A narrative review on cervical interventions in adults with chronic whiplash-associated disorder

Abstract

IntroductionWhiplash injuries are common in society, but clinical interventions are inconclusive on the most effective treatment. Research and reviews have been completed with the goal of determining clinical interventions that are effective for whiplash injuries and disorders, but literature has not recently been summarised on best practices for cervical spine interventions for adults with chronic whiplash.PurposeThe objective of this narrative review is to update and expand on previous works, to provide recommendations for clinical interventions and future research in the area of cervical spine rehabilitation for adults with chronic whiplash-associated disorder.MethodThe Arskey and O’Malley methodology was used for this narrative review. CINHAL, EMBASE, Medline, PsychInfo, Scopus, Web of Science, as well as grey literature, were searched from 2003 to April 2017. Two reviewers screened titles and abstracts for relevance to the review, and content analysis summarised the study findings. A total of 14 citations were included in the final review.FindingsExercise-based interventions targeted at the cervical spine appear most beneficial for adults with chronic whiplash-associated disorder (WAD). Invasive interventions still require more rigorous studies to deem their effectiveness for this population.ConclusionFurther research is required to investigate and determine clinically relevant results for cervical spine intervention in patients with chronic WAD.

Does Motor Cortex Engagement During Movement Preparation Differentially Inhibit Nociceptive Processing in Patients with Chronic Whiplash Associated Disorders, Chronic Fatigue Syndrome and Healthy Controls? An Experimental Study

“…Moreover, nociception-motor interactions can be activated when preparing a movement on the contralateral side of the painful area, but also on a remote side. The finding of similar responses in healthy volunteers and patients with cWAD and CFS further supports the use of regular body movement and exercise interventions for managing these conditions (due to their inhibitory effect on pain), which is in line with current treatment guidelines for both conditions [72][73][74][75].…”

The significance of cervical sagittal alignment for nonrecovery after whiplash injury

“…Symptomatic pharmacological therapies with analgesic and anti-inflammatory drugs, combined with the advice to stay active, are considered the first-line therapy. However, there is no standardized algorithm for treatment of WAD [90]. For chronic WAD, neck-specific physiotherapy-including muscular strengthening and postural control-appear to have a positive effect [65,91,92].…”

“…Moreover, general exercise does not appear to improve the outcome [93]. Further, for alternative interventions-such as acupuncture, yoga, and osteopathic treatment-evidence is low in favour of a long-term positive effect [90,94]. There are also opinions that indicate that doing as little as possible has the best therapeutic effect [95].…”

Verification of the Conditions for Whiplash-Type Injuries With the SDC Method Using the SRS-Airbag System Activation Parameters

“…The significance of the impact biomechanics for assessing the cervical vertebrae and clinical symptoms are discussed, e.g., in other studies [20,21], whereas another article [22] presents a study of the relationship between the recovery of a road accident victim with a whiplash injury and the insurance claim.…”