ࡱ > @ ] bjbjFF y` , , k 4 6 N N N h BO O 6 N Q V ( .V .V .V W #W /W $ N R T 9 h W W h h .V .V o o o h .V .V _y J o h o o o .V Q Yh2 N }k @ o p D 0 N o n o 6 6 o x 7W \ o ` 4 d 7W 7W 7W 6 6 L N o 6 6 N Table 1. Course of WAD.
Author(s), Year, Study DesignSetting and Subjects
Number (n) EnrolledFollow-upCourseBerglund, 2000 ADDIN REFMGR.CITE Berglund2000476The association between exposure to a rear-end collision and future neck or shoulder pain: a cohort studyJournal476The association between exposure to a rear-end collision and future neck or shoulder pain: a cohort studyBerglund,A.Alfredsson,L.Cassidy,J.D.Jensen,I.Nygren,A.2000/11Accidents,TrafficAdultCohort StudiesConfidence IntervalsEpidemiologyEtiologyFemaleFollow-Up StudiesHumanInjuriesMaleMiddle AgeNeckNeck InjuriesNeck PainPainRiskShoulderShoulder PainStatistics & Numerical DataSupport,Non-U.S.Gov't.SwedenWhiplash InjuriesNot in File10891094Journal of Clinical Epidemiology5311Y (The list was sent in November 2002)Scientifically admissibleCohortPrognosis6MedlineDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. anita.berglund@knv.ki.seJournal of Clinical Epidemiology11
Cohort
Adult car drivers, insured by one company in Sweden, involved in rear-end collisions in 1987-1988. N=182 with WAD; N=136 without WAD. Compared with random sample of persons insured by same company, no history of collision.
Follow-up in at 7 years after collision by mailed survey
39.6% of those with WAD after a collision reported a 3-month period prevalence (often or always) of neck or shoulder pain at 7 years, compared with 14.0% for those not injured 7 years earlier and 11.1% of those who had not been in a collision.
Borchgrevink et al., 1996 ADDIN REFMGR.CITE Borchgrevink1996337National health insurance consumption and chronic symptoms following mild neck sprain injuries in car collisionsJournal337National health insurance consumption and chronic symptoms following mild neck sprain injuries in car collisionsBorchgrevink,G.E.Lereim,I.Royneland,L.Bjorndal,A.Haraldseth,O.1996/12AccidentsAccidents,TrafficAdultChronic DiseaseEconomicsEmergenciesEpidemiologyFemaleHumanInjuriesInsurance,DisabilityMaleNeckNeck PainNorwayPainPatientsQuality of LifeRehabilitation.Retrospective StudiesSick LeaveStatistics & Numerical DataStatistics,NonparametricSupport,Non-U.S.Gov'tUtilizationWhiplash InjuriesNot in File264271Scandinavian Journal of Social Medicine244Y (The list was sent in November 2002)Scientifically admissibleCohortPrognosis34MedlineEmergency Clinic, University Hospital in Trondheim, NorwayScandinavian Journal of Social Medicine12
Cohort
Patients registered with neck sprain injury from car collision, 1985-1990, at hospitals in 4 cities in Norway (representing 7.3% of population of Norway) (n=473)
Follow-up 2.5 to 8.5 years post-collision, using administrative Social Security data.
Outcomes: presence, duration and timing of sick leave27% of those with WAD were on sick leave. 14% had sick leave for less than 2 weeks immediately after collision, 8% for more than 2 weeks immediately after collision and 5% sometime later over follow-up. At follow-up, 58% reported symptoms and 5% claimed rehabilitation or permanent disability pension.
Boyd et al., 2002 ADDIN REFMGR.CITE Boyd20021773Whiplash associated disorder in children attending the emergency departmentJournal1773Whiplash associated disorder in children attending the emergency departmentBoyd,R.Massey,R.Duane,L.Yates,D.W.2002/7EmergenciesNot in File311314Emergency Medicine Journal4Scientifically AdmissibleCohortPrognosis + Primary Prevention/Risk272Emergency Medicine Journal13
Cohort
Children aged 4-16 in northwest England with Grades I and II WAD after car crash; consecutive presentations to 3 urban ERs. Excludes those needing admission.
(n=49)
Followed until asymptomatic or up to 56 days via clinical exam followed by telephone call to confirm continued asymptomatic status.Mean duration of symptoms was 8.8 days (range was 3-70 days). None had symptoms lasting more than 2 months.Bylund et al., 1998 ADDIN REFMGR.CITE Bylund19981156Sick leave and disability pension among passenger car occupants injured in urban trafficJournal1156Sick leave and disability pension among passenger car occupants injured in urban trafficBylund,P.O.Bjornstig,U.1998/5/1Accidents,TrafficAdolescenceAdultAgedAnalysisCervical VertebraeCohort StudiesEconomicsEpidemiologyEpidemiology.FemaleHealth Care CostsHumanInjuriesInsurance,DisabilityMaleMethodsMiddle AgeSick LeaveSocioeconomic FactorsSpinal InjuriesSpineStatistics & Numerical DataSupport,Non-U.S.Gov'tSurgerySwedenUrban PopulationWhiplash InjuriesNot in File10231028Spine239R-rScientifically AdmissibleCohortPrimary Prevention/Risk + Prognosis707MedlineUmea Accident Analysis Group, Department of Surgery, Umea University, SwedenSpine14
Cohort
Passenger car occupants aged 16-64 y involved in car accidents in the city of Umea Sweden from January 1, 1990 to December 31, 1991 who were registered by the Accident Analysis Group at the University Hospital (n=255)Follow-up at 2.5 years post-injury and on January 1, 1996 (4-6 years post-injury), using data from Social Insurance Office records (universal coverage) to assess days on sick leave, costs of sick leave and disability pension. During the 2.5 years following the car accident 40% (103) had been on sick leave totaling 12,500 days for total benefits of 0.8 million US dollars. Cervical strains accounted for 75% of total sick-leave days. Within 2.5 years, only 18 (7%) still on sick leave.
By 4-6 years after injury, 9 people had been approved for disability pension (all with cervical strains) and 9 others were on full or partial sick leave.
Disability pension costs estimated between $1.1 and 3.8 million (USD).
