Is the Method of Signal Analysis and Test Selection Important for Measuring Standing Balance in Subjects with Persistent Whiplash?

Abstract

Dizziness and or unsteadiness, associated with episodes of loss of balance, are frequent complaints in those suffering from persistentproblems following a whiplash injury. Research has been inconclusive with respect to possible aetiology, discriminative tests and analysesused. The aim of this pilot research was to identify the test conditions and the most appropriate method for the analysis of sway that may differentiate subjects with persistent whiplash associated disorders (WAD) from healthy controls. The six conditions of the Clinical Test for Sensory Interaction in Balance was performed in both comfortable and tandem stance in 20 subjects with persistent WAD compared to 20 control subjects. The analyses were carried out using a traditional method of measurement, total sway distance, to results obtained from the use of wavelet analysis. Subjects withWAD were significantly less able to complete the tandem stance tests on a firm surface than controls. In comfortable stance, using wavelet analysis, significant differences between subjects withWAD and the control group were evident in total energy of the trace for all test conditions apart from eyes open on the firm surface. In contrast, the results of the analysis using total sway distance revealed no significant differences between groups across all six conditions. Wavelet analysis may be more appropriate for detecting disturbances inbalance in whiplash subjects because the technique allows separation of the noise from the underlying systematic effect of sway. Thesefindings will be used to direct future studies on the aeitiology of balance disturbances in WAD.