Developmental trajectories for neck disability after whiplash injury have been identified. Their relationship to cold and mechanical sensitivity trajectories is not known. We aimed to (1) identify recovery trajectories of cold and mechanical sensitivity, (2) explore their codevelopment with disability trajectories, (3) identify predictors of sensitivity trajectories, and (4) explore codevelopment of cold and mechanical sensitivity trajectories. Participants (n = 233) were assessed at <1, 3, 6, and 12 months after whiplash injury. Outcomes were cold pain detection threshold (CPT at neck), pressure pain detection thresholds (PPT, neck C5, and tibialis anterior), and the Neck Disability Index. We used group-based trajectory models to identify postinjury recovery trajectories and multinominal logistic regression to explore associations between baseline characteristics and trajectory membership. We identified the following trajectory groups: CPT (low [50.0%], moderate [29.7%], and high [20.4%] sensitivity); PPT C5 (low [10.8%] and high [89.2%] sensitivity); and PPT tibialis anterior (low [23.9%], moderate [39.0%], and high [37.1%] sensitivity); all were stable over the 12 months. There was good correspondence between disability and cold sensitivity trajectory groups but not for mechanical sensitivity; cold and mechanical sensitivity trajectories were not well associated. Higher baseline pain predicted membership of the high cold sensitivity trajectory (RR 1.27, 95% CI 1.01-1.59) and hyperarousal symptoms predicted membership of the moderate cold sensitivity trajectory (RR 1.17, 95% CI 1.01-1.36). We found no associations between baseline characteristics and mechanical sensitivity. There is an interplay between cold allodynia, pain, and hyperarousal symptoms in development of ongoing disability after whiplash injury. Different mechanisms likely underlie cold and mechanical sensitivity.

中文翻译：

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寒冷而非机械敏感性的轨迹与挥鞭伤后的残疾轨迹相对应。


已经确定了挥鞭伤后颈部残疾的发育轨迹。它们与寒冷和机械敏感性轨迹的关系尚不清楚。我们的目标是 （1） 确定寒冷和机械敏感性的恢复轨迹，（2） 探索它们与残疾轨迹的共同发展，（3） 确定敏感性轨迹的预测因子，以及 （4） 探索寒冷和机械敏感性轨迹的共同发展。参与者 （n = 233） 在挥鞭伤后 <1 、 3 、 6 和 12 个月进行评估。结局是冷痛检测阈值 （颈部 CPT） 、压痛检测阈值 （PPT 、颈部 C5 和胫骨前肌） 和颈部残疾指数。我们使用基于组的轨迹模型来识别损伤后恢复轨迹，并使用多名词 logistic 回归来探索基线特征与轨迹隶属关系之间的关联。我们确定了以下轨迹组：CPT（低 [50.0%]、中 [29.7%] 和高 [20.4%] 敏感性）;PPT C5（灵敏度低 [10.8%] 和高 [89.2%]）;和胫骨前肌 （低 [23.9%]、中度 [39.0%] 和高 [37.1%] 敏感性）;在 12 个月内均保持稳定。残疾和冷敏感轨迹组之间存在良好的对应关系，但机械敏感性没有;寒冷和机械敏感性轨迹没有很好的关联。较高的基线疼痛预测了高冷敏感轨迹的成员 （RR 1.27,95% CI 1.01-1.59），过度觉醒症状预测了中度冷敏感轨迹的成员 （RR 1.17,95% CI 1.01-1.36）。我们发现基线特征和机械敏感性之间没有关联。 冷痛痛、疼痛和过度觉醒症状在挥鞭伤后持续残疾的发展中存在相互作用。寒冷和机械敏感性可能是不同的机制。