Cassidy at al., 2000 ADDIN REFMGR.CITE Cassidy20001314Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injuryJournal1314Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injuryCassidy,J.D.Carroll,L.J.Côté,P.Lemstra,M.Berglund,A.Nygren,A.2000/4/20Accidents,TrafficAdultCanadaComparative StudyComplicationsEconomicsEpidemiology.EtiologyFemaleHumanIncidenceInjuriesInsurance Claim ReportingInsurance Claim ReviewInsurance,AccidentInsurance,LiabilityLegislation & JurisprudenceMaleMethodsNeckNeck PainPainPrognosisResearchSaskatchewanStatistics & Numerical DataSupport,Non-U.S.Gov'tTime FactorsUtilizationWhiplash InjuriesNot in File11791186New England Journal of Medicine34216Y (The list was sent in November 2002)Scientifically admissibleCohortPrimary Prevention/Risk + Prognosis7MedlineAlberta Centre for Injury Control and Research, Department of Public Health Sciences, University of Alberta, Edmonton, Canada. dcassidy@ualberta.caNew England Journal of Medicine15
Cohort
All adults submitting personal injury claims after motor vehicle injury in Saskatchewan, Canada, 1994-1995; self-reported neck or shoulder pain after collision. Excluded reopened claims, hospitalized for more than 2 days. (n=5,398)
Follow-up of time to claim closure by administrative database to 1997; claim closure in both tort and no fault system validated against self-reported recovery in depression, neck pain and physical functioning. Median time to claim closure was 433 (95% CI 409-457) days under the tort system and 194 (95% CI 182-206) days under the subsequent no fault system.Cassidy et al., 2007 ADDIN REFMGR.CITE Cassidy20072171Does multidisciplinary rehabilitation benefit whiplash recovery? Results of a population-based incidence cohort study.Journal2171Does multidisciplinary rehabilitation benefit whiplash recovery? Results of a population-based incidence cohort study.Cassidy,J.D.Carroll,L.J.Côté,P.Frank,J.W.2007/1/1AdultCanadaClinical MedicinecohortCohort StudiesExerciseHealthHealth ServicesHealth Services ResearchIncidenceInjuriesInsurance BenefitsMethodsNeck PainOntarioPolicyPopulationPrognosisPublic HealthrecoveryRehabilitationResearchSaskatchewanSelf ReportTimeUniversitieswhiplashWorkNot in File126131Spine321Scientifically AdmissibleCohort StudyIntervention17090362-2436Spine16
Cohort
All adults submitting personal injury claims after motor vehicle injury in Saskatchewan, Canada, 1997-1998; self-reported collision-related neck pain. Excluded those hospitalized for more than 2 days. (n=6,021)
Follow-up by telephone interview at 6 weeks, 3, 6, 9 and 12 months. Self-reported global recovery, as determined by endorsement of all better or quite a bit of improvement.Median time to recovery was 4 months. Drottning et al., 2002 ADDIN REFMGR.CITE Drottning20022043Cervicogenic headache (CEH) after whiplash injuryJournal2043Cervicogenic headache (CEH) after whiplash injuryDrottning,M.Staff,P.H.Sjaastad,O.2002/4*Headache Disordersep [Epidemiology]*Whiplash Injuriesep [Epidemiology]AccidentsAdolescentAdultAgedCohort StudiesComparative StudyEmergenciesFemaleHeadacheHeadache Disorderset [Etiology]Headache Disorderspp [Physiopathology]HumanInjuriesMaleMiddle AgedMotionNeckNeck PainNeurologyNorwayPainPatientsProspective StudiesQuestionnaireQuestionnairesUniversitiesWhiplash InjuriesWhiplash Injuriesco [Complications]Whiplash Injuriespp [Physiopathology]Not in File165171Cephalalgia223R-RScientifically AdmissibleClinical DescriptivePrognosis1227MedlineCephalalgia17
Descriptive
Patients with possible WAD attending emergency department in Oslo after a traffic collision; 1993-1995. (n=587). Initial questionnaire at 4 weeks, followed by examination for cervicogenic headache at 6 weeks and follow-up at 6 months and 1 year. 8.2% of patients had cervicogenic headache at 6 weeks, 4.4% at 6 months and 3.4% at 1 year. At 1 year, 44% of whole sample had neck pain (12% had daily neck pain). Of those with cervicogenic headache at 1 year, 90% had concurrent neck pain (35% had daily neck pain)
Gargan et al., 1994 ADDIN REFMGR.CITE Gargan1994434The rate of recovery following whiplash injuryJournal434The rate of recovery following whiplash injuryGargan,M.F.Bannister,G.C.1994AdolescenceAdultChildComplicationsFemaleFollow-Up StudiesHumanInjuriesMaleMiddle AgeNeckNeck InjuriesPatientsPrognosisProspective StudiesTherapy.Time FactorsWhiplash InjuriesNot in File162164European Spine Journal33R-RScientifically AdmissibleCohort StudyPrimary Prevention/Risk/Prognosis1022MedlineTrauma Service, John Radcliffe Hospital, Oxford, UKEuropean Spine Journal18
Cohort
Patients attending the emergency department in Swindon, England from May to September, 1991, following a rear-end collision; most were symptomatic. All were given soft collars and non-steroidal medication. (n=50)
Symptoms assessed within 7 days by examination and after three months, via temporal records82% had neck pain within 7 days of the collision and another 4% had later symptoms. After 3 months, 66% reported neck pain.Holm et al. 1999 ADDIN REFMGR.CITE Holm19991033Impairment and work disability due to whiplash injury following traffic collisions. An analysis of insurance material from the Swedish Road Traffic Injury CommissionJournal1033Impairment and work disability due to whiplash injury following traffic collisions. An analysis of insurance material from the Swedish Road Traffic Injury CommissionHolm,L.Cassidy,J.D.Sjogren,Y.Nygren,A.1999Accidents,TrafficAdolescenceAdultAge FactorsAnalysisCost of IllnessCross-Sectional StudiesDisabled PersonsEmploymentEpidemiologyFemaleHumanInjuriesInjury Severity ScoreInsurance Claim ReportingMaleMiddle AgeSocioeconomic FactorsStatistics & Numerical DataSupport,Non-U.S.Gov'tSwedenTrendsWhiplash InjuriesWorkWork Capacity Evaluation.Not in File116123Scandinavian Journal of Public Health272Y (The list was sent in November 2002)Scientifically admissibleCross-sectional studyPrognosis17MedlineDepartment of Clinical Neuroscience, Karolinska Institute, Stockholm, SwedenScandinavian Journal of Public Health19
Cross-sectional
Swedish population with a permanent medical impairment of 10% or more due to road traffic injury during years 1989 or 1994. (n=184 impaired due to WAD in 1989 and n=481 in 1994).
