Abstract
This study investigates whether baseline pain extent, extracted from an electronic pain drawing, is an independent predictive factor of pain and disability measured 1 year and 2 years later in people with chronic WAD. Participants completed questionnaires assessing neck pain intensity, disability via the Neck Disability Index (NDI), psychological features, and work ability. Participants also completed electronic pain drawings from which their pain extent was extracted. A two-step modelling approach was undertaken to identify the crude and adjusted association between pain extent and NDI measured at 1-year and 2-year follow-ups. A total of 205 participants were included in the analysis. The univariate analysis showed that pain extent was significantly associated with the NDI score at the 1-year (p = 0.006, 95% CI: 0.159–0.909) and 2-year (p = 0.029, 0.057–0.914) follow-ups. These associations were not maintained when we introduced perceived disability, psychological health, and work ability into the model after 1 year (p = 0.56, 95%CI: −0.28–0.499) and 2 years (p = 0.401, −0.226–0.544). Pain extent, as an independent factor, was significantly associated with perceived pain and disability in patients with chronic WAD for up to 2 years. This association was masked by neck disability, psychological health, and work ability.
Highlights
The primary cause of whiplash-associated disorders (WAD) is motor vehicle collision, which results in a neck injury due to the acceleration–deceleration mechanism [1]
A secondary analysis of data from a randomized controlled trial (ClinicalTrials.gov, NCT01528579, 1 Febrary 2021) [22] was performed to investigate whether pain extent was associated with long-term outcome in people with chronic WAD
A one-percent increase in pain extent significantly increased Neck Disability Index (NDI) by 0.5 units (t = 2.88, p = 0.006, 95% CI: 0.159–0.909) (Table 4)
Summary
The primary cause of whiplash-associated disorders (WAD) is motor vehicle collision, which results in a neck injury due to the acceleration–deceleration mechanism [1]. Improvements in pain and disability are likely to occur in the first three months after the injury but do not change substantially after this time. 50% of patients with WAD continue to experience persistent symptoms one year after the trauma [5,6]. Prognosis following WAD is multifactorial and may include personal, social, and environmental factors. Indicators of central sensitization appear to influence recovery in people with WAD [7,8,9]. Widespread pain is often seen in patients with chronic
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