Neck Disability Index Is Better in Classification of Recovery after Whiplash Injury in Comparison with Ultrasound Shear Wave Elastography of Trapezius Muscle

Abstract

A prospective observational study comparing shear wave elastography (SWE) of trapezius muscle with Neck Disability Index (NDI) in a prediction model of health status six months after a whiplash injury. Both SWE values, measured by two radiologists, and NDI scores were obtained at baseline and after physical therapy (PT) (6-month period). Those values were compared with a 3-point Likert scale (no, partial or full recovery). Twenty-two subjects completed the study. A decrease in trapezius stiffness was detected by both radiologists, statistically significant for one (Δ10.1 kPa; p = 0.04) but not for the second radiologist (Δ8.63 kPa; p = 0.07). The measurements showed excellent intra-observer (ICC 0.75–0.94) and inter-observer (ICC 0.78–0.88) reliability. After six months, fully recovered patients showed lower NDI scores than partially recovered patients (Δ22.98; p p = 0.82). The single most accurate variable in classifying health status six months after whiplash injury was the relative change of NDI, and it showed the highest accuracy (73.9%) and low Akaike information criterion (AIC = 39.2). Overall, the most accurate classification was obtained when combining NDI and SWE after physical therapy with an accuracy of 77.3% and a decrease in AIC (32.8).

Keywords

• car accident
• stiffness
• depression
• neck pain
• recovery