Outcome assessed average of 4 years after injury.
Outcomes: prevalence of medical impairment, reduced or full work disabilityIn those judged to have permanent medical impairment of 10% or more due to WAD, 63% had returned to full working capacity in 1989 and 69% in 1994. Jnsson et al., 1994 ADDIN REFMGR.CITE Jonsson19941631Findings and outcome in whiplash-type neck distortionsJournal1631Findings and outcome in whiplash-type neck distortionsJonsson,H.Cesarini,K.Sahlstedt,B.Rauschning,W.1994/12/15*Intervertebral Disk Displacementet [Etiology]*Soft Tissue Injurieset [Etiology]*Whiplash Injuriesco [Complications]AdolescentAdultFemaleFollow-Up StudiesHumanIncidenceInjuriesIntervertebral Disk Displacementdi [Diagnosis]Intervertebral Disk Displacementsu [Surgery]Magnetic Resonance ImagingMaleMethodsMiddle AgedNeckNeck PainPainPatientsSoft Tissue InjuriesSupport,Non-U.S.Gov'tSurgerySwedenTreatment OutcomeWhiplash Injuriesdi [Diagnosis]Whiplash Injuriessu [Surgery]WomenNot in File27332743Spine1924Scientifically AdmissibleCohortPrognosis345Spine110
Cohort (Phase 1)
Consecutive patients with a WAD-type injury in automobile collisions presenting to the only available emergency primary care trauma center in Uppsala, Sweden during a 13 month period.
(n=50)Questionnaires and physical examination at 6 weeks, one year and 5 yearsAt 6 weeks, 26 (52%) had recovered and resumed their previous activities without restriction; 24 (48%) had persistent or aggravated neck pain; and of these, 19 had radiating pain. Of the 26 asymptomatic at 6 weeks, 19 (73%) were asymptomatic at 5 years.
Of the 24 symptomatic at 6 weeks, 14 (58%) reported neck pain at 5 years (11-point VAS of 1-6) and had extensive treatment (physical therapy, chiropractic, surgery).
Kasch et al., 2003 ADDIN REFMGR.CITE Kasch20031566Development in pain and neurologic complaints after whiplash: A 1-year prospective studyJournal1566Development in pain and neurologic complaints after whiplash: A 1-year prospective studyKasch,H.Bach,F.W.Stengaard-Pedersen,K.Jensen,T.S.2003/3/11BackExtremitiesHeadInjuriesMethodsNeckNeurologyPainPatientsProspective StudiesWhiplash InjuriesNot in File743749Neurology605Scientifically AdmissibleCohort StudyPrognosis256Hand searchNeurology111
Cohort
Consecutive adult patients in Aarhus area attending emergency department with neck pain or headache after exposure to rear collision; January 1997 through January 1998. Excludes those with prior neck or low back disorder or head trauma. (n=141 with WAD)
Questionnaires, interview and clinical examination at 1 week and 1, 3, 6 and 12 months.At 1 month, overall pain decreased from 23 to 16 on the 100 mm VAS. Median neck pain fell from 32 at 1 week to 23 at 1 monthMayou et al, 2002 ADDIN REFMGR.CITE Mayou20021461Psychiatry of whiplash neck injuryJournal1461Psychiatry of whiplash neck injuryMayou,R.Bryant,B.2002/5*Accidents,Trafficpx [Psychology]*Mental Disorderset [Etiology]*Whiplash Injuriespx [Psychology]AdolescentAdultAgedEmergenciesFemaleFollow-Up StudiesHumanInjuriesInsurance,DisabilityLogistic ModelsMaleMiddle AgedNeckNeck InjuriesPainPainet [Etiology]PrognosisStress Disorders,Post-Traumaticet [Etiology]UniversitiesNot in File441448British Journal of Psychiatry180R-RScientifically AdmissibleCohortPrognosis943MedlineBritish Journal of Psychiatry112
Cohort
Patients with WAD attending the Accident and Emergency Department at John Radcliffe Hospital in Oxford, England over a 1-year period. No date range given for this 1-year period. Excludes head injuries with > 15 minutes loss of consciousness.
(N=278).Follow-up questionnaires at 3 months.3 months after injury, 64% reported minor/major problems; 37% had moderate to very severe pain; 57% saw a general practitioner; 24% had post-traumatic stress disorders; 21% had anxiety or depression; 21% had phobic travel anxiety; 37% had psychological consequences; 47% had minor/major financial problems; 15 had moderate to extreme limitations of daily activities in the past month; and 62% were claiming compensation.
