The Journal of head trauma rehabilitation · 2025
Cervical Range of Motion and Pericranial Muscle Tenderness in Patients With Persistent Post-Concussion Symptoms: A Cross-Sectional Study.
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Stenbro Laura Westh, Hellemose Line Amalie, Kothari Simple Futarmal, Kasch Helge, Nielsen Jørgen Feldbæk, Eggertsen Peter Preben
Аннотация
OBJECTIVES: To examine the active cervical range of motion (aCROM) in 15- to 30-year-old patients with high levels of persistent post-concussion symptoms (PCS) 2-6 months after a mild traumatic brain injury (mTBI) compared with healthy individuals. Additionally, we examined the association between aCROM, the severity of PCS (measured by the Rivermead Post-Concussion Symptom Questionnaire [RPQ]), and the pericranial tenderness score (pTTS).
SETTING: A research outpatient clinic at a rehabilitation hospital in the Central Denmark Region. Patients were recruited by referral from general practitioners or emergency departments.
PARTICIPANTS: Young individuals (aged 15-30 years) with high levels of PCS (n = 108) within 2-6 months after a direct head trauma. Reference data of aCROM was obtained from a published study conducted on healthy individuals (n = 100) (aged 20-29 years).
DESIGN: Cross-sectional study using baseline data from a randomized controlled trial examining the effect of a non-pharmacological intervention for PCS.
MAIN OUTCOME MEASURES: aCROM measured using a CROM 3 device, pTTS, and RPQ-score.
RESULTS: Patients with PCS had a 5% lower mean total aCROM compared with a published reference mean on healthy individuals (mean group difference [95% confidence interval] = -19°[-31; -7.0], P = .002). The reduction in aCROM was primarily driven by a subset of individuals (n = 12). A significant negative correlation was found between total pTTS and total aCROM ( ρ = -.43, P < .001). There was no significant correlation between the RPQ score and the total aCROM (r = -0.12, P = .214).
CONCLUSION: The findings indicate that concomitant cervical impairment may exist in a subset of patients with PCS. A clinical implication could be to include systematic neck examination in patients with mTBI to ensure accurate diagnosis. However, further research is necessary before implementing this information into regular clinical practice.
SETTING: A research outpatient clinic at a rehabilitation hospital in the Central Denmark Region. Patients were recruited by referral from general practitioners or emergency departments.
PARTICIPANTS: Young individuals (aged 15-30 years) with high levels of PCS (n = 108) within 2-6 months after a direct head trauma. Reference data of aCROM was obtained from a published study conducted on healthy individuals (n = 100) (aged 20-29 years).
DESIGN: Cross-sectional study using baseline data from a randomized controlled trial examining the effect of a non-pharmacological intervention for PCS.
MAIN OUTCOME MEASURES: aCROM measured using a CROM 3 device, pTTS, and RPQ-score.
RESULTS: Patients with PCS had a 5% lower mean total aCROM compared with a published reference mean on healthy individuals (mean group difference [95% confidence interval] = -19°[-31; -7.0], P = .002). The reduction in aCROM was primarily driven by a subset of individuals (n = 12). A significant negative correlation was found between total pTTS and total aCROM ( ρ = -.43, P < .001). There was no significant correlation between the RPQ score and the total aCROM (r = -0.12, P = .214).
CONCLUSION: The findings indicate that concomitant cervical impairment may exist in a subset of patients with PCS. A clinical implication could be to include systematic neck examination in patients with mTBI to ensure accurate diagnosis. However, further research is necessary before implementing this information into regular clinical practice.