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dc.contributor.authorJull, Gwendolen
dc.contributor.authorKenardy, Justin
dc.contributor.authorHendrikz, Joan
dc.contributor.authorCohen, Milton
dc.contributor.authorSterling, Michele
dc.date.accessioned2017-05-03T12:02:38Z
dc.date.available2017-05-03T12:02:38Z
dc.date.issued2013
dc.date.modified2014-06-12T23:45:08Z
dc.identifier.issn0304-3959
dc.identifier.doi10.1016/j.pain.2013.05.041
dc.identifier.urihttp://hdl.handle.net/10072/60175
dc.description.abstractAcute whiplash is a heterogeneous disorder that becomes persistent in 40% to 60% of cases. Estimates of recovery have not changed in recent decades. This randomized, single-blind, controlled trial tested whether multidisciplinary individualized treatments for patients with acute whiplash (<4 weeks postinjury) could reduce the incidence of chronicity at 6 mo by 50% compared to usual care. Participants (n = 101) were recruited from accident and emergency centres and the community. It was hypothesized that better recovery rates were achievable if the heterogeneity was recognised and patients received individualised interventions. Patients randomized to pragmatic intervention (n = 49) could receive pharmaceutical management (ranging from simple medications to opioid analgesia), multimodal physiotherapy and psychology for post-traumatic stress according to their presentations. The treatment period was 10 wks with follow-up at 11 weeks and 6 and 12-months. The primary outcome was neck pain and disability (Neck Disability Index (NDI)). Analysis revealed no significant differences in frequency of recovery (NDI ?8%) between pragmatic and usual care groups at 6 months (OR 95%, CI = 0.55, 0.23-1.29), P = 0.163) or 12 mo (OR 95%, CI = 0.65, 0.28-1.47, P = 0.297). There was no improvement in current nonrecovery rates at 6 mo (63.6%, pragmatic care; 48.8%, usual care), indicating no advantage of the early multiprofessional intervention. Baseline levels of pain and disability had a significant bearing on recovery both at 6 and 12 mo in both groups, suggesting that future research focus on finding early effective pain management, particularly for the subgroup of patients with initial high levels of pain and disability, towards improving recovery rates.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.languageEnglish
dc.language.isoeng
dc.publisherElsevier
dc.publisher.placeNetherlands
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrom1798
dc.relation.ispartofpageto1806
dc.relation.ispartofissue9
dc.relation.ispartofjournalPain
dc.relation.ispartofvolume154
dc.rights.retentionY
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchPhysiotherapy
dc.subject.fieldofresearchPsychology
dc.subject.fieldofresearchcode32
dc.subject.fieldofresearchcode420106
dc.subject.fieldofresearchcode52
dc.titleManagement of acute whiplash: A randomized controlled trial of multidisciplinary stratified treatments
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorSterling, Michele


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