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Aims: To explore the development of cervical motor and nociceptive dysfunction in whiplash patients (WPs) and non-recovery based on injury-related work-disability 1-year after injury compared with ankle-injured controls (ACs).Methods: A 1-year observational prospective study examining consecutive WPs, and age- and sex-matched ACs at 1 week and 3, 6 months and 1-year post-injury using semi-structured interviews; global pain rating (VAS0-10) and from McGill Pain Questionnaire the pain rating index (PRI-T), number-of-words-chosen; examining nociceptive functioning using cold pressor test (CPT), pressure algometry, and methodic palpation, and central pain processing using counter-stimulation; examining motor functioning by active cervical range-of-motion (CROM), neck strength (maximal voluntary contraction flexion/extension (MVC). One-year work disability/non-recovery was determined using a semi-structured interview. Results: A total of 141 WPs and 40 ACs were included. Total pain rating index (PRI-T) and number-of-words chosen (NWC) were higher in ACs initially, however, higher in WPs after 3, 6 months, and 1 year. Ongoing global pain was higher in WP initially and after 3, 6 months, but not 1 year. Pressure pain thresholds were reduced, and palpation were higher in the neck and jaw in WPs after 1 week, but not consistently different from AC afterwards. Cervical mobility was reduced in WPs after 1 week, 3, 6 months, but not 1 year and MVC was significantly reduced in WPs as compared with ACs after 1 week, and 1-year, but not 3, and 6 months. One-year non-recovery was only encountered in 11 WPs, and not in the AC group. Non-recovered WPs (N-WP) had consistently significantly higher VAS0-10, PRI-T, NWC, and reduced pressure pain thresholds and raised muscle-tenderness and reduced active-cervical-range of-motion, reduced active-neck-flexion/extension, and reported higher neck disability scores than recovered WPs. Of special interest there was increasing tenderness in trigeminal derived muscles based on palpation scores and marked reduction of PPDT most pronounced in N-WP as compared to recovered WPs and ACs.Conclusion: Cervical motor dysfunction and segmental nociceptive sensitization were present from early after injury in WPs and prolonged in N-WPs. Difference in trigeminal and cervical motor and sensory function in N-WPs could be of interest for future treatment studies.

Validated self-report measures of post-stroke fatigue are lacking. The Dutch Multifactor Fatigue Scale (DMFS) was translated into Danish, and response process evidence of validity was evaluated. DMFS consists of 38 Likert-rated items distributed on five subscales: Impact of fatigue (11 items), Signs and direct consequences of fatigue (9), Mental fatigue (7), Physical fatigue (6), and Coping with fatigue (5). Response processes to DMFS were investigated using a Three-Step Test-Interview (TSTI) protocol, and data were analyzed using Framework Analysis. Response processes were indexed on the following categories: (i) “congruent,” response processes were related to the subscale construct; (ii) “incongruent,” response processes were not related to the subscale construct; (iii) “ambiguous,” response processes were both congruent and incongruent or insufficient to evaluate congruency; and (iv) “confused,” participants did not understand the item. Nine adults were recruited consecutively 10–34 months post-stroke (median = 26.5) at an outpatient brain injury rehabilitation center in 2019 [five females, mean age = 55 years (SD = 6.3)]. Problematic items were defined as

Additional file 1.

ObjectivesThe purpose of this systematic review is to identify and synthesise studies evaluating performance-based functional outcome measures designed to evaluate the functional abilities of patients with neck pain.DesignSystematic review.Data sourcesA literature search using PubMed, Scopus, CINAHL, EMBASE, COCHRANE, Google Scholar and a citation mapping strategy was conducted until July 2019.Eligibility criteriaMore than half of the study’s patient population had neck pain or a musculoskeletal neck disorder and completed a functional-based test. Clinimetric properties of at least one performance-based functional tests were reported. Both traumatic and non-traumatic origins of neck pain were considered.Data extraction and synthesisRelevant data were then extracted from selected articles using an extraction guide. Selected articles were appraised using the Quality Appraisal for Clinical Measurement Research Reports Evaluation Form (QACMRR).ResultsThe search obtained 12 articles which reported on four outcome measures (functional capacity evaluations (FCE), Baltimore Therapeutic Equipment Work Simulator II (BTEWS II), Functional Impairment Test-Hand and Neck/Shoulder/Arm (FIT-HaNSA)) and a physiotherapy test package, to assess the functional abilities in patients with mechanical neck pain. Of the selected papers: one reports content validity, five construct validity, four reliability, one sensitivity to change and one both reliability and construct validity. QACMRR scores ranged from 68% to 95%.ConclusionsThis review found very good quality evidence that the FIT-HaNSA has excellent inter and intra-rater reliability and very weak to weak convergent validity. Excellent quality evidence of fair test-retest reliability, weak convergent validity and very weak known groups validity for the BTEWS II test was found. Good to excellent quality evidence exists that an FCE battery has poor to excellent reliability and very weak to strong validity. Good to excellent quality of weak to strong validity and trivial to strong effect sizes were found for a physiotherapy test package.Prospero registration numberCRD42018112358