Miettinen et al., 2004 ADDIN REFMGR.CITE Miettinen20042110Whiplash injuries in Finland--the possibility of some sociodemographic and psychosocial factors to predict the outcome after one yearJournal2110Whiplash injuries in Finland--the possibility of some sociodemographic and psychosocial factors to predict the outcome after one yearMiettinen,T.Airaksinen,O.Lindgren,K.A.Leino,E.2004/12/2*Whiplash Injuriesrh [Rehabilitation]AccidentsAccidents,TrafficAdultEducationFemaleFinlandHealthHealth StatusHumansInjuriesMaleMedicineNeckNeck InjuriesPrognosisProspective StudiesProspective studyQuestionnaireQuestionnairesRehabilitationResearchResearch Support,Non-U.S.Gov'tRisk FactorsSeat BeltsSick LeaveStress,Psychologicalet [Etiology]UniversitiesWhiplash InjuriesWhiplash Injuriespx [Psychology]Not in File13671372Disability & Rehabilitation2623R-RScientifically AdmissibleCohort StudyPrognosis1417Disability & Rehabilitation113
Cohort
Miettinen et al., 2004 ADDIN REFMGR.CITE Miettinen20046397Whiplash injuries in Finland: the situation 3 years laterJournal6397Whiplash injuries in Finland: the situation 3 years laterMiettinen,T.Leino,E.Airaksinen,O.Lindgren,K.A.2004/8*Health Status*Whiplash Injuriespp [Physiopathology]AccidentsAdultArticleClassificationDisabilityFemaleFinlandfollow-upFollow-Up StudiesGov'tHealthHealth ServicesHealth Servicesut [Utilization]HumansInjuriesMaleMedicineNeckNeck PainNeck Painet [Etiology]PainQuestionnaireQuestionnairesRehabilitationResearchRiskRisk FactorRisk FactorsSelf ReportTRAFFIC accidentsUniversitieswhiplashWhiplash InjuriesWhiplash Injuriesrh [Rehabilitation]Whiplash Injuriesth [Therapy]Not in File415418European Spine Journal135Scientifically AdmissibleCohortPrognosis1754European Spine Journal114
Cohort
Insurance claimants with neck pain after a motor vehicle collision in Finland in 1998. (n=312 respondents at baseline; 182 at one year and 144 at 3 years)1-year and 3 year follow-ups. Outcomes were frequency of sick leave and health impairment compared to pre-injury status (judged by participants as due to injury).Frequency of sick leave: 61% had no sick leave; 12.6% had sick leave less than 1 week; 14.8% for 1 week to 1 month, and 11.5% for more than one month. Norris et al., 1983 ADDIN REFMGR.CITE Norris1983200The prognosis of neck injuries resulting from rear-end vehicle collisionsJournal200The prognosis of neck injuries resulting from rear-end vehicle collisionsNorris,S.H.Watt,I.1983/11Accidents,TrafficAdultAgedClassificationDiagnosisEnglandFemaleFollow-Up StudiesHumanInjuriesInsurance BenefitsInsurance,AccidentMaleMiddle AgeNeckNeck InjuriesPrognosisRadiography.SpasmWhiplash InjuriesNot in File608611Journal of Bone & Joint Surgery - British Volume655Y (This list was sent in July 2003)Scientifically admissibleCohort Prognosis 92MedlineJournal of Bone & Joint Surgery - British Volume115
Cohort
Presentation to a British accident department with neck injury from rear-end MVC between September 1977 and May 1980 (n=61). 3 severity groups: Group 1 symptoms but no physical findings (n=27); Group 2 symptoms and reduced range of movement, no neurological signs (n=24); Group 3 symptoms, reduced movement and neurological loss on examination (n=10).
At least 6 months: Mean follow-up times in months: Group 1 - 19.7; Group 2 23.9; Group 3 24.7. Follow-up data ascertained at clinic visit through self-report and physical examination Time to return to work (weeks): 2.4 (s.d. 2) for Group 1; 4.5 (s.d. 3) for Group 2 and 10.3 (s.d. 3.3) for Group 3.
Free of symptoms at follow-up: Group 1 (56%); Group 2 (19%) and group 3 (10%).Obelieniene et al., 1999 ADDIN REFMGR.CITE Obelieniene19991458Pain after whiplash: a prospective controlled inception cohort studyJournal1458Pain after whiplash: a prospective controlled inception cohort studyObelieniene,D.Schrader,H.Bovim,G.Miseviciene,I.Sand,T.1999/3Accidents,TrafficAdultAwarenessCohort StudiesFearFemaleHeadacheHumanInjuriesLithuaniaMaleMethodsMiddle AgeNeckNeck PainNeurologyPainPhysiopathologyPhysiopathology.PolicePopulationProspective StudiesQuestionnairesSupport,Non-U.S.Gov'tSyndromeTime FactorsWhiplash InjuriesNot in File279283Journal of Neurology, Neurosurgery & Psychiatry663Y (The list was sent in November 2002)Scientifically admissibleCohortPrognosis + Primary Prevention/Risk1MedlineDepartment of Neurology, Kaunas Medical Academy, LithuaniaJournal of Neurology, Neurosurgery & Psychiatry116
Cohort Adults in Kaunas, Lithuania, mid 1990s. Subjects exposed to rear-end collisions, reported to police (n=59 with neck pain after the collision)
Follow-up at 2 and 12 months after the collision through mailed survey.
Median duration of neck pain was 3 days (range < 3 hours to 17 days). Partheni et al., 2000 ADDIN REFMGR.CITE Partheni20001325A prospective cohort study of the outcome of acute whiplash injury in GreeceJournal1325A prospective cohort study of the outcome of acute whiplash injury in GreecePartheni,M.Constantoyannis,C.Ferrari,R.Nikiforidis,G.Voulgaris,S.Papadakis,N.2000/1Acute DiseaseAdolescenceAdultAgedArmCohort StudiesComplicationsDizzinessEmergenciesEtiologyFemaleGreeceHeadacheHumanInjuriesLongitudinal StudiesMaleMethodsMiddle AgeNeckNeck PainNeurosurgeryPainPhysiopathologyPhysiopathology.PrevalenceProspective StudiesQuestionnairesSensation DisordersShoulderShoulder PainSyndromeTherapyWhiplash InjuriesNot in File6770Clinical & Experimental Rheumatology181Y (The list was sent in November 2002)Scientifically admissibleCohortPrognosis13MedlineDepartment of Neurosurgery, University Hospital of Patras, GreeceClinical & Experimental Rheumatology117
Cohort
Patients from an emergency department in Patras, Greece from July 1995-July 1998, involved in rear, lateral or frontal motor vehicle collision with WAD Grades I or II with symptom onset within 2 days of collision (n=180)
Follow-up at 1, 3 and 6 months post-collision by questionnaireProportion reporting neck pain fell from 100% in the first three days post-injury, to 9.4% at 1 month, 1.7% at 3 months and 1.1% at 6 months.Sterling et al., (2003) ADDIN REFMGR.CITE Sterling20031195Development of motor system dysfunction following whiplash injuryJournal1195Development of motor system dysfunction following whiplash injurySterling,M.Jull,G.Vicenzino,B.Kenardy,J.Darnell,R.2003/5*Motor Skills Disorderset [Etiology]*Movement*Whiplash Injuriesco [Complications]AdultArthralgiapp [Physiopathology]AustraliaCervical Vertebraein [Injuries]Cervical Vertebraepp [Physiopathology]Comparative StudyDisabilityDisability EvaluationElectromyographyFearFearpx [Psychology]FemaleHumanInjuriesMaleMiddle AgedMotor Skills Disorderspx [Psychology]MovementNeckNeck Musclespp [Physiopathology]Neuropsychological TestsOutcome Assessment (Health Care)PainProspective StudiesQueenslandQuestionnairesRange of Motion,Articularph [Physiology]ResearchSupport,Non-U.S.Gov'tTimeTime FactorsUniversitiesWhiplash InjuriesWhiplash Injuriespx [Psychology]Not in File6573Pain1031-2R-RScientifically AdmissibleCohort StudyPrognosis1183MedlinePain118
Cohort
Volunteers with WAD (n=66; neck pain after motor vehicle crash). Healthy volunteers (n=20)Follow-up at 1, 2 and 3 months by examination (ROM, joint position error, EMG) and fear of movement questionnaire (TAMPA).
