by Monica Chamness
Staff Writer
A new evaluation and treatment machine geared specifically toward neck injuries may offer some relief to attorneys involved in whiplash cases.
Historically, diagnosing whiplash or other neck-related injuries, has been nebulous at best. X-rays, MRIs (Magnetic Resonance Imaging) or other conventional methods used to detect soft tissue damage do not identify all medical problems the patient complains about. Conditions such as a broken bone, bulging disc or nerve damage are obvious. However, soft tissue is not. As a result, insurance companies have waged war against injured parties and their attorneys because of a lack of support for the patient’s claim.
The Hanoun Multi Cervical Unit (MCU) may change all that. The MCU is a computerized-system that objectively analyzes muscle strength and range of motion for those suffering from strains, sprains, falls, whiplash or sports-related injuries.
“The machine tests for deficiencies due to injuries,” said Scott Hyams, physical therapist and clinical director for Heartland Rehabilitation Services. “If there is a muscle imbalance, the machine can pick it up. Scores are compared to normative data. Once we determine where the deficit is, we can treat it.”
“This machine is one of only two of this kind in Florida,” added Susan Meek, marketing and communications director for the clinic.
“Doctors and lawyers are not sure they believe [the patient],” said Hyams. “We get most of our referrals from physicians or attorneys. There is interest for personal injury and workers compensation attorneys because it gives them more objective measures. If a client is in litigation and nothing is discovered, they come in here. We can find where the deficits are and that can be presented in a court of law. The MCU determines the extent of the injury, charts it, prints out bar graphs and creates a treatment plan. It could be used by either side of the case to prove injury [to obtain benefits or medical reimbursement].”
Before testing, the patient is given a general physical to screen individuals who could not withstand testing because of artery insufficiencies in the vertebrae, joint mobility problems or lack of upper body strength and range of motion.
“As you go up the spine, the size of the vertebrae gets smaller,” explained Hyams of why the neck needs special attention. “You have two vertebral arteries that run up the spine. The area is a lot more delicate to evaluate. You can’t get too aggressive with that.”
Common symptoms of neck pain sufferers include headaches, dizziness, fatigue, pain in the shoulder, arm or jaw, an inability to hold their head up and difficulty sleeping because of neck pain.
“As an initial injury resolves itself, the muscles become imbalanced,” said Hyams. “Once it goes through this acute phase, the pain is difficult to assess; other machines can’t test for weakness at that point. We test in every direction the muscles are involved in.”
According to the manufacturer, other measurements use a manual muscle scale which cannot be compared subsequently to other test results. These type of tests are viewed by many insurers as too subjective.
Coaches, trainers, employers, insurance adjusters, case managers and creditors can also benefit from the machine.
For those trying to manipulate the results, cheating on the test can be recognized easily.
“For patients that don’t give accurate readings, there is a standard deviation to show if they’re being consistent,” said Hyams, a physical therapist for seven years. “If they’re trying to manipulate the results, the co-efficient of variance will spot it and the test will be deemed inaccurate. We’re not saying that they’re faking it but the test would read that they were not testing to their full potential. The idea is not to catch someone at something. It’s the doctor who makes the diagnosis. If the test was invalid, it would be for a court to determine.”
Having the evidence needed to prove a client’s claim by determining their true limitations can assist an attorney with closing a case or supporting legal cases concerning disability.
Developed in Toronto, the MCU documents the patient’s pain over a period of one week as opposed to the precise moment of examination. A head harness and counter weights are employed. Isometric strength is studied using a combination of movement patterns including flexion, extension, rotation and lateral flexion, i.e. stretching the neck to the side, back and down. Considering the myriad of angles each of these tests can be conducted at (neck bent at 20 degrees, 45 degrees or any other angle), 570 different positions are possible. Small plates of weights similar to those in a fitness gym are attached to the machine. They range from one-quarter of a pound to 50 pounds.
“The isometric test gives resistance through different planes of motion to one-tenth of a degree,” said Hyams. “We don’t test all the planes in one day because the patient would be sore.”
The company has been using the MCU since October.