or threated tissue damage

Question 9

Does acute pain always mean tissue damage w/ whiplash?

Answer 9

No, it might be nociplastic pain

Question 10

Does chronic pain automatically mean nociplastic pain?

Answer 10

No, the tissue might still be damaged / irretated

Question 11

How does neuropathic pain present in someone w/ a whiplash injury?

Answer 11

referred arm pain

Question 12

What 4 intervention would you use w/ a pt that has nociceptive pain after whiplash?

Answer 12

Exercise
Massage
TENS
Manipulation

Question 13

What interventions would you do w/ a nociplastic (more chronic) whiplash pt?

Answer 13

Education
EX
Massage
Manipulation
TENS

Question 14

What would you do for a neuropathic whiplash pt?

Answer 14

EX

Question 15

Poor WAD prognosis if their NDI score is above ______

Note: this is also an increased risk of presistent pain

Answer 15

30%

Question 16

Poor WAD prognosis if their high pain intensity score is = to or greater than __/10

NOTE: this also is the same for an increased risk o presistent pain

Answer 16

6

Question 17

KNOW: None of the things below affect prognosis for WAD

Angular deformity of the neck
Impact direction
Seating position in the vehicle
Awareness of impending collision
Having a headrest in place at the time of the collision
Stationary vs moving when hit (the car moving)
Older age - DOES NOT AFFTECT WAD

Question 18

Should an acute WAD pt be wearing a soft collar?

Answer 18

No collar - theres no stufcutral damage - we need to get them to remain active, act as usual

Question 19

KNOW: for someone w/ chronic WAD its best to find a psyco therapist to assest along w/ you

KNOW: We start throwing in endurance EX for subacute / longterm WAP injuries to try and reup those muscles

Question 20

KNOW: Whenever a WAD has long term difficulties they stop moving their neck. We want to throw in vestibular work for someone w/ chronic WAD because they arent moving their neck which means they arent ever sitmulating their vestiular

Question 21

KNOW: If pt is scared of pain w/ right shoulder flexion get them to work on left shoulder flexion. It will help those neuro pathways on both sides to form

Question 22

What is graded exposure?

Answer 22

Doing some intervention that encourgaes moving into pain which they are fearful of

We start slowly

For EX: if picking something off the ground hurts start by going halfway down