Abstract
Up to now no therapy study has used the classification system of the Quebec Task Force (QTF) to differentiate between patients with (QTF II°) and without functional disorders (QTF I°). This differentiation seems meaningful, as this difference may be relevant for the correct treatment planning. In this context the effect of the therapy recommendation “act as usual” has been evaluated in a homogeneous patient collective with whiplash injuries QTF I°.470 patients with acute whiplash injuries had been catched in this study and classified according to the QTF. 359 patients (76.4%) with QTF I° injuries could be identified. Out of that 162 patients were enrolled to the study and received the therapy recommendation “act as usual” and the adapted pain treatment with non-steroidal anti-inflammatory drugs (NSAID). After six months the outcome was evaluated by phone.After injury the median pain score assessed by a visual analogue scale (VAS) was 5.4 (min = 3.3; max = 8.5). After six months 5 of the 162 patients complained intermittent pain symptoms (VAS values < 2). This is consistent with a chronification rate of 3.1%. After injury, the median pain disability index (PDI) was 3.9 (min = 1.9; max = 7.7). After six months 3 of the 162 patients stated persisting disability during sporting and physical activities (VAS values < 1).The therapy recommendation “act as usual” in combination with an adapted pain treatment is sufficient. Usually patients with whiplash injuries QTF I° do not need physical therapy. An escalation of therapy measures should be reserved to patients with complicated healing processes.
Highlights
In the age of increasing private transport, one can observe a steady increase in the incidence of whiplash injuries of the cervical spine (Bener, Rahman, & Mitra, 2009; Halpin, Greenspan, Haileyesus, & Annest, 2009; Quinlan, Annest, Myer, Ryan, & Hill, 2004)
Out of that 162 patients were enrolled to the study and received the therapy recommendation “act as usual” and the adapted pain treatment with non-steroidal anti-inflammatory drugs (NSAID)
The majority of whiplash injuries of the cervical spine are a domain of conservative treatment
Summary
In the age of increasing private transport, one can observe a steady increase in the incidence of whiplash injuries of the cervical spine (Bener, Rahman, & Mitra, 2009; Halpin, Greenspan, Haileyesus, & Annest, 2009; Quinlan, Annest, Myer, Ryan, & Hill, 2004). In view of the frequency by which the physicians and physical therapists are confronted with this diagnosis and under consideration of its economic relevance the aim of acute therapy must be the best possible reduction of the healing time and the prevention of chronicity of the symptoms. Previous studies have compared a wide variety of therapy measures such as mobilisation (Gross et al, 2004), manual therapy (D'Sylva et al, 2010; Gross et al, 2004), traction (D'Sylva et al, 2010), machine-assisted muscle building training (Taimela, Takala, Asklof, Seppala, & Parviainen, 2000), ultrasound (Koes et al, 1992), electromagnetic waves (Kroeling, Gross, & Houghton, 2005), TENS (Foley Nolan, Barry, Coughlan, O'Connor, & Roden, 1990), nerve stimulation (Provinciali, Baroni, Illuminati, & Ceravolo, 1996) and Caiontophoresis (Provinciali et al, 1996)
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