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Are altered smooth pursuit eye movements related to chronic pain and disability following whiplash injuries? A prospective trial with one-year follow-up

The Back Research Center part of Clinical Locomotion Science, Back Center Funen, alik{at}shf.fyns-amt.dk

Lars Vincents Jørgensen

The Back Research Center part of Clinical Locomotion Science, Back Center Funen

Charlotte Leboeuf-Yde

Institute of Sports Science and Clinical Biomechanics part of Clinical Locomotion Science, University of Southern Denmark

Erisela Qerama

Danish Pain Research Center and Department of Neurology, Aarhus University Hospital

Lars Korsholm

Department of Statistics, University of Southern Denmark

Tom Bendix

The Back Research Center part of Clinical Locomotion Science, Back Center Funen and Institute of Sports Science and Clinical Biomechanics part of Clinical Locomotion Science, University of Southern Denmark, Denmark

Objective: To evaluate the ability of early smooth pursuit testing to predict chronic whiplash-associated disorders, and to study whether the presence of abnormal smooth pursuit eye movements at one-year follow-up is associated with symptoms at that time.

Design: Prospective cohort study with one-year follow-up.

Setting: The study was carried out at a university research centre and participants were recruited from emergency units and general practitioners.

Subjects: In all, 262 participants were recruited within 10 days from a whiplash injury.

Main measures: Smooth pursuit eye movements were tested with electrooculography (EOG) an average of 12 days after a whiplash trauma and again after one year. Analyses of EOG recordings were computerized. Associations between test results both from baseline and one-year tests and self-reported neck pain, headache, neck disability and working ability one year after the car collision were determined.

Results: Results of early eye movement tests were not associated with the prognosis. Reduced smooth pursuit performance when tested in static cervical rotation at the one-year follow-up was significantly associated with higher neck pain intensity at that time (regression coefficient 0.8, 95% confidence interval (CI) 0.04—1.5), but the association was too weak for the test to discriminate between recovered participants and those with lasting symptoms.

Conclusions: Although reduced smooth pursuit performance at one-year follow-up was associated with persistent neck pain, smooth pursuit eye movement tests are not useful as predictive or diagnostic tests in whiplash-associated disorders.

Clinical Rehabilitation, Vol. 22, No. 5, 469-479 (2008)
DOI: 10.1177/0269215507082141


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