Pathophysiology behind prolonged whiplash associated disorders: Study protocol for an experimental study

Anneli Peolsson, Anette Karlsson, Bijar Ghafouri, Tino Ebbers, Maria Engström, Margaretha Jönsson, Karin Wåhlén, Thobias Romu, Magnus Borga, Eythor Kristjansson, Hilla Sarig Bahat, Dmitry German, Peter Zsigmond, Gunnel Peterson

Research output: Contribution to journalArticlepeer-review


Background: There is insufficient knowledge of pathophysiological parameters to understand the mechanism behind prolonged whiplash associated disorders (WAD), and it is not known whether or not changes can be restored by rehabilitation. The aims of the projects are to investigate imaging and molecular biomarkers, cervical kinaesthesia, postural sway and the association with pain, disability and other outcomes in individuals with longstanding WAD, before and after a neck-specific exercise intervention. Another aim is to compare individuals with WAD with healthy controls. Methods: Participants are a sub-group (n = 30) of individuals recruited from an ongoing randomized controlled study (RCT). Measurements in this experimental prospective study will be carried out at baseline (before intervention) and at a three month follow-up (end of physiotherapy intervention), and will include muscle structure and inflammation using magnetic resonance imaging (MRI), brain structure and function related to pain using functional MRI (fMRI), muscle function using ultrasonography, biomarkers using samples of blood and saliva, cervical kinaesthesia using the "butterfly test" and static balance test using an iPhone app. Association with other measures (self-reported and clinical measures) obtained in the RCT (e.g. background data, pain, disability, satisfaction with care, work ability, quality of life) may be investigated. Healthy volunteers matched for age and gender will be recruited as controls (n = 30). Discussion: The study results may contribute to the development of improved diagnostics and improved rehabilitation methods for WAD. Trial registration: Protocol ID: NCT03664934, initial release 09/11/2018.

Original languageEnglish
Article number51
JournalBMC Musculoskeletal Disorders
Issue number1
StatePublished - 2 Feb 2019

Bibliographical note

Publisher Copyright:
© 2019 The Author(s).


  • Biomarkers
  • Chronic
  • Diagnostic imaging
  • Exercise therapy
  • Follow-up study
  • MRI
  • Neck
  • Outcome
  • Physiopathology
  • Physiotherapy
  • Randomized
  • Rehabilitation
  • Scan
  • Spine
  • Ultrasonography
  • Whiplash injury

ASJC Scopus subject areas

  • Rheumatology
  • Orthopedics and Sports Medicine


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