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  • Toward optimal early management after whiplash injury to lessen the rate of transition to chronicity: discussion paper 5

    Author(s)
    Jull, Gwendolen A
    Soderlund, Anne
    Stemper, Brian D
    Kenardy, Justin
    Gross, Anita R
    Cote, Pierre
    Treleaven, Julia
    Bogduk, Nikolai
    Sterling, Michele
    Curatolo, Michele
    Griffith University Author(s)
    Sterling, Michele
    Year published
    2011
    Metadata
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    Abstract
    Study Design. Expert debate and synthesis of research to inform future management approaches for acute whiplash disorders. Objective. To identify a research agenda toward improving outcomes for acute whiplash-injured individuals to lessen the incidence of transition to chronicity. Summary of Background Data. International figures are concordant, estimating that 50% of individuals recover from pain and disability within 3 to 6 months of a whiplash injury. The remainder report continuing symptoms up to 1 to 2 years or longer postinjury. As no management approach to date has improved recovery rates, new clinical/research ...
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    Study Design. Expert debate and synthesis of research to inform future management approaches for acute whiplash disorders. Objective. To identify a research agenda toward improving outcomes for acute whiplash-injured individuals to lessen the incidence of transition to chronicity. Summary of Background Data. International figures are concordant, estimating that 50% of individuals recover from pain and disability within 3 to 6 months of a whiplash injury. The remainder report continuing symptoms up to 1 to 2 years or longer postinjury. As no management approach to date has improved recovery rates, new clinical/research directions are required for early management of whiplash-injured patients. Methods. A group of multidisciplinary researchers critically debated evidence and current research concerning whiplash from biological, psychological, and social perspectives toward informing future research directions for management of acute whiplash. Results. It was recognized that effective treatments for acute whiplash are constrained by a limited understanding of causes of whiplash-associated disorders. Acute whiplash presentations are heterogeneous leading to the proposal that a research priority was development of a triage system based on modifiable prognostic indicators and clinical features to better inform individualized early management decisions. Other priorities identified included researching effective early pain management for individuals presenting with moderate to high levels of pain; development of best education/information for acute whiplash; testing the efficacy of stratified and individualized rehabilitation, researching modes of delivery considering psychosocial modulators of pain and disability; and the timing, nature, and mode of delivery of cognitive-behavioral therapies. Directions were highlighted for future biomechanical research into injury prevention. Conclusion. The burden of whiplash injuries, the high rate of transition to chronicity, and evidence of limited effects of current management on transition rates demand new directions in evaluation and management. Several directions have been proposed for future research, which reflect the potential multifaceted dimensions of an acute whiplash disorder.
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    Journal Title
    Spine
    Volume
    36
    Issue
    25 suppl
    DOI
    https://doi.org/10.1097/BRS.0b013e3182388449
    Subject
    Biomedical engineering
    Clinical sciences
    Clinical sciences not elsewhere classified
    Publication URI
    http://hdl.handle.net/10072/60824
    Collection
    • Journal articles

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