The Effect of Visual Feedback of the Neck During Movement in People With Chronic Whiplash-Associated Disorders: An Experimental Study

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STUDY DESIGN:Controlled laboratory study.BACKGROUND:Chronic whiplash-associated disorder (WAD) is an important health issue associated with poor recovery outcomes. Sensorimotor incongruence (SMI), defined as a mismatch between the efference copy in the brain and afferent sensory feedback from the body, is proposed as a possible underlying cause of chronic pain.OBJECTIVES:To determine whether SMI causes sensory disturbances or pain in people with chronic WAD and healthy controls.METHODS:Sixty-four participants (30 with chronic WAD and 34 healthy controls) participated in a visual feedback experiment involving the neck and a bimanual coordination experiment involving the arms. In both experimental setups, SMI was induced by modifying the visual feedback during movement. Sensory disturbances and pain were the primary outcomes.RESULTS:A statistically significant difference in perceived sensory disturbance between conditions was found in the WAD group (P<.001). Intensity scores were highest for induced SMI, but only for visual feedback of the neck and not for visual feedback of the arms. This effect was not present in the control group (P = .139). Sensorimotor incongruence did not affect pain in either group.CONCLUSION:Persons with chronic WAD are more susceptible to sensory disturbances owing to SMI, and this effect is specific to the region affected by pain. The hypothesis that SMI causes pain was not substantiated by the results of the present study.

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