Whiplash - latest evidence for rehabilitation and recovery

WHIPLASH: LATEST EVIDENCE FOR REHABILITATION AND RECOVERY

Presenter: Sterling M

Consistent international data indicate that up to 50% of people will not

have recovered one year post whiplash injury. Whilst there is variability

in recovery pathways, recent exploration using trajectory modelling

analytical techniques has identified distinct recovery pathways

(trajectories). Various physical and psychological factors have also been

identified as being prognostic of poor health outcomes following whiplash

injury, including initial pain intensity, initial disability, pain catastrophizing,

posttraumatic stress symptoms, recovery expectations and signs of

central sensitisation. Many trials have investigated relatively simple

interventions such as exercise programs that may not be sufficient to

address the complex clinical presentation seen in those with already

chronic symptoms or those individuals with acute whiplash pain identified

as being at high risk of poor-recovery. A recent high quality trial showed

little benefit of an early multi-disciplinary intervention on the incidence

of chronic pain development. Another high quality trial of an intensive

physical rehabilitation program for people with chronic whiplash showed

no greater effect than simple advice. In overall terms, currently available

trials for whiplash could be described as showing mostly small effects in

improving health outcomes. Whilst the question of how to prevent the

transition from acute to chronic pain after whiplash injury cannot yet be

answered, this presentation will outline and discuss possible ways forward

for the management of this condition.

CPD Points: 0.5