Acute Treatment of Whiplash Neck Sprain Injuries

Borchgrevink, Grethe E.; Kaasa, Aaste; McDonagh, David L.; Stiles, Tore C.; Haraldseth, Olav; Lereim, I

doi:10.1097/00007632-199801010-00006

Cited by 196 publications

(28 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is documented that decreased activity after a MVC increases the risk of chronic WAD, 43 but the mechanisms by which decreased activity influences skeletal muscle structure and function following whiplash are largely unknown. The effect of depriving healthy individuals from their normal daily activity (as may be expected to occur if an individual reduces normal activity after a whiplash injury) can lead to fatigue, mood swings, reductions in muscle volume and intramuscular fatty infiltration.…”

Section: Discussionmentioning

confidence: 99%

The Rapid and Progressive Degeneration of the Cervical Multifidus in Whiplash

Elliott

Courtney

Rademaker

et al. 2015

Spine

View full text Add to dashboard Cite

Study Design Single-center prospective longitudinal study Objective To study the 1) temporal development of muscle fatty infiltrates (MFI) in the cervical multifidii following whiplash, 2) differences in multifidii MFI between those who recover or report milder pain related disability from those who report moderate/severe symptoms at 3 months, and 3) predictive value of multifidii MFI outcomes. Summary of Background Data The temporal development of MFI on conventional MRI has been shown to be associated with specific aspects of pain and psychological factors. The replication of such findings has yet to be explored longitudinally. Methods 36 subjects with whiplash injury were enrolled at < 1-week post-injury and classified at 3-months using percentage scores on the Neck Disability Index as recovered/mild (0–28%) or severe (≥ 30%). A fat/water MRI measure, patient self-report of pain related disability and post-traumatic stress were collected at <1-week, 2-weeks and 3-months post-injury. The effects of time and group (per NDI) and the interaction of time by group on MFI were determined. Receiver operating characteristic curve (ROC) analysis was used to determine a cut-point for MFI at 2 weeks to predict outcome at 3 months. Results There was no difference in MFI across groups at enrolment. MFI values were significantly higher in the severe group when compared to the recovered/mild group at 2-weeks and 3-months.The ROC analysis indicated that MFI levels of 20.5% or above resulted in a sensitivity of 87.5% and a specificity of 92.9% for predicting outcome at 3 months. Conclusions Consistent with previous evidence, muscle degeneration occurs soon after injury but only in those patients with poor functional recovery. This study provides further evidence that 1) multifidii MFI occurs in tandem with known predictive risk factors (older age, pain-related disability, and post-traumatic stress) and that 2) routine imaging protocols may need to be reconsidered in the vast majority of patients following whiplash.

show abstract

Section: Discussionmentioning

confidence: 99%

The Rapid and Progressive Degeneration of the Cervical Multifidus in Whiplash

Elliott

Courtney

Rademaker

et al. 2015

Spine

View full text Add to dashboard Cite

show abstract

“…Although gender was unknown for porcine donors in the present study, based upon results of previous experimental mechanical studies, it remains unlikely that this factor would have significantly affected physiological or rupture arterial mechanics. However, continued studies of gender effects on soft-tissue material properties are warranted due to differences in arterial trauma rates cited above, as well as other soft-tissue injury modalities wherein gender discrepancies are clinically and epidemiologically identified [62][63][64].…”

Section: Discussionmentioning

confidence: 99%

Mechanics of Fresh, Refrigerated, and Frozen Arterial Tissue

Stemper¹,

Yoganandan²,

Stineman³

et al. 2007

Journal of Surgical Research

154

102

View full text Add to dashboard Cite

“…These included educational booklets (for mechanical neck disorder; Glossop et al 1982 [52]), advice on acting as usual and instructions for self-training exercises to be initiated immediately (for acute WAD [53]) and mobilization advice (for acute WAD [54]). Advice on activation given through these modes showed low or very low evidence of benefit when compared to teaching exercises alone (for short-term pain and knowledge (Glossop et al 1982 [52]), immobilization (for short- and intermediate-term pain, range of motion and cognitive symptoms [53] and physiotherapy or rest (for short-term pain and long-term presence of symptoms [54]. …”

Section: Evidence Of Benefitmentioning

confidence: 99%

“…The research also showed low GRADE evidence of no difference (1 trail, 211 participants, Borchgrevink et al 1998 [53]) when comparing the use of a collar versus advice to “act as usual” for immediate, short-term or intermediate-term pain relief, global perceived effect, improving ROM, or time on sick leave. Also there was not difference in pain at the short- and intermediate-term follow-up if a collar was worn 2 days versus 7 days (1 trials, 70 participants, Dehner et al , 2006 [92]).…”

Section: Low or Very Low Evidencementioning

confidence: 99%

See 1 more Smart Citation

Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain: An Systematic Overview Update as Part of the ICON§ Project

Gross¹,

Kaplan²,

Huang³

et al. 2013

TOORTHJ

View full text Add to dashboard Cite

Objectives: To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain.Search Strategy: Computerized databases and grey literature were searched (2006-2012).Selection Criteria: Systematic reviews of randomized controlled trials (RCTs) on pain, function/disability, global perceived effect, quality-of-life and patient satisfaction were retrieved.Data Collection & Analysis: Two independent authors selected articles, assessed risk of bias using AMSTAR tool and extracted data. The GRADE tool was used to evaluate the body of evidence and an external panel to provide critical review.Main Results: We retrieved 30 reviews (5-9 AMSTAR score) reporting on 75 RCTs with the following moderate GRADE evidence. For acute whiplash associated disorder (WAD), an education video in emergency rooms (1RCT, 405participants] favoured pain reduction at long-term follow-up thus helping 1 in 23 people [Standard Mean Difference: -0.44(95%CI: -0.66 to -0.23)). Use of a soft collar (2RCTs, 1278participants) was not beneficial in the long-term. For chronic neck pain, a mind-body intervention (2RCTs, 1 meta-analysis, 191participants) improved short-term pain/function in 1 of 4 or 6 participants. In workers, 2-minutes of daily scapula-thoracic endurance training (1RCT, 127participants) over 10 weeks was beneficial in 1 of 4 participants. A number of psychosocial interventions, workplace interventions, collar use and self-management educational strategies were not beneficial.Reviewers' Conclusions: Moderate evidence exists for quantifying beneficial and non-beneficial effects of a limited number of interventions for acute WAD and chronic neck pain. Larger trials with more rigorous controls need to target promising interventions

show abstract

Acute Treatment of Whiplash Neck Sprain Injuries

Abstract: The outcome was better for patients who were encouraged to continue engaging in their normal, pre-injury activities as usual than for patients who took sick leave from work and who were immobilized during the first 14 days after the neck sprain injury.

Cited by 196 publications

References 14 publications

The Rapid and Progressive Degeneration of the Cervical Multifidus in Whiplash

The Rapid and Progressive Degeneration of the Cervical Multifidus in Whiplash

Mechanics of Fresh, Refrigerated, and Frozen Arterial Tissue

Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain: An Systematic Overview Update as Part of the ICON§ Project

Contact Info

Product

Resources

About