At three months, 38% recovered; 33% had mild and 29% had moderate/severe pain. Those with moderate/severe pain at three months had decreased
ROM, decreased joint function, more EMG activity and high fear of movement at each measurement point. Mild group became more like the recovered group over follow-up.
Suissa et al., 1995 ADDIN REFMGR.CITE Suissa19951538The Quebec Whiplash-Associated Disorders Cohort StudyJournal1538The Quebec Whiplash-Associated Disorders Cohort StudySuissa,S.Harder,S.Veilleux,M.1995/4/15Accidents,TrafficCanadaClassificationDiagnosisEconomicsEpidemiologyEtiologyFemaleHumanIncidenceMalePractice GuidelinesPrognosisQuebecResearchSpineTherapyWhiplash InjuriesWhiplash Injuries.Cohort StudiesNot in File12S20SSpine208 SupplY (The list was sent in November 2002)Scientifically admissibleCohortPrognosis + Primary Prevention/Risk + Economic Costs43MedlineDepartment of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, CanadaSpine119
Cohort
All WAD claims from MVC (ICD 9 code 847.0) receiving compensation from SAAQ in Qubec in 1987; with collision-related data from police report. (n=3014).
Follow-up to claim closure, ascertained through administrative database or May 1993.22% were on benefits for less than 1 week. Overall, 50% claims closed within 1 month, 64% within 60 days, 87% within 6 months and 97% within 1 year. Suissa et al., 2006 ADDIN REFMGR.CITE Suissa20062208Assessing a whiplash management model: a population-based non-randomized intervention studyJournal2208Assessing a whiplash management model: a population-based non-randomized intervention studySuissa,S.Giroux,M.Gervais,M.Proulx,P.Desbiens,D.Delaney,J.Quail,J.Stevens,B.Nikolaj,S.2006whiplashIntervention StudiesNot in File581587The Journal of Rheumatology33Scientifically AdmissibleControlled Trial of InterventionsPrognosis/Intervention1659The Journal of Rheumatology120
Cohort
WAD traffic injury claimants in Qubec presenting to treatment centres between March and September, 2001. Comparison group was WAD claimants not seen at the centres. (n=2163)
Follow-up to claim closure, using administrative database, or for 1 year. At one year, 40% of patients attending and over 50% of patients not attending treatment programs were still on compensation.
Table 2. Prognostic factors for recovery after WAD.
Author(s), Year, Study DesignSetting and Subjects
Number (n) EnrolledPrognostic Factors ConsideredFollow-up and Outcomes MeasuredKey FindingsBerglund et al, 2001 ADDIN REFMGR.CITE Berglund20011878The association between exposure to a rear-end collision and future health complaintsJournal1878The association between exposure to a rear-end collision and future health complaintsBerglund,A.Alfredsson,L.Jensen,I.Cassidy,J.D.Nygren,A.2001/8*Accidents,Traffic*Health Status*Whiplash Injuriesco [Complications]AdultAgedBackBack PainCohort StudiesFatigueFemaleHeadacheHealthHumanInjuriesLow Back PainMaleMiddle AgedNeckNeck PainPainPrevalenceQuestionnairesRiskShoulderShoulder PainSleepSupport,Non-U.S.Gov'tSwedenSwedenep [Epidemiology]Time FactorsWhiplash InjuriesWhiplash Injuriesep [Epidemiology]Not in File851856Journal of Clinical Epidemiology548R-RScientifically AdmissibleCohortPrognosis/Primary Prevention/Risk861MedlineJournal of Clinical Epidemiology121
Cohort (Phase II)Adult car drivers, insured by one company in Sweden, involved in rear-end collisions in 1987-1988.
N=232 exposed to rear-end collision. N=157 with neck injuries alone; N=75 with neck and other injuries; N=204 without neck injuries; N=3688 unexposed subjects.
Exposure to rear-end collision, with or without claim for WAD adjusted for age, genderFollow-up in at 7 years after collision by mailed survey.
Outcomes: 3-month period prevalence of general health, fatigue, depressive mode, sleep disturbance, headache, thoracic pain, low back pain and stomach ache.Compared to unexposed subjects, exposed subjects with WAD were more likely to experience headache (OR-=3.7, 95% CI 2.6-5.3), thoracic pain (OR= 3.1, 95% CI 2.0-4.8), low back pain (OR= 1.7, 95% CI 1.3-2.4), ill health (OR= 3.3, 95% CI 2.2-5.0), sleep disturbance (OR= 2.4, 95% CI 1.5-3.9) and fatigue (OR= 1.6, 95% CI 1.1-2.3).
Exposed subjects without WAD and unexposed subjects equally likely to experience symptoms at 7 years.
Berglund et al., 2006 ADDIN REFMGR.CITE Berglund20066425The influence of prognostic factors on neck pain intensity, disability, anxiety and depression over a 2-year period in subjects with acute whiplash injuryJournal6425The influence of prognostic factors on neck pain intensity, disability, anxiety and depression over a 2-year period in subjects with acute whiplash injuryBerglund,A.Bodin,L.Jensen,I.Wiklund,A.Alfredsson,L.2006/12/5*Anxietyep [Epidemiology]*Depressionep [Epidemiology]*Disability Evaluation*Neck Paindi [Diagnosis]*Neck Painep [Epidemiology]*Risk Assessmentmt [Methods]AdolescentAdultAgedAnxietyArticlecohortCohort StudiesComorbidityDepressionDisabilityEducationFemaleFollow Upfollow-upGenderGov'tHeadacheHumansIncidenceIncomeInjuriesLongitudinal StudiesMaleMiddle AgedNeckNeck PainNeck Paincl [Classification]Odds RatioPainQuestionnaireQuestionnairesResearchRetrospective StudiesRisk FactorsSeverity of Illness IndexSwedenSwedenep [Epidemiology]TimewhiplashWhiplash InjuriesNot in File244256Pain1253Scientifically AdmissibleCohortPrognosis1068Pain122
Cohort (Phase II)
Swedish adults with acute WAD from a car collision, 1993-94, and making an injury claim. (n=2280 enrolled)
Gender, age, income, education, position in vehicle, direction of collision, awareness of collision, use of headrest, use of seat belt, head position, broken car seat, initial neck pain intensity, initial headache, self-reported WAD severity, helplessness (to control consequences of pain), health locus of control (latter two measured at one month).Follow-up by mailed questionnaire at 1 month, 6 months, 1 year, 2 years post-injury.
