Group 1 & 3: Active intervention (within 96 hours of injury or delayed 14 days).
Group 2 & 4: Standard intervention (within 96 hours of injury or delayed 14 days).
The subjects were assessed at 6 months and 3 years post injury. The outcomes measures were pain intensity using a visual analog scale, cervical range of motion (ROM) measurement and the amount of sick leave required due to the WAD.
Phase 1 was given to all patients and included information on postural control, and cervical rotation exercises that were to be performed 10 times every 1 hour as far as pain permits. This phase was meant to encourage safe and frequent home exercising and appropriate pain coping behavior.
Phase 2 was initiated at 20 days post injury if symptoms persisted, and consisted of a standard dynamic mechanical assessment. The evaluation was administered by a physical therapist that has been formally trained in Mechanical Diagnosis and Therapy (MDT). The MDT program consisted of end range spinal movements and/or manual therapy techniques. MDT also incorporates advice on appropriate postures, pain coping behavior, and home exercise.
The standard intervention consisted of written information on the injury mechanism, advice on suitable activities, and postural advice. The advice was to rest the neck during the first weeks after trauma and that a soft cervical collar could provide comfort as well as prevent the neck from excessive movement. The patients were instructed to perform active movements of the neck and shoulders 2-3 times daily starting a few weeks after trauma.
The main finding in this study was that active intervention in patients with WAD resulted in a significantly greater reduction in pain intensity, a greater chance to retain or regain ROM, and reduced sick leave compared with a standard intervention. The main clinical implication is that patients with acute WAD should be instructed in self-mobilization as soon as possible. If symptoms persist more than 20 days after trauma, patients should seek treatment from a health professional trained in MDT. In the Oklahoma city area you can visit Stover PT. Despite this evidence, standard intervention continues to be recommended to patients (Rosenfeld, Seferiadis, Carlsson, & Gunnarsson, 2003, p. 2491).
Rosenfeld, M., Seferiadis, A., Carlsson, J., & Gunnarsson, R. (2003). Active intervention in patients with whiplash associated disorders improves long term prognosis: A Randomized controlled clinical trial. Spine, 28 (22), 2491-2498