7.3  Whiplash Associated Disorder. (60 BB)

Age at test:       30

Key Signs:

These patients show a characteristic pattern consisting of three components. First, roll angles are abnormal for several complex gait tasks (for example walking up and down stairs or going over barriers - see first set of traces below). Second, gait tasks with simultaneous large voluntary head movements (walking with head pitching movements – see second set of traces below) show pitch angles and velocities less than normal, and thirdly, stance tasks show sway slightly greater than normal values. This pattern often yields a normal Balance Control Index (even to a less than normal index without the stairs values – see summary below).

Walking up and down stairs.

Walking 3m with head pitching.

Summary Data:

The summary shows the typical pattern due to these patients stiffening themselves up during gait. Any task which requires head movements to keep gaze fixated, for example walking upstairs or over barriers, leads the excessive roll sway because the trunk is moved instead of the head on the trunk. In contrast, for walking tasks where gaze fixation is not required, the patient hardly moves the head and walks slowly leading to less than normal trunk movement. Thus, rehabilitation should concentrate on improving neck mobility.