Outcomes: neck pain intensity, disability (Disability Rating Index), anxiety and depression (HADS), sick leave exceeding 14 days.At 2 years, higher intensity of neck pain was predicted by higher initial neck pain (severe pain OR=8.4, 95% CI 6.5-10.9), being female (OR=1.3, 95% CI 1.0-1.6), higher (self-rated) WAD grade (WAD II OR=1.5, 95% CI 1.1-1.9; for WAD III, OR=2.4, 1.8-3.2), initial headache (OR=1.3, 95% CI 1.1-1.7), high helplessness (OR=2.7, 95% CI 2.1-3.4) and low education (OR=1.8, 95% CI 1.3-2.4). Greater disability was predicted by higher initial neck pain (severe pain OR=6.4, 95% CI 4.9-8.4), being female (OR=1.3, 95% CI 1.1-1.6), higher self-rated WAD grade (WAD II OR=1.6, 95% CI 1.2-2.1; for WAD III, OR=3.4, 95% CI 2.5-4.5), initial headache (1.7, 95%CI 1.4-2.1), high helplessness (OR=2.2, 1.7-2.8) and low education (OR=1.4, 95% CI 1.1-2.0).
Borchgrevink et al., 1996 ADDIN REFMGR.CITE Borchgrevink1996337National health insurance consumption and chronic symptoms following mild neck sprain injuries in car collisionsJournal337National health insurance consumption and chronic symptoms following mild neck sprain injuries in car collisionsBorchgrevink,G.E.Lereim,I.Royneland,L.Bjorndal,A.Haraldseth,O.1996/12AccidentsAccidents,TrafficAdultChronic DiseaseEconomicsEmergenciesEpidemiologyFemaleHumanInjuriesInsurance,DisabilityMaleNeckNeck PainNorwayPainPatientsQuality of LifeRehabilitation.Retrospective StudiesSick LeaveStatistics & Numerical DataStatistics,NonparametricSupport,Non-U.S.Gov'tUtilizationWhiplash InjuriesNot in File264271Scandinavian Journal of Social Medicine244Y (The list was sent in November 2002)Scientifically admissibleCohortPrognosis34MedlineEmergency Clinic, University Hospital in Trondheim, NorwayScandinavian Journal of Social Medicine12
Cohort (Phase I)
Patients registered with neck sprain injury from car collision, 1985-1990, at hospitals in 4 cities in Norway (representing 7.3% of population of Norway) (n=473) Presence and duration of sick leave for neck problems in the 2-8 years prior to collision, gender
Follow-up 2.5 to 8.5 years post-collision using Social Security data.
Outcomes: presence, duration and timing of sick leave (Social Security data); symptoms; quality of life, analgesic use; rehabilitation or permanent disability pension.
Chronic symptoms associated with female gender (neck pain RR=1.2; dizziness RR=1.5; nausea RR=2.5), longer or later sick leave associated with past history of sick leave for neck pain.
Boyd et al., 2002 ADDIN REFMGR.CITE Boyd20021773Whiplash associated disorder in children attending the emergency departmentJournal1773Whiplash associated disorder in children attending the emergency departmentBoyd,R.Massey,R.Duane,L.Yates,D.W.2002/7EmergenciesNot in File311314Emergency Medicine Journal4Scientifically AdmissibleCohortPrognosis + Primary Prevention/Risk272Emergency Medicine Journal13
Cohort (Phase I)
Children aged 4-16 in northwest England with WAD after car crash; consecutive presentations to 3 urban ERs. Excludes those needing admission.
(n=49)
WAD severity: Grade I (n=40) and Grade II (n=9)
Followed until asymptomatic or up to 56 days via clinical exam followed by telephone call to confirm continued asymptomatic status.
Outcome: time to recovery (defined as no neck pain).Symptoms lasted longer for Grade II than for Grade I (19.7 days vs. 6.4 days). Bylund et al., 1998 ADDIN REFMGR.CITE Bylund19981156Sick leave and disability pension among passenger car occupants injured in urban trafficJournal1156Sick leave and disability pension among passenger car occupants injured in urban trafficBylund,P.O.Bjornstig,U.1998/5/1Accidents,TrafficAdolescenceAdultAgedAnalysisCervical VertebraeCohort StudiesEconomicsEpidemiologyEpidemiology.FemaleHealth Care CostsHumanInjuriesInsurance,DisabilityMaleMethodsMiddle AgeSick LeaveSocioeconomic FactorsSpinal InjuriesSpineStatistics & Numerical DataSupport,Non-U.S.Gov'tSurgerySwedenUrban PopulationWhiplash InjuriesNot in File10231028Spine239R-rScientifically AdmissibleCohortPrimary Prevention/Risk + Prognosis707MedlineUmea Accident Analysis Group, Department of Surgery, Umea University, SwedenSpine14
Cohort (Phase 1)
WAD injuries in traffic collisions in Umea, Sweden; January 1, 1990 to December 31 1991; ages 16-64; registered by the Accident Analysis Group at the University Hospital. (n=255)
Gender, mechanism of injuryDays of sick leaveWomen had a longer average sick leave than did men, (RR=2.9) and a higher proportion of women took sick leave (RR= 2.4). Those in rear-end collisions had the longest average sick leave (RR=2.8).
