Abstract
BACKGROUND CONTEXT
Five out of 10 injured in a motor vehicle collision (MVC) will develop persistent
pain and disability. It is unclear if prolonged symptoms are related to peritraumatic
pain/disability, psychological distress, muscle fat, lower extremity weakness.
PURPOSE
To test if widespread muscle fat infiltration (MFI) was (1) unique to those with poor
recovery, (2) present in the peritraumatic stage, (3) related to known risk factors.
STUDY DESIGN/SETTING
A cohort study, single-center Academic Hospital.
PATIENT SAMPLES
A total of 97 men and women (age 18–65) presenting to an urban academic emergency
medicine department following MVC, but not requiring inpatient hospitalization.
PRIMARY OUTCOME MEASURE
Neck disability at 12-months.
METHODS
Participants underwent magnetic resonance imaging (MRI) to quantify neck and lower
extremity MFI, completed questionnaires on pain/disability and psychological distress
(< 1-week, 2-weeks, 3-, and 12-months) and underwent maximum volitional torque testing
of their lower extremities (2-weeks, 3-, and 12-months). Percentage score on the Neck
Disability Index at 12-months was used for a model of (1) Recovered (0%–8%), (2) Mild
(10%–28%), and (3) Moderate/Severe (≥ 30%). This model was adjusted for BMI and age.
RESULTS
Significant differences for neck MFI were revealed, with the Recovered group having
significantly lower neck MFI than the Mild and Moderate/Severe groups at all time
points. The Mild group had significantly more leg MFI at 12-months (p=.02) than the
Recovered group. There were no other significant differences at any other time point.
Lower extremity torques revealed no group differences. The Traumatic Injury Distress
Scale (TIDS) and MFI of the neck at 1-week postinjury significantly predicted NDI
score at 12-months.
CONCLUSIONS
Higher neck MFI and distress may represent a risk factor though it is unclear whether
this is a pre-existing phenotype or result of the trauma.
Trial Registration
ClinicalTrials.gov Identifier: NCT02157038.
Keywords
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Article info
Publication history
Published online: March 20, 2023
Accepted:
March 10,
2023
Received in revised form:
February 17,
2023
Received:
November 16,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
FDA device/drug status: Not applicable.
Author disclosures: JME: Grant: NIH (H, paid directly to institution); Royalties: Handspring Publishing (A); Consulting: Orofacial Therapeutics (B); Grants: NSW Spinal Cord Injury Research Awards (H, paid directly to institution). DMW: Royalties: Handspring Publishing (A); Consulting: Pain Assessment and Prediction (B). SRA: Nothing to disclose. DMC: Grant: NIH (H, paid directly to institution). GPS: Consulting fee or honorarium: NIH (B, paid directly to institution); Stock Ownership: MEA Forensic (10% ownership) LJC: Nothing to disclose. KW: Grant: NIH (G, paid directly to institution); Fees for participation in review activities such as data monitoring boards, statistical analysis, end point committees, and the like: Norwegian Chiropractors Research Foundation (A); Speaking and/or Teaching Arrangements: Parker University (C). ACS: Grant: NIH (NIH NICHD K01 Award, paid directly to institution) (E).
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