Agreement is very low between a clinical prediction rule and physiotherapist assessment for classifying the risk of poor recovery of individuals with acute whiplash injury

Kelly, Joan; Ritchie, Carrie; Sterling, Michele

doi:10.1016/j.msksp.2018.11.003

Cited by 6 publications

(5 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are several tools available to achieve this—WhipPredict for patients with WAD, the short-form Orebro Musculoskeletal screen for WAD and non-traumatic neck pain, and StartMSK for non-traumatic neck pain (see Table 2 for availability). Research suggests that rehabilitation health care providers are not aware of prognostic indicators and do not use clinical risk screening tools for patients with neck pain [71,72]. The majority of patients will fall into the ‘low risk’ category; in other words, they should recover well with minimal treatment comprising a few sessions of advice, reassurance, and exercise.…”

Section: Promising Directions For Clinical Practicementioning

confidence: 99%

“…Another example would be information about likely prognosis nominated as important by patients [76], but which health care providers may not usually provide or be uncomfortable with how to deliver this information to patients. We have consistently found that physiotherapists are not well aware of the consistent predictors of poor recovery after whiplash injury [71,80], so may not routinely assess for such factors with the view of gauging prognosis. There are clinical prediction rules available to identify patients both at risk of poor recovery and those that will recover well [67,68,69] but to date the clinical uptake of these has been slow.…”

Section: Promising Directions For Clinical Practicementioning

confidence: 99%

See 1 more Smart Citation

Best Evidence Rehabilitation for Chronic Pain Part 4: Neck Pain

Sterling

Zoete

Coppieters

et al. 2019

JCM

Self Cite

View full text Add to dashboard Cite

Neck pain, whether from a traumatic event such as a motor vehicle crash or of a non-traumatic nature, is a leading cause of worldwide disability. This narrative review evaluated the evidence from systematic reviews, recent randomised controlled trials, clinical practice guidelines, and other relevant studies for the effects of rehabilitation approaches for chronic neck pain. Rehabilitation was defined as the aim to restore a person to health or normal life through training and therapy and as such, passive interventions applied in isolation were not considered. The results of this review found that the strongest treatment effects to date are those associated with exercise. Strengthening exercises of the neck and upper quadrant have a moderate effect on neck pain in the short-term. The evidence was of moderate quality at best, indicating that future research will likely change these conclusions. Lower quality evidence and smaller effects were found for other exercise approaches. Other treatments, including education/advice and psychological treatment, showed only very small to small effects, based on low to moderate quality evidence. The review also provided suggestions for promising future directions for clinical practice and research.

show abstract

Section: Promising Directions For Clinical Practicementioning

confidence: 99%

Section: Promising Directions For Clinical Practicementioning

confidence: 99%

Best Evidence Rehabilitation for Chronic Pain Part 4: Neck Pain

Sterling

Zoete

Coppieters

et al. 2019

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…The basic elements of this treatment plan are: (1) time phase after accident, which is markedly associated with disability, coping, and fear avoidance, and (2) the patient’s course of recovery since the accident, which is moderately associated with pain intensity, disability, coping, and fear avoidance. A dynamic plan of treatment, based on the modifiability of a number of prognostic psychological and physical factors by physiotherapy intervention, was developed in 2003 [ 77 ] and later adapted in 2018 [ 30 ]. Further research is needed to link the modifiable prognostic factors and underlying mechanisms to treatment goals, treatment, and patient-related outcomes.…”

Section: Discussionmentioning

confidence: 99%

Exploratory Study of Associations and Agreement between Prognostic Patient-Registered Factors, Physiotherapists’ Intuitive Synthesis, and Patient-Reported Factors in Whiplash-Associated Disorders

Oostendorp

Scholten-Peeters

Mulder

et al. 2023

JCM

View full text Add to dashboard Cite

Background: A large proportion of people who sustain a whiplash injury will have persistent pain, disability, and participation problems. Several prognostic factors for functional recovery have been reported in the literature but these factors are often evaluated based on differing implementations in clinical practice. Additionally, physiotherapists also rely on their clinical intuition to estimate the functional prognosis of their patients, but this is seldom measured in experimental research. Furthermore, no study to date has explored the associations between clinical intuition, clinically estimated factors, and objectively measured factors for functional recovery of patients with Whiplash-Associated Disorders (WAD). Aim: The aim of this exploratory study is to evaluate associations between prognostic factors for functional recovery, based on routinely collected data in a specialized primary care physiotherapy practice in a consecutive sample of patients (n = 523) with WAD. Methods: Three sources of prognostic factors were selected: (1) physiotherapists’ synthesis of clinical intuition in terms of high-risk, inconclusive risk, or low-risk for functional recovery, (2) patient-registered factors from history taking, and (3) patient-reported prognostic factors derived from questionnaires. Prognostic factors were selected based on the literature, recommendations in Dutch clinical practice guidelines, and consensus between experts. Spearman’s rank correlation coefficients were calculated to explore the associations between sources of prognostic factors, using a cutoff ≥0.25 for acceptable association. Results: Associations between physiotherapists’ intuitive synthesis and patient-registered variables were substantial (rs = 0.86), between patient-registered variables and patient-reported variables fair (ranging from 0.30 to 0.41) to substantial (ranging from 0.69 to 0.73), and between physiotherapists intuitive synthesis and patient-reported variables fair (ranging from 0.30 to 0.37). Conclusion: When estimating prognosis for functional recovery using clinical reasoning, physiotherapists should integrate patients’ registered experience of their course of recovery, as well as the timeline after an accident, with their own synthesis of clinical intuition regarding prognostic factors in patients with WAD.

show abstract

“…Another survey was excluded, as it looked at which psychosocial factors physiotherapists have knowledge of, and which ones they feel are important, but again there was no discussion about ability or confidence (Overmeer et al, 2004). Three studies were excluded, as they were related to physiotherapist prognostic ability, rather than specifically the assessment of psychosocial factors (Cook et al, 2015;Dagfinrud et al, 2013;Kelly et al, 2019). A study which was found in the initial stage one scoping search, was excluded, as it was a systematic review (Gray & Howe, 2013).…”

Section: Author Contributionsmentioning

confidence: 99%