Carroll et al., 2006 ADDIN REFMGR.CITE Carroll20062219The role of pain coping strategies in prognosis after whiplash injury: passive coping predicts slowed recoveryJournal2219The role of pain coping strategies in prognosis after whiplash injury: passive coping predicts slowed recoveryCarroll,L.J.Cassidy,J.D.Côté,P.2006/9*Adaptation,Psychologicalph [Physiology]*Painet [Etiology]*Painpx [Psychology]*Recovery of Functionph [Physiology]*Whiplash Injuriesco [Complications]*Whiplash Injuriespx [Psychology]AdolescentAdultArticleBehaviorCanadacohortCohort StudiesComparative StudyConfounding Factors (Epidemiology)Depressionet [Etiology]Disability EvaluationDisease ProgressionFemaleFollow-Up StudiesHealthHumansInjuriesMaleMiddle AgedNetherlandsPainPain Measurementmt [Methods]Painep [Epidemiology]PopulationPredictive Value of TestsPrognosisProportional Hazards ModelsProspective StudiesPublic HealthQuestionnairesrecoveryRetrospective StudiesSelf ReportTelephoneTimeTime FactorsUniversitieswhiplashWhiplash InjuriesWhiplash Injuriesep [Epidemiology]Not in FilePain.124(1-2):18-26,Scientifically AdmissibleCohort StudyPrognosis1663Pain.124(1-2):18-26,123
Cohort (Phase III)
Traffic injuries in Saskatchewan, Canada between December 1997-November 1999, aged 18 and over; with self-reported neck pain after the collision. (n=2320)
Pain coping strategies measured at 6-weeks post-injury (controlling for demographic and socioeconomic factors, initial pain intensity and extent, post-injury symptoms, prior health)
Follow-up to recovery or up to one year.
Outcome: Time to self-reported global recovery.Passive coping predicted slower recovery (OR=0.45, 95% CI 0.36-0.56), especially in the presence of concurrent depression (OR =0.25, 95% CI 0.17-0.39). Depression at six weeks predicted slower recovery (HRR=0.68, 95% CI 0.62-0.76). Active coping did not predict time to recovery (OR=1.08, 95% CI 0.87-1.33).
Cassidy at al., 2000; Ct et al., 2001 ADDIN REFMGR.CITE Cassidy20001314Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injuryJournal1314Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injuryCassidy,J.D.Carroll,L.J.Côté,P.Lemstra,M.Berglund,A.Nygren,A.2000/4/20Accidents,TrafficAdultCanadaComparative StudyComplicationsEconomicsEpidemiology.EtiologyFemaleHumanIncidenceInjuriesInsurance Claim ReportingInsurance Claim ReviewInsurance,AccidentInsurance,LiabilityLegislation & JurisprudenceMaleMethodsNeckNeck PainPainPrognosisResearchSaskatchewanStatistics & Numerical DataSupport,Non-U.S.Gov'tTime FactorsUtilizationWhiplash InjuriesNot in File11791186New England Journal of Medicine34216Y (The list was sent in November 2002)Scientifically admissibleCohortPrimary Prevention/Risk + Prognosis7MedlineAlberta Centre for Injury Control and Research, Department of Public Health Sciences, University of Alberta, Edmonton, Canada. dcassidy@ualberta.caNew England Journal of Medicine1Côté20011883The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplashJournal1883The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplashCôté,P.Hogg-Johnson,S.Cassidy,J.D.Carroll,L.Frank,J.W.2001/3*Depressionet [Etiology]*Insurance Claim Review*Neck Painet [Etiology]*Whiplash Injuriesec [Economics]*Whiplash Injuriespp [Physiopathology]Accidents,Trafficec [Economics]AdultCanadaCohort StudiesComparative StudyDepressionec [Economics]FemaleHealthHumanInjuriesInsurance,Accidentlj [Legislation & Jurisprudence]MaleMiddle AgedNeckNeck PainNeck Painec [Economics]PainPain MeasurementSaskatchewanSocioeconomic FactorsSupport,Non-U.S.Gov'tTimeWhiplash InjuriesWhiplash Injuriesco [Complications]WorkNot in File275286Journal of Clinical Epidemiology543R-R874MedlineJournal of Clinical Epidemiology15;24
Cohort (Phase II)
All personal injury claimants after motor vehicle injury in Saskatchewan, Canada, July 1994 to December 1995; 18 years or older; self-reported neck or shoulder pain after collision. Excluded reopened claims, hospitalized for more than 2 days. Population-based. (total n=5,398)Compensation system (tort or no fault), age, gender, marital status, education, employment, characteristics of collision, seat belt use, headrest, initial pain intensity and extent, prior health, other associated injuries and symptoms, at fault for collision, lawyer retained, type of care provider.
Follow-up by administrative database up to 1997 (n=5398) and at 6 weeks, 4, 8 and 12 months by mailed self-report questionnaire (n=2783).
Outcomes: time to claim closure (n=5,398). Outcome of claim closure validated against self-reported recovery in depression, neck pain and physical functioning. ADDIN REFMGR.CITE Côté20011883The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplashJournal1883The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplashCôté,P.Hogg-Johnson,S.Cassidy,J.D.Carroll,L.Frank,J.W.2001/3*Depressionet [Etiology]*Insurance Claim Review*Neck Painet [Etiology]*Whiplash Injuriesec [Economics]*Whiplash Injuriespp [Physiopathology]Accidents,Trafficec [Economics]AdultCanadaCohort StudiesComparative StudyDepressionec [Economics]FemaleHealthHumanInjuriesInsurance,Accidentlj [Legislation & Jurisprudence]MaleMiddle AgedNeckNeck PainNeck Painec [Economics]PainPain MeasurementSaskatchewanSocioeconomic FactorsSupport,Non-U.S.Gov'tTimeWhiplash InjuriesWhiplash Injuriesco [Complications]WorkNot in File275286Journal of Clinical Epidemiology543R-R874MedlineJournal of Clinical Epidemiology124
Longer time to claim closure in tort than no fault system. For all claims, longer claim duration associated with female gender (HRR=0.84 (0.77-0.91), more neck pain (HRR=0.63, 0.52-0.76 for VAS 80-100 in tort system) , higher % of body in pain (HRR=0.59 for 40-100% in tort system), retaining a lawyer (HRR=0.60, 0.53-0.68 in tort system, 0.61, 0.49-0.75 in no fault system), type of initial health care provider (HRR=0.61 for MD + Chiropractor in tort system, and 0.61 for Chiropractor in no fault system). Shorter duration of claims in low education (HRR=1.56, 95% CI 1.27-1.92 for < grade 8). For tort claims only, longer claim duration in those with painful jaw (HRR=0.80, 0.70-0.92) and those not at fault for collision (HRR=0.70, 0.61-0.80). For no fault claims only, longer duration in those with arm pain (HRR=0.84, 0.77-0.92) or fractures (0.70, 0.55-0.89).
