Clinical characteristics differ between patients with non-traumatic neck pain, patients with whiplash-associated disorders, and pain-free individuals

M.S. Stenneberg*, G.G.M. Scholten-Peeters, C.S. den Uil, M.E. Wildeman, E. van Trijffel, R.A. de Bie

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BackgroundEvidence is lacking to what extent patients with Whiplash-Associated Disorders (WAD), those with non-traumatic neck pain (NTNP), and pain-free individuals differ regarding type and severity of impairments, disability, and psychological factors.Objective To compare clinical characteristics between patients with WAD, with NTNP, and pain-free individuals in primary care physiotherapy. Additionally, differences between patient groups for both acute and chronic symptoms were assessed.MethodA cross-sectional study was conducted including 168 patients with WAD, 336 matched patients with NTNP, and 336 pain-free individuals. Differences and prevalence rates were calculated for pain intensity, pain distribution, cervical range of motion, neck flexor muscle endurance, self-reported disability, and psychological factors.Results Patients with WAD had higher pain intensity (median 6/10 vs. 5/10 p<.01), had a wider distribution of their neck pain (p=.02), more restricted cervical flexion-extension (-11.9 degrees) and rotation (-12.4 degrees), less muscle endurance (-5.5 seconds), and more disability (+14.0%), compared to patients with NTNP. More patients with WAD reported low back pain (+9.5%) and headache (+12.2%) as musculoskeletal comorbidities. Regarding anxiety, depression, and stress, most patients (>83%) scored in the normal range. No significant differences between the patient groups were observed (p>.16). Both patient groups scored significantly worse than pain-free individuals on all characteristics. Patients with WAD and NTNP experienced different types of activity limitations and participation restrictions.ConclusionWAD is a more severe condition than NTNP and should be considered a separate subgroup. A different approach in clinical practice and research is required for WAD and NTNP.
Original languageEnglish
Pages (from-to)2592–2602
Number of pages11
JournalPhysiotherapy Theory and Practice
Volume38
Issue number13
Early online date2 Sep 2021
DOIs
Publication statusPublished - 2022

Keywords

  • Subgroups
  • cervical spine
  • clinical characteristics
  • disability
  • whiplash injury
  • ANXIETY STRESS SCALES
  • ICF LINKING RULES
  • DISABILITY INDEX
  • RATING-SCALE
  • TASK-FORCE
  • RELIABILITY
  • DEPRESSION
  • VALIDITY
  • HEALTH
  • MODEL

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