Recovery Pathways and Prognosis After Whiplash Injury

Ritchie, Carrie; Sterling, Michele

doi:10.2519/jospt.2016.6918

Cited by 38 publications

(36 citation statements)

References 53 publications

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“…Both objectively measured, "constructed", and patient-reported definitions have been used [6], but there is no conclusiveness about the best clinical value of the different measures. Qualitative data suggest, however, that measuring only symptom intensity is insufficient for describing recovery [7].…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation

et al. 2018

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Purpose The long-term outcome of Whiplash-associated disorder (WADs) has been reported to be poor in populations from medical settings. However, no trials have investigated the long-term prognosis of patients from medico-legal environment. For this group, the "compensation hypothesis" suggests financial compensation being associated with worsened outcome. The aims of this study were to describe long-term (2-4 years) non-recovery rates in participants with WAD recruited from insurance companies and to investigate the association between self-reported non-recovery and financial compensation. Methods 144 participants, reporting neck pain after a motor vehicle accident, were recruited from two major insurance companies in Sweden. Self-reported recovery was measured at 6 months and 2-4 years. Those who received financial compensation from an insurance company were compared with those who received no compensation. Results The overall non-recovery rate after 2-4 years was 55.9% (66/118). In the non-compensated group, the non-recovery rate was 51.0% (25/49) and in the compensated group 73% (27/37) (p = 0.039). Adjusted OR was 4.33 (1.37-13.66). High level of pain at baseline was a strong predictor of non-recovery ]. However, no association was found between pain level at baseline and financial compensation. Conclusions The non-recovery rate among patients making insurance claims is high, especially among those receiving financial compensation even if causal relationship cannot be determined based on this study. However, lack of association between baseline level of pain and compensation supports the compensation hypothesis.

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Section: Introductionmentioning

confidence: 99%

Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation

et al. 2018

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“…The injury and pain cause an altered function in the cervical spine and neck muscles (4)(5)(6)(7)(8) and can affect upper limb function (9)(10)(11). Self-reported pain and neck-related disability which affect personal care, lifting, reading, work, driving, and recreation can predict recovery after whiplash injury (12), but the relations between physical capacity and neck pain and disability are inconclusive (13,14). Improved neck muscle endurance was an important factor in decreasing neck pain in WAD (15).…”

Section: Introductionmentioning

confidence: 99%

Randomized controlled trial of exercise interventions for chronic whiplash-associated disorders: One-year follow-up of the effect on neck muscle endurance, active cervical range of motion and grip strength.

Peterson

Ludvigsson

Peolsson³

2020

Preprint

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Abstract Background: Years after whiplash injury, more than 40 % of people experience persistent neck pain and disability, called whiplash-associated disorders (WAD). The relations between neck related function, neck pain and disability are inconclusive and need to be further investigated. The aims were; a) to compare the effect of three different exercise interventions – neck-specific exercise (NSE), NSE with a behavioral approach (NSEB) and prescribed physical activity (PPA) – on neck-muscle endurance (NME), active cervical range of motion (AROM), grip strength and pain intensity immediately before and after the tests, and b) to compare neck-disability in individuals who are below or above the cut-off for normative reference values of healthy individuals regarding NME, AROM and grip strength.Methods: This is a secondary analysis of a randomized controlled multicenter study including 12 months’ follow-up. A total of 216 individuals with chronic WAD grades II or III were recruited. Data were recorded at baseline, 3, 6, and 12 months. Linear mixed models were used and sub-group analyses were evaluated with non-parametric tests.Results: NSE and NSEB resulted in greater improvements compared to PPA (p < .01) and were maintained at 12 months’ follow-up in ventral (only males) and dorsal NME, AROM and pain intensity during testing. In grip strength, there were no significant between-group differences (p > 0.05). There were no significant differences between the NSE and NSEB groups (p > .05). Sub-group analyses revealed improvement in disability at 12 months follow-up in NSE and/or NSEB for individuals both below and above the cut-off reference value in NME and AROM. More severe disability was seen in individuals below the reference values both at baseline and 12 months’ follow-up. Individuals in the PPA group below the reference values in NME and AROM reported increasing disability at 12 months compared to baseline.Conclusion: The results suggest that neck-specific exercises (NSE, NSEB) improved clinical function and decreased disability in chronic WAD compared to PPA. The results may imply that higher neck-related clinical function can be important for reduced disability. Trial Registration: ClinicalTrials.gov: NCT01528579, date of registration: February 8, 2012, retrospectively registered; https://clinicaltrials.gov/ct2/show/NCT0152857

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“…This special issue presents several relevant commentaries that present the current thoughts in this area. 5,6,20 Decisions made in the emergency department regarding possible diagnosis and the timing and means of the imaging used are important. 5 In conjunction with debate on the use of conventional imaging, the potential use of a wider scope of imaging technology is discussed to understand possible changes that might occur centrally and/or peripherally with pain and injury.…”

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confidence: 99%

“…Another issue of importance that is presented is how to shape and translate the growing knowledge base of predictors of poorer and better prognoses into valid and usable clinical tools to aid decision making. 2,20,31 Other contributions further reveal the current multifaceted research into the varying aspects of whiplash-associated disorders. Research into neurological/ stress/immune processes may help us to understand mechanisms and provide novel treatment directions.…”

mentioning

confidence: 99%

“…Local morphological change in the neck muscles (fatty infiltrate) has again been verified as unique to chronic whiplash, 15 and how psychosocial features might influence outcomes following a whiplash injury is presented. 20 The eclectic group of commentaries in this special issue reflects the multifaceted nature of whiplash-associated disorders and the wide-ranging research in the field. While management of whiplash, especially the challenge of lessening the rate of transition to chronicity, has yet to be achieved, the picture is becoming clearer.…”

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confidence: 99%

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Whiplash Continues Its Challenge

Jull¹

2016

J Orthop Sports Phys Ther

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There have been many advances in the management of neck pain disorders, but a personal frustration as a clinician and researcher in the field is that the incidence of full recovery following a whiplash injury as a result of a motor vehicle crash has not increased and, subsequently, the rate of transition to chronic neck pain has not lessened. The commentaries in this special issue reflect the multifaceted nature of whiplash-associated disorders and the wide-ranging research in the field. While management of whiplash, especially the challenge of lessening the rate of transition to chronicity, has yet to be achieved, the picture is becoming clearer. This should give great confidence and some hope to individuals with whiplash-associated disorders who have long-term pain and functional disability that after the next decade of research and clinical development, the outcomes following whiplash are likely to be vastly improved. J Orthop Sports Phys Ther 2016;46(10):815-817. doi:10.2519/jospt.2016.0112.

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Recovery Pathways and Prognosis After Whiplash Injury

Cited by 38 publications

References 53 publications

Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation

Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation

Randomized controlled trial of exercise interventions for chronic whiplash-associated disorders: One-year follow-up of the effect on neck muscle endurance, active cervical range of motion and grip strength.

Whiplash Continues Its Challenge

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