Cassidy et al., 2007 ADDIN REFMGR.CITE Cassidy20072171Does multidisciplinary rehabilitation benefit whiplash recovery? Results of a population-based incidence cohort study.Journal2171Does multidisciplinary rehabilitation benefit whiplash recovery? Results of a population-based incidence cohort study.Cassidy,J.D.Carroll,L.J.Côté,P.Frank,J.W.2007/1/1AdultCanadaClinical MedicinecohortCohort StudiesExerciseHealthHealth ServicesHealth Services ResearchIncidenceInjuriesInsurance BenefitsMethodsNeck PainOntarioPolicyPopulationPrognosisPublic HealthrecoveryRehabilitationResearchSaskatchewanSelf ReportTimeUniversitieswhiplashWorkNot in File126131Spine321Scientifically AdmissibleCohort StudyIntervention17090362-2436Spine16
Cohort (Phase III)
All adults submitting personal injury claims after motor vehicle injury in Saskatchewan, Canada, 1997-1998; self-reported collision-related neck pain. Excluded those hospitalized for more than 2 days. (n=6,021)
Prognostic actors: Type and timing of rehabilitation program compared to usual care; controlling for demographic and socioeconomic factors, collision factors, initial pain and symptoms, initial health care providersFollow-up by telephone interview at 6 weeks, 3, 6, 9 and 12 months. Self-reported global recovery, as determined by endorsement of all better or quite a bit of improvement.Attendance at rehabilitation programs predicted slower recovery. Rehabilitation type, Fitness training:
Attended before 70 days of injury (HRR= .68, 95% CI .54-.86). Outpatient Rehabilitation: Attended before 120 days of injury, (HRR=. 50, 95% CI .33-.77).
Ct et al., 2005 ADDIN REFMGR.CITE Côté20052099Initial patterns of clinical care and recovery from whiplash injuries: a population-based cohort studyJournal2099Initial patterns of clinical care and recovery from whiplash injuries: a population-based cohort studyCôté,P.Hogg-Johnson,S.Cassidy,J.D.Carroll,L.Frank,J.W.Bombardier,C.2005/10/24*Delivery of Health Careut [Utilization]*Physician's Practice Patternsut [Utilization]*Population Surveillance*Whiplash Injuriesrh [Rehabilitation]AdultArticleCanadaChiropracticCohort StudiesComparative StudyConfidence IntervalsDelivery of Health Caretd [Trends]FemaleFollow-Up StudiesHealthHumansIncidenceInjuriesMaleMethodsOffice Visitsut [Utilization]OntarioOutcome Assessment (Health Care)PatientsProportional Hazards ModelsResearch Support,Non-U.S.Gov'tRetrospective StudiesRisk FactorsSaskatchewanSaskatchewanep [Epidemiology]TimeTime FactorsTrauma Severity IndicesUnited StatesUniversitiesWhiplash InjuriesWhiplash Injuriesdi [Diagnosis]Whiplash Injuriesep [Epidemiology]WorkNot in File22572263Archives of Internal Medicine165Scientifically AdmissibleCohort StudyPrognosis/Intervention13970003-9926Archives of Internal Medicine125
Cohort (Phase III)
Ct et al., 2007 ADDIN REFMGR.CITE Côté2005755Initial patterns of clinical care and recovery from whiplash injuries: a population-based cohort studyJournal755Initial patterns of clinical care and recovery from whiplash injuries: a population-based cohort studyCôté,PHogg-Johnson,S.Cassidy,J.D.Carroll,L.Frank,J.W.Bombardier,C.2005/10/24*Delivery of Health Careut [Utilization]*Physician's Practice Patternsut [Utilization]*Population Surveillance*Whiplash Injuriesrh [Rehabilitation]AdultArticleCanadaChiropracticcohortCohort StudiesComparative StudyConfidence IntervalsDelivery of Health Caretd [Trends]FemaleFollow-Up StudiesHealthHumansIncidenceInjuriesMaleMethodsOffice Visitsut [Utilization]OntarioOutcome Assessment (Health Care)PatientsProportional Hazards ModelsrecoveryResearch Support,Non-U.S.Gov'tRetrospective StudiesRisk FactorsSaskatchewanSaskatchewanep [Epidemiology]TimeTime FactorsTrauma Severity IndicesUniversitieswhiplashWhiplash InjuriesWhiplash Injuriesdi [Diagnosis]Whiplash Injuriesep [Epidemiology]WorkNot in File22572263Archives of Internal Medicine16519R-R1553MedlineArchives of Internal Medicine126
Cohort (Phase III)
All personal injury claimants after motor vehicle injury in Saskatchewan, Canada, July 1994 to December 1995; 18 years or older; self-reported neck or shoulder pain after collision; excludes those making a personal injury claim later than 30 days post-injury, and those whose patterns of post-injury health care did not fit into one of 8 pre-determined patterns (n= 1693 in the Tort cohort and n=2486 in the no fault cohort)
Prognostic factors: Type and intensity of health care during the first 30 days after traffic-related neck injury (WAD), controlled for demographics, injury severity, prior health, pre-collision health care utilization, lawyer retained and collision characteristics. Administrative health data used for pre- and post-injury health care utilization.Follow-up to claim closure by administrative database. Outcome of claim closure validated against self-reported recovery in depression, neck pain and physical functioning. ADDIN REFMGR.CITE Côté20011883The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplashJournal1883The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplashCôté,P.Hogg-Johnson,S.Cassidy,J.D.Carroll,L.Frank,J.W.2001/3*Depressionet [Etiology]*Insurance Claim Review*Neck Painet [Etiology]*Whiplash Injuriesec [Economics]*Whiplash Injuriespp [Physiopathology]Accidents,Trafficec [Economics]AdultCanadaCohort StudiesComparative StudyDepressionec [Economics]FemaleHealthHumanInjuriesInsurance,Accidentlj [Legislation & Jurisprudence]MaleMiddle AgedNeckNeck