Søren Krogh, Helge Kasch
Spinal Cord Injury Center of Western Denmark, Viborg Regional Hospital, DK-8800 Viborg, Denmark
DOI: 10.2340/16501977-2348

Objective: To investigate the temporal development of neck muscle function following whiplash injuries.
Design: A 1-year prospective, controlled observational study.
Subjects: A total of 141 individuals exposed to whiplash injury due to rear-end vehicle collisions and 40 age- and sex-matched controls with acute ankle distortion.
Methods: Neck muscle strength and endurance during cervical flexion and extension were measured at 1 week, 1 month, 3 months, 6 months and 1 year after injury.
Results: Notable reductions (23–30%) of neck strength in both directions were seen for whiplash-exposed subjects at all time points, compared with controls. Also, extensor endurance was reduced at 1 week, 1 month, 3 months, 6 months* and 1 year* (*non-significant). Within the whiplash group, non-recovered individuals (individuals who had not returned to pre-injury work capacity at one year) displayed ~50% reductions in cervical strength in both directions at all time points, compared with recovered whiplash individuals.
Conclusion: Cervical muscular functioning is impaired for at least one year after whiplash injury, well beyond the time course of recovery of neck mobility and pain sensations. In whiplash-exposed individuals, non-recovery is associated with considerable muscular weakness. There is a need for increased clinical focus on early neck function after whiplash injury.

Whiplash injuries from car accidents can result in long-term disabilities in the individual, with resulting considerable societal costs. The after-effects of whiplash injury have been investigated extensively, but not much is known about the long-term effect of these injuries on neck muscle functioning, or the role that neck muscle function plays in the process of recovery after whiplash injuries. This paper provides evidence that: () some areas of neck muscle function are affected for at least one year after the injury; and () whiplash-exposed individuals who recover (are able to return within one year to pre-injury work routines) present with much better neck muscle function than those who do not. The paper also discusses the importance of neck muscle function in rehabilitation after injury.