February 20, 2024

Postural Consequences of Craniocervical Trauma: Research Review

51 minutes

This conversation between Dr. John Stenberg and Dr. Cameron Bearder explores the topic of post-traumatic cranial cervical disorders from a postural control perspective. The discussion covers the mechanisms of insult with mild traumatic brain injury and whiplash injuries, as well as their impact on postural control. The conversation also delves into the biopsychosocial aspects of managing patients with prolonged recovery and the importance of assessing psychosocial implications. The chapters cover various systems involved in postural control, including the ocular sensorimotor system, vestibular system, vestibulospinal system, cervical spine, and stomatognathic system.

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Post-Traumatic Craniocervical Disorders From a Postural Control Perspective: A Narrative Review

Takeaways

Post-traumatic cranial cervical disorders can result from mild traumatic brain injury and whiplash injuries, leading to symptoms such as dizziness, vertigo, headache, neck pain, visual complaints, anxiety, and neurocognitive dysfunction.

Psychosocial factors, including pre-existing anxiety, depression, and post-traumatic stress disorder, can affect the expression of symptoms and contribute to prolonged recovery in patients with post-concussion syndrome and whiplash-associated disorders.

Impaired postural control is commonly observed after cranios cervical trauma, involving the ocular sensorimotor system, vestibular system, vestibulospinal system, cervical spine, and stomatognathic system.

Manual therapy, patient education, range of motion reassurance, strengthening exercises, and multimodal care are useful interventions for managing neck pain and post-traumatic cranial cervical disorders.

TMJ disorders can be a potential cause of post-traumatic cranial cervical disorders, and their diagnosis relies on a history of TMJ complaints associated with movement, local discomfort, and physical examination. When evaluating patients, it is important to track progress over time and consider the different systems that may be affected.

Treatment of temporomandibular joint disorder (TMD) and related headaches may have poor outcomes when associated with whiplash.

Postural control is influenced by ocular sensorimotor, vestibular, cervical proprioceptive, and somatic-nathic systems, which may be damaged by cervical spine trauma.

Future research should consider all these systems from a postural control perspective in the context of cranioservical trauma.

Chapters

00:00 Introduction and Paper Overview

01:41 Common Symptoms and Mechanisms of Injury

04:47 Psychosocial Factors and Prolonged Recovery

06:49 Ocular Sensorimotor System and Post-Traumatic Impairment

07:48 Vestibular System and Post-Traumatic Impairment

09:42 Vestibulospinal System and Post-Traumatic Impairment

11:33 Cervical Spine Impairment and Neck Pain

19:12 Stomatognathic System and Post-Traumatic Impairment

32:50 Cervicogenic Dizziness and Interventions

37:42 TMJ Disorders and Otological Symptoms

45:58 Tracking Progress and Treatment Approach

47:26 Consideration of Global Perspective

48:23 Postural Control and Systems Damage

49:15 Conclusion and Further Research

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By Dr. John Stenberg & Dr. Cameron Bearder

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