Gwendolen Jull

The research focuses on the evaluation and management of neck pain from a physical therapy perspective

The research in the Cervical Spine and Whiplash Research Unit in the School of Health and Rehabilitation Sciences has an applied clinical focus. Two models of neck pain are being investigated, idiopathic neck pain and neck pain following trauma. The research questions and investigates the possible physical and psychological processes underlying the pain and functional disturbances associated with neck disorders to better identify and quantify the impairments or disturbances in the sensory, muscle, sensorimotor and psychological systems.

Whiplash associated disorders

Processes associated with chronic whiplash associated disorders have been researched, identifying problems in the sensory, motor and postural control systems. A prospective study of prognostic indicators for whiplash from within 4 weeks of injury to recovery or chronicity (6 months post injury) identified sensory, motor and psychological processes associated with recovery and non recovery. A multicentre, international collaborative project is underway to test the sensitivity and specificity of these indicators. This research questions the current classification system for whiplash associated disorders. One RCT of management of chronic whiplash associated disorders has been completed. Currently an RCT is underway to test whether a pragmatic multi-professional management program for acute whiplash will lessen the incidence of transition to chronicity.

Cervicogenic headache

Research into cervicogenic headache has established the physical criteria which characterise cervicogenic headache. A specific pattern of articular and muscle impairment clearly identifies cervicogenic headache from other types of benign intermittent frequent headache with symptomatic overlap (eg tension-type headache and frequent migraine without aura). An RCT has been conducted to investigate the efficacy of physiotherapy treatment methods designed to address these impairments. Current research is investigating cervicogenic headache in the elderly.

Impairment in the neck muscle system and sensorimotor control

The nature of impairments in the cervical muscle system associated with neck pain is being researched. Impairments in the motor control of the deep and superficial neck muscles have been identified in cognitive, functional and automatic tasks. The changes appear to be generic reactions to neck pain syndromes regardless of aetiology. Two randomised controlled trials have been conducted testing the effectiveness of a specific exercise regime developed from this research. The possible physiological mechanisms underlying the effectives of different therapeutic exercise strategies are currently being researched to ensure best evidence-based practice in the field of therapeutic exercise for cervical disorders.