Rom and Strengthening Exercises as a Treatment Option
ROM and Strengthening Exercises as a Treatment Option
There are multiple kinds of exercise that could be beneficial in treating acute whiplash. Literature shows exercises such as a McKenzie treatment, postural training exercise, endurance strengthening and motor control, eye fixation, isometric exercises, and resistive exercises. In reviewing the literature, these exercises were combined with other treatment strategies such as modalities or mobilization to get the most effective outcome. Also, at this point although there is a large amount of research done on treatment of whiplash injury, the conclusions that are made from this literature conflict each other. However, there is a consensus that excessive treatment of whiplash associated disorder may be counterproductive in the acute stages of injury. (Cochrane review) The evidence does not support episodes of care that last longer than 6-8 weeks with any one or combination of noninvasive interventions. If the intervention that is being attempted at that time is unsuccessful, it is then recommended that a different intervention be attempted. (Cochrane review) Based on this information, if active ROM and strengthening exercises are to be used, the intensity and frequency should be monitored closely to avoid increased injury. In comparing the effectiveness of these exercises, many studies compared them to periods of “standard care”. Standard Care included rest, analgesia, and general advice on gradual mobilization after a short period of rest.
McKenzie treatment is based on the principle of centralization of pain and the use of exercises to reduce the stress on the surrounding neck musculature. For acute WAD patient’s, the goal is to stretch and decrease the tightness of the cervical extensor muscles, which may be overly contracted in this patient population. A common exercise to accomplish this is the chin tuck, where the patient retracts their chin and repeats this activity for a given number of repetitions.
There are multiple kinds of exercise that could be beneficial in treating acute whiplash. Literature shows exercises such as a McKenzie treatment, postural training exercise, endurance strengthening and motor control, eye fixation, isometric exercises, and resistive exercises. In reviewing the literature, these exercises were combined with other treatment strategies such as modalities or mobilization to get the most effective outcome. Also, at this point although there is a large amount of research done on treatment of whiplash injury, the conclusions that are made from this literature conflict each other. However, there is a consensus that excessive treatment of whiplash associated disorder may be counterproductive in the acute stages of injury. (Cochrane review) The evidence does not support episodes of care that last longer than 6-8 weeks with any one or combination of noninvasive interventions. If the intervention that is being attempted at that time is unsuccessful, it is then recommended that a different intervention be attempted. (Cochrane review) Based on this information, if active ROM and strengthening exercises are to be used, the intensity and frequency should be monitored closely to avoid increased injury. In comparing the effectiveness of these exercises, many studies compared them to periods of “standard care”. Standard Care included rest, analgesia, and general advice on gradual mobilization after a short period of rest.
McKenzie treatment is based on the principle of centralization of pain and the use of exercises to reduce the stress on the surrounding neck musculature. For acute WAD patient’s, the goal is to stretch and decrease the tightness of the cervical extensor muscles, which may be overly contracted in this patient population. A common exercise to accomplish this is the chin tuck, where the patient retracts their chin and repeats this activity for a given number of repetitions.