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The sequelae of cervical whiplash injury. Static posturography for evaluating disability and the efficacy of rehabilitation (mesotherapy versus physiotherapy)
Florio A, Ceruti R, Sguazzini-Viscontini G, Cisari C
Europa Medicophysica [Mediterranean Journal of Physical and Rehabilitation Medicine] 1999;35(4):171-176
clinical trial
3/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: There is an increase in the number of patients presenting at physiatric out-patient clinics with the sequelae of cervical 'whiplash' injuries. The variety of the symptoms (dizzines in particular) and the paucity of clinical signs complicate the assessment of disability, of its natural history and of the medical-legal aspects. Rehabilitative Medicine is calledinto play during the post-acute stage. The real efficacy of the previously proposed interventions remains under debated. METHODS: In the present study, patients with the sequelae of cervical trauma underwent on objective, repeatable assessment with the aim of providing a basis on which to compare the outcomes of two different therapeutic approaches: mesotherapy and antalgic instrumental physiotherapy. The investigation was conducted in 50 patients. Inclusion criteria were: no history of previous major vestibular and visual pathologies; a persistent subjective 'feeling of instability'; no evidence of conditions of the locomotor system affecting the upright posture; the absence of focal lesions of the CNS, the presence of at least one pathologic stabilometric test result. PROTOCOL: Physiatric examination; stabilometric test; randomised prescription of therapy based on two different protocols; examination and stabilometric test following treatment. RESULTS: Comparison of the healthy/pathological posturographic data (track length and area) proved to be statistically significant; thus, static posturograghy is a valid evaluation method. The comparison of patients before and after treatment was not significant. CONCLUSIONS: Neither of the two therapeutic modalities induced any significant objective improvements, even though both had an extremely positive subjective effect.

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