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Whiplash-associated Disorders: Who Gets Depressed? Who Stays Depressed?

Chiro.Org Blog: In a prior study we reported that post crash depression is common following crash related WAD. As a follow-up to that, we now report the characteristics that can assist clinicians to identify not only which patients are more likely to experience post-crash depression, but also identify which are at risk for a more severe course of depression. This is important because depressed mood in those with WAD is not only an additional health burden in itself, but is also associated with slower recovery. The most important characteristics in identifying those with WAD who are likely to experience depression were higher post crash pain, other post-crash symptoms, sustaining a fractured bone, the presence of post-crash anxiety, and the presence of prior mental health problems. […]

Low Speed Frontal Crashes and Low Speed Rear Crashes

Chiro.Org Blog: Analysis of data revealed that the rear impact vector crash resulted in 2.8 times greater head linear acceleration than frontal crashes. Rear impact crashes resulted in biphasic, complex kinematics compared to the monophasic, less complex frontal crashes. Rear impact crashes were rated markedly less tolerable. Sex-specific differences are also discussed. […]

Mild Traumatic Brain Injury After Motor Vehicle Collisions:
What Are the Symptoms and Who Treats Them?

Chiro.Org Blog: A total of 1716 adults suffered MTBI after a motor vehicle collision over the 2-year inception period. Six weeks after the collision, 75% reported having more than 3 symptoms and 30% had clinically significant pain in more than 3 body sites. Over time, the prevalence of symptoms and pain decreased but they were still common after 1 year. Almost all participants sought care for their symptoms at all time points, most commonly from a physician. Care-seeking from physiotherapists, chiropractors, and massage therapists was also very common, and most participants sought care from 2 or 3 providers at all follow-up points. […]

A Population-based, Incidence Cohort Study of Mid-back Pain After Traffic Collisions

Chiro.Org Blog: Mid-back pain after traffic collisions is common, especially in women and in young individuals. A substantial proportion of participants in this cohort experienced a delayed recovery. Prognostic factors with the strongest influence on recovery were poor expectations for recovery and having a previous experience of a traffic injury. […]

Comparing 2 Whiplash Grading Systems
To Predict Clinical Outcomes

Chiro.Org Blog: In 1993, a formal whiplash grading system was introduced by Croft, [5, 6] and in 1995, a modified version was published by the Quebec Task Force on Whiplash-Associated Disorders (QTF-WAD). [7] These grading systems are compared in Table 1. Subsequent reports have indicated some correlation between outcome and grade of severity, [8-15] but most authors have studied only grade 1 and 2 injuries. […]

Vertical Posture and Head Stability in Patients With Chronic Neck Pain

Chiro.Org Blog: Patients with chronic neck pain, in particular those with whiplash-associated disorders, showed larger sway areas and reduced ability to successfully execute more challenging balance tasks. They also displayed larger sway areas and reduced head stability during perturbations. The results show that disturbances of postural control in chronic neck pain are dependent on the etiology, and that it is possible to quantify characteristic postural disturbances in different neck pain conditions. […]

Management of Neck Pain and Associated Disorders

Chiro.Org Blog: This guideline is based on recent systematic reviews of high-quality studies. A multidisciplinary expert panel considered the evidence of effectiveness, safety, cost-effectiveness, societal and ethical values, and patient experiences (obtained from qualitative research) when formulating recommendations. Target audience includes clinicians; target population is adults with grades I-III NAD <6 months duration. […]

Patients’ Experiences With Vehicle Collision

Chiro.Org Blog: The purpose of this narrative inquiry was to explore the experiences of persons who were injured in traffic collisions and seek their recommendations for the development of clinical practice guideline (CPG) for the management of minor traffic injuries. […]

Function in Patients With Cervical Radiculopathy or Chronic Whiplash-Associated Disorders Compared With Healthy Volunteers

Chiro.Org Blog: Patient groups exhibited significantly lower performance than the healthy group in all physical measures (P < .0005) except for neck muscle endurance in flexion for women (P > .09). There was a general trend toward worse results in the CR group than the WAD group, with significant differences in neck active range of motion, left hand strength for women, pain intensity, Neck Disability Index, EuroQol 5-dimensional self-classifier, and Self-Efficacy Scale (P < .0001). […]

Whiplash & Chiropractic

Chiro.Org Blog: Whiplash is an enigmatic injury. We spend billions of dollars each year to treat it. Yet many lawyers, legislators, and medical doctors deny its existence. It affects millions of people around the world, yet research is severely under-funded. It is a largely preventable injury, yet we do little to prevent it. Fortunately, times are changing as whiplash enters a new phase of research and understanding. […]

Sleep Characteristics in Patients with Whiplash-Associated Disorders: A Descriptive Study

Chiro.Org Blog: Neck pain related to whiplash-associated disorders (WAD) constitutes a significant health issue that leads patients to seek medical care in chiropractic and other physical therapy, rehabilitative clinics. Studies have indicated that individuals experience multiple clinical manifestations of WADs that lead to chronicity including postural changes, disability, headache, fatigue, and sleep disturbances. [1-4] Although studies have shown that sleep disturbances occur as a result of chronic pain, few studies have explored the relationship between patients with WAD and sleep quality. [4-6] […]

Central Hypersensitivity In Chronic Pain
After Whiplash Injury

Chiro.Org Blog: The authors found a hypersensitivity to peripheral stimulation in whiplash patients. Hypersensitivity was observed after cutaneous and muscular stimulation, at both neck and lower limb. Because hypersensitivity was observed in healthy tissues, it resulted from alterations in the central processing of sensory stimuli (central hypersensitivity). Central hypersensitivity was not dependent on a nociceptive input arising from the painful and tender muscles. […]

Comparison of Outcomes in Neck Pain Patients With and Without Dizziness

Chiro.Org Blog: Neck pain patients with dizziness reported significantly higher pain and disability scores at baseline compared to patients without dizziness. A high proportion of patients in both groups reported clinically relevant improvement on the PGIC scale. At 6 months after start of chiropractic treatment there were no differences in any outcome measures between the two groups. […]

A Systematic Review of Chiropractic Management of Adults with Whiplash Associated Disorders: Recommendations for Advancing Evidence-based Practice and Research

Chiro.Org Blog: There is a baseline of evidence that suggests chiropractic care improves the cervical range of motion (cROM) and pain in the management of WAD. However, the level of this evidence relevant to clinical practice remains low or draws on clinical consensus at this time. The WAD-Plus Model has implications for use by chiropractors and interdisciplinary professionals in the assessment and management of acute, sub-acute and chronic pain due to WAD. Furthermore, the WAD-Plus Model can be used in the future study of interventions and outcomes to advanced evidenced-based care in the management of WAD. […]

Symptomatic Classification of Whiplash Injury and the Implications for Treatment

Chiro.Org Blog: Gargan and Bannister are renowned orthopedic trauma researchers from the Department of Orthopedic Surgery, John Radcliffe Hospital in Bristol, Oxford, England. In 1994, they published a paper in the European Spine Journal on the recovery rate of patients with whiplash injuries, and discovered that IF a patient was still symptomatic after three months, there was almost a 90% chance they would remain so. [1] […]