Distribution Characteristics of Meridian Sinew(Jingjin) Syndrome in 313 Cases of Whiplash-Associated Disorders

Objective：To investigate and analyze the characteristics of Meridian Sinew（Jingjin） syndrome in patients with whiplash-associated disorders（WAD）.Methods：From August 2010 to September 2011,313 WAD cases from New York and California states were collected.The survey mostly collects the information of ＂Sinew Knotted Points＂ and symptoms of four types of Meridian Sinew differentiation—Taiyang,Shaoyin,Shaoyang and Yangming.Results：Among the cases which are on the average of medium injury level,the higher frequency of ＂Sinew Knotted Points＂ tenderness were found on Jianwaishu（SI 14）,Jianzhongshu（SI 15）,Tianchuang（SI 16）,C3-6 Spinous Process,Dazhui（GV 14）,Fengchi（GB 20）,Tianliao（SJ 15） and Tianding（LI 17）.The most commonly presented symptoms were widespread spasm and tenderness in the neck（Taiyang）,difficulty in lateral flexion（Shaoyang）,problems of extension and flexion（Taiyang）,and stiffness and pain during neck movement（Yangming）.Among the cases,237 cases（75.72%） were related to Taiyang Meridian Sinew syndrome,82 cases（26.20%） to Shaoyin syndrome and 175（55.91%） and176（56.23%） cases to Shaoyang and Yangming syndrome respectively.The most of cases presented in a combination format.The syndrome distribution under Grade Ⅰ,Ⅱ and Ⅲ reflected that more combination of the Meridian Sinew syndromes in the whiplash injury patients which is resulted from more severity of injury.Conclusion：It is practical to identify the location of abnormality through Meridian Sinew differentiation,considering both ＂Sinew Knotted Points＂ tenderness and corresponding symptoms,for the local neck symptoms of WAD.

Correlation between expectations of recovery and injury severity perception in whiplash-associated disorders

Objective:To assess the correlation between expectations of recovery and whiplash patients' perceptions of injury severity using a simplified instrument.Expectations of recovery have been shown to predict rate of recovery from whiplash injury in population-based studies.The perception of having more severe pathology or more ominous diagnostic labels has also been associated with a worse prognosis.Methods:Consecutive patients with whiplash-associated disorder grade 1 or 2,presenting in the acute stage to a primary care centre,were asked "do you think that your injury will…" with response options "get better soon;get better slowly;never get better;don't know." Injury severity perception (ISP) was measured with a numerical rating scale which ranged from 0-10,on which subjects were asked to rate how severe (in terms of damage) they thought their injury was.The anchors were labeled "no damage" (0) and "severe,and maybe permanent damage" (10).The primary outcome measure was the correlation between the subject's ISP score and expectation of recovery.Results:A total of 94 subjects (34 males,60 females,and mean age (40.6±10.0) years,range 19-60 years) were included.The initial responses to expectation of recovery were:get better soon (29/94);get better slowly (22/94);never get better (11/94);don't know (32/94).The mean ISP score was 4.9±1.7 (range 2-9 out of 10).There was a high correlation between expectations and ISP scores (Spearman's rank correlation coefficient 0.68).Those who expected to recover soon and those who expected to get better slowly had the lowest ISP scores.Conclusions:The more slowly whiplash patients expect to recover,or the less sure they are of recovery,the more severe their initial perceptions of injury.