New remote technology to help people with neck injuries

There is no need to explain the importance of improving treatments and prognoses for people who have suffered neck injuries in traffic collisions. These injuries are unfortunately very common and often cause significant pain and prevent people from working, studying or pursuing their hobbies. The cost is significant, not just for individuals, but also for society as a whole.  

Research is currently being conducted at UI that looks at the effectiveness of a new treatment in physiotherapy and the use of new technology aimed precisely at people who have suffered neck injuries in traffic collisions. The aim is to improve the patients' well-being and reduce the costs of the injuries. 

Guðný Lilja Oddsdóttir, adjunct lecturer, and Kristín Briem, professor at the Department of Physiotherapy at the University of Iceland, are leading the research team, which also includes physiotherapist and PhD student Harpa Ragnarsdóttir. They plan to compare the success of two physiotherapy treatments short and long term using both subjective and objective measurements. Both cohorts in the study will be treated by physiotherapists specialised in the diagnosis and treatment of problems with the skeletal system. The physiotherapist Arnar Snær, who has recently been focusing on cancer research, also has extensive experience with these kinds of injuries. 

"But when it comes to the exercises, one group will receive remote treatment while the other will do the exercises that the physiotherapist has previously used for this group of patients and are considered appropriate for the individual," explains Harpa. "The remote treatment group will follow a home programme using new technology manufactured by the Icelandic software company NeckCare. The equipment enables patients to perform extremely specialised exercises which strengthen positional and motor awareness in the neck. The patient can do these exercises while using a computer at home or at work. The exercises only take between 5 and 20 minutes, depending on how far along in the rehabilitation process the patient is, and will be performed almost every day."

An extremely large group struggle with problems caused by neck injuries
The researchers say that people who have sustained neck injuries in traffic collisions make up a very large group among physiotherapy patients. Harpa reports that many patients have been referred to her to be treated for injuries caused by a traffic collision and that this inspired her to improve her knowledge in this area. This kind of injury is better known as whiplash injury. "It is a very complex injury and can cause a combination of various symptoms, for example dizziness, headaches, visual disturbances, neck and shoulder pains, reduced working capacity etc. Due to the nature of the symptoms, often the patient doesn't realise they are connected to the accident and believes they are caused by something much more serious. This is why education is so important."

Reduce suffering and lower costs
If this remote treatment proves effective, it will not only help whiplash patients to more systematically reduce symptoms, but will also lower the cost to patients and society as a whole. Costs include things like health insurance payouts and loss of working capacity. 

"The results of this research will help us understand what the best possible treatment is for patients diagnosed with whiplash injuries after a traffic collision. Our findings will therefore benefit society by reducing the number of patients with chronic neck injuries or symptoms in that area, since we hope that this treatment will significantly reduce the likelihood of long-term symptoms following this kind of injury," explains Harpa. 

As the situation currently stands, tax-payers subsidise over 90% of healthcare services. The costs for insurance companies of claims following traffic collisions can also run into the millions for each claimant.

Difficult to diagnose and treat people with chronic symptoms
Guðný Lilja explains that the inspiration behind this research and other studies related to whiplash injuries caused by traffic collisions is that clinics have found it difficult to diagnose and treat the symptoms, especially in cases where they have persisted for a long time. "The need to help these people raised various research questions for me," says Guðný Lilja. "In order to find the answers, I worked with the development of diagnostic technology in my research in order to evaluate the control and coordination of neck movements in people with whiplash symptoms. Disturbances in this area are believed to cause chronic symptoms. These specialised exercises that we are now researching were in fact developed as a follow on from development of the diagnostic technology." 

Harpa explains that she was introduced to NeckCare's technology and started using it for measurements and physical therapy treatments at the start of 2020. "I started using it in the clinic, where I quickly saw that this technology could be extremely useful. For the first time, I was able to objectively measure neck movements and also positional and motor awareness in the neck. The technology has been researched to some extent as a diagnostic tool, but there have not been any studies into its usefulness as a treatment. That's where the idea behind this research came from."

A focus on innovation
The research is strongly connected to Goal 3 of the UN Sustainable Development Goals, since it relates to equality of access to healthcare services. The study began this May and researchers will continue to observe participants for at least another year.
The innovation aspect of the research is very strong and the study represents a broad collaboration between academia and industry. Part of the research will be conducted under clinical conditions, where people are seeking physical therapy, and a high-tech company is also involved. The University of Iceland signed a partnership agreement with NeckCare in December 2019. 

"This technology will help therapists monitor whether our patients are actually doing their exercises and how they are getting on with them. As far as I know, this hasn't been possible before, particularly in the case of the kinds of specialised exercises that we often have to use for neck problems," says Harpa.

Guðný Lilja Oddsdóttir adjunct lecturer amd Harpa Ragnarsdóttir PhD student.