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 language | English |
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Pages (from-to) | 2592–2602 |
Number of pages | 11 |
Journal | Physiotherapy Theory and Practice |
Volume | 38 |
Issue number | 13 |
Early online date | 2 Sept 2021 |
DOIs | |
Publication status | Published - 18 Nov 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