Soft-collar use in rehabilitation of whiplash-associated disorders - A systematic review and meta-analysis

Christensen, Steffan Wittrup; Rasmussen, Michael Bo; Jespersen, Christoffer Lund; Sterling, Michele; Skou, Søren Thorgaard

doi:10.1016/j.msksp.2021.102426

Cited by 2 publications

(4 citation statements)

References 53 publications

(93 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the overall quality of the evidence was low, and the majority of the relevant randomized controlled trials on the topic [45,61,71,72] lack blinding [73] and are affected from affection bias [74], the two most recent systematic reviews did not observe any advantages of an immobilization protocol by the use of a soft collar [27]. Notably, nonimmobilization of the neck showed a greater pain intensity reduction [27] and function recovery at the long-term follow-up [26]. Interestingly, these results seem to be independent from the adjunct of physical therapy, highlighting the negative influences of the collar on the non-physical components and, then, the patients' prognosis [26].…”

Section: Discussionmentioning

confidence: 99%

“…Although methodological concerns that may have a direct impact on the interpretation of the findings arose [25], Ricciardi et al, in their systematic review, concluded that a non-immobilization protocol for WAD has better outcomes in relieving pain and in the recovery of neck function [26]. In a more recent systematic review, Christenesen et al confirmed that an active/act-as-usual approach has more favorable outcomes in terms of pain reduction [27]. These findings increase the attention on the soft cervical collar as a contributor to the persistence of symptoms.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of Soft Cervical Collar among Whiplash Patients in Two Italian Emergency Departments Is Associated with Persistence of Symptoms: A Propensity Score Matching Analysis

et al. 2021

View full text Add to dashboard Cite

Purpose: Although the use of soft cervical collars in the emergency department (ED), for whiplash-associated disorders (WAD), is controversial, it is still widely adopted. The purpose of our study was to investigate the impact of the early use of soft cervical collars on the return to the ED, within three months of a road traffic collision. Methods: We conducted a retrospective observational study on WAD patients from two EDs in Verona (Italy). Patients in the earlier acute phase of WAD (within 48 h from the trauma) were included; those with serious conditions (WAD IV) were excluded. As an end point, we considered patients who returned to the ED complaining of WAD symptoms within three months as positive outcome for WAD persistence. Results: 2162 patients were included; of those, 85.4% (n = 1847/2162) received a soft cervical collar prescription. Further, 8.4% (n = 156/1847) of those with a soft cervical collar prescription, and 2.5% (n = 8/315) of those without a soft cervical collar (p < 0.001) returned to the ED within three months. The use of the soft cervical collar was an independent risk factor for ED return within three months, with an OR, adjusted for possible clinical confounders, equal to 3.418 (95% CI 1.653–7.069; p < 0.001). After the propensity score matching, 25.5% of the patients (n = 25/98) using the soft cervical collar returned to the ED at three months, compared to the 6.1% (n = 6/98) that did not adopt the soft cervical collar. The use of a soft cervical collar was associated with ED return with an OR = 4.314 (95% CI 2.066–11.668; p = 0.001). Conclusions: Our study shows that the positioning of the soft collar in a cohort of patients with acute WAD, following a rear-end car collision, is an independent potential risk factor to the return to the ED. Clinically, the use of the collar is a non-recommended practice and seems to be related to an increased risk of delayed recovery. There is a need to inform healthcare providers involved in the ED of the aim to limit the use of the soft cervical collar. A closer collaboration between clinicians (e.g., physicians, physical therapists, nurses) is suggested in the ED. Future primary studies should determine differences between having used or not having used the collar, and compare early physical therapy in the ED compared with the utilization of the collar.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of Soft Cervical Collar among Whiplash Patients in Two Italian Emergency Departments Is Associated with Persistence of Symptoms: A Propensity Score Matching Analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Currently, various types of braces are available for spinal injury patients, ranging from soft-cervical collars to skeletal skull traction and halo vests, each with a distinct application [ 5 ]. Soft-cervical collars are the most common brace used to limit neck movement and reduce pain [ 6 ]. They are typically used in cases of mild to moderate neck pain such as whiplash injury, following a spinal injury, or surgery [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Soft-cervical collars are the most common brace used to limit neck movement and reduce pain [ 6 ]. They are typically used in cases of mild to moderate neck pain such as whiplash injury, following a spinal injury, or surgery [ 6 ]. Conversely, skeletal skull traction is used to reduce fractures or dislocations of the neck and limit movement of the head and neck [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Spine Bracing: When to Utilize—A Narrative Review

et al. 2023

View full text Add to dashboard Cite

Spinal bracing is a common non-surgical technique that allows clinicians to prevent and correct malformations or injuries of a patient’s spinal column. This review will explore the current standards of practice on spinal brace utilization. Specifically, it will highlight bracing usage in traumatic injuries, pregnancy, pediatrics, osteoporosis, and hyperkyphosis; address radiological findings concurrent with brace usage; and provide an overview of the braces currently available and advancements in the field. In doing so, we aim to improve clinicians’ understanding and knowledge of bracing in common spinal pathologies to promote their appropriate use and improve patient outcomes.

show abstract

Soft-collar use in rehabilitation of whiplash-associated disorders - A systematic review and meta-analysis

Cited by 2 publications

References 53 publications

Use of Soft Cervical Collar among Whiplash Patients in Two Italian Emergency Departments Is Associated with Persistence of Symptoms: A Propensity Score Matching Analysis

Use of Soft Cervical Collar among Whiplash Patients in Two Italian Emergency Departments Is Associated with Persistence of Symptoms: A Propensity Score Matching Analysis

Spine Bracing: When to Utilize—A Narrative Review

Contact Info

Product

Resources

About