Patients with whiplash associated disorder Grade II can be distinguished from healthy control subjects according to the presence of cervical muscle dysfunction, as assessed by surface electromyography of the upper trapezius muscles. Particularly the decreased ability to relax the trapezius muscles seems to be a promising feature to identify patients with whiplash associated disorder Grade II. Assessment of the muscle (dys)function by surface electromyography offers a refinement of the whiplash associated disorder classification and provides an indication to a suitable therapeutic approach.

No abstract

It appears that the cervical muscle dysfunction in patients with chronic whiplash-associated disorder Grade 2 is not related to the specific trauma mechanism. Rather, cervical muscle dysfunction appears to be a general sign in diverse chronic neck pain syndromes.

Pressure ulcers are a large problem in subjects who use a wheelchair for their mobility. These ulcers originate beneath the bony prominences of the pelvis and progress outward as a consequence of prolonged pressure. Interface pressure is used clinically to predict and prevent pressure ulcers. However, the relation between interface pressure and the development of pressure ulcers is not clear. A systematic review was performed to address the research question of whether interface pressure can be used to predict the development of pressure ulcers or to determine the prognosis of an ulcer once developed. Seven studies were identified that measured interface pressure and used the development or healing of pressure ulcers as an outcome measure. There appears to be a weak qualitative relation between interface pressure and the development of pressure ulcers. However, no conclusive clinical threshold for the interface pressure can be given. This, combined with the influence of individual characteristics, the low internal validity of interface pressure measurement for the prediction of pressure ulcers, and an incongruent relation between pressure magnitude and duration, results in the fact that no quantification of the predictive or prognostic value of interface pressure can be given.