Category: Allied Health Options
Injury Type: Acute
What is it?
Clinical biomechanics of posture (CBP) rehabilitation involves specific chiropractic adjustments including: mirror-image drop table adjustments, mirror-image handheld instrument adjustments, mirror-image isometric exercise and mirror-image extension-compression traction techniques. Posture correction may also include analysis of posture to check the alignment of your spine, advice and/or exercises to help correct any deviations from the ideal situation. It may also involve devices to remind you to check and adjust your posture throughout the day (i.e. mirror, back braces, alarms/reminders).
How does it work?
The aim of posture correction is to place the spine in its correct anatomical alignment in order to reduce the stress on the muscles and joints of the body. Often neck pain (after whiplash and in general) is associated with a forward position of the head (where the chin pokes forward). This posture may place a great deal of strain on the muscles at the back of the neck, which can cause a lot of pain. Thus, correction or reduction of this poor posture can help reduce pain levels.
Is it effective?
A CBP rehabilitation protocol has been examined in a single patient case study. In conjunction with exercise and traction, five months of treatment improved one patients' neck posture, pain, and disability. The patient in this case study was treated initially by a chiropractor using spinal manipulative therapy with no improvement in symptoms. The patient was then treated for an additional 3 months at a medical rehabilitation clinic with focus on functional rehabilitation (range of movement exercises, stretching), electrical muscle stimulation, high-voltage galvanism, ultrasound, deep tissue massage therapy, anti-inflammatory medication and pain medication. The patient again demonstrated no permanent improvement and continued to display chronic symptoms for 8 months before being treated with the Clinical Biomechanics of Posture (CBP) technique as the primary treatment method.
Recent guidelines published in 2007 recommended that advice about posture (sitting and standing) may be helpful in addition to maintaining usual activities and exercising, especially if there has been no improvement already. A recent systematic review of high quality scientific studies concluded that in the sub-acute stage (between 2 and 12 weeks) following whiplash injury there is strong evidence to support the use of 'postural training'.
Are there any disadvantages?
There were no disadvantages to treatment according to the single patient case study. This type of treatment is only provided by qualified professionals, thus there may be considerable costs involved, especially if multiple treatments are required.
Where do you get it?
Chiropractors provide this specific type of posture correction. Other professionals that may provide advice and exercises in relation to posture correction may include doctors, physiotherapists, osteopaths, ergonomists and exercise/rehabilitation providers.
Although a small study on one patient found CBP to be effective, its routine use cannot be recommended based on this study alone. Learning how to sit and stand correctly may be useful in conjunction with other treatments, especially if there has been no improvement already. Postural advice and/or postural exercises are recommended in the sub-acute stage (between 2 and 12 weeks) following whiplash injury.
- Dehner, C, Heym, B, Maier a, D, Sander, S, Arand, M, Elbel, M, Hartwig, E & Kramer, M 2008, 'Postural control deficit in acute QTF grade II whiplash injuries', Gait and Posture, vol. 28, no. 1, pp. 113–119.
- Dehner, C, Elbel, M, Strobel, P, Scheich, M, Schneider, F, Krischak, G & Kramer, M 2009, 'Grade II whiplash injuries to the neck: what is the benefit for patients treated by different physical therapy modalities?', Patient Safety in Surgery , vol. 3, no. 2, doi: 10.1186/1754-9493-3-2.
- Ferrantelli, JR, Harrison, DE, Harrison, DD & Stewart, D 2005, 'Conservative treatment of a patient with previously unresponsive whiplash associated disorders using clinical biomechanics of posture rehabilitation methods', Journal of Manipulative and Physiological Therapeutics, vol. 28, no. 3, pp. e1-e8.
- Mercer, C, Jackson, A & Moore, A 2007, 'Developing clinical guidelines for the physiotherapy management of whiplash associated disorder (WAD)', International Journal of Osteopathic Medicine, vol.10, no. 2-3, pp. 50-54.
- Motor Accidents Authority 2007, Your guide to whiplash recovery in the first 12 weeks after the accident, MAA, Sydney, Australia.