A meta-analysis and systematic review of changes in joint position sense and static standing balance in patients with whiplash-associated disorder

Journal article


Abichandani, D., Mazaheri, M., Kingman, I., Treleaven, J. and Falla, D. (2021). A meta-analysis and systematic review of changes in joint position sense and static standing balance in patients with whiplash-associated disorder. PLoS ONE. https://doi.org/10.1371/journal.pone.0249659
AuthorsAbichandani, D., Mazaheri, M., Kingman, I., Treleaven, J. and Falla, D.
Abstract

Objective
To synthesise and analyse the current evidence regarding changes in joint position sense (JPS) and standing balance in people with whiplash-associated disorder (WAD) taking the presence or absence of dizziness into account.

Data sources
PubMed, CINAHL Plus, Web of Science, Embase, MEDLINE and APA PsycINFO were searched by two independent reviewers from inception until August 2020 and reference lists of all included studies were also reviewed.

Study selection
Only cross-sectional studies that measured JPS and/or standing balance between people with WAD vs. healthy controls (HC) or people with WAD complaining of dizziness (WADD) vs. those not complaining of dizziness (WADND) were selected.

Data extraction
Relevant data were extracted using specific checklists and quality assessment was performed using Downs and Black Scale (modified version).

Data synthesis
Twenty-six studies were included. For JPS, data were synthesized for absolute error in the primary plane of movement for separate movement directions. For standing balance, data were synthesized for traditional time- and frequency domain sway parameters considering the conditions of eyes open (EO) and eyes closed (EC) separately. For meta-analysis, reduced JPS was observed in people with WAD compared to HC when the head was repositioned to a neutral head position (NHP) from rotation (standardised mean difference [SMD] = 0.43 [95%: 0.24–0.62]) and extension (0.33 [95%CI: 0.08–0.58]) or when the head was moved toward 50° rotation from a NHP (0.50 [0.05–0.96]). Similarly, people with WADD had reduced JPS compared to people with WADND when the head was repositioned to a NHP from rotation (0.52 [0.22–0.82]). Larger sway velocity and amplitude was found in people with WAD compared to HC for both EO (0.62 [0.37–0.88] and 0.78 [0.56–0.99], respectively) and EC (0.69 [0.46–0.91] and 0.80 [0.58–1.02]) conditions.

Conclusion
The observed changes of JPS and standing balance confirms deficits in sensorimotor control in people with WAD and especially in those with dizziness.

Year2021
JournalPLoS ONE
PublisherPublic Library of Science (PLoS)
ISSN1932-6203
Digital Object Identifier (DOI)https://doi.org/10.1371/journal.pone.0249659
Publication dates
Print08 Apr 2021
Publication process dates
Deposited20 Jul 2022
Publisher's version
License
File Access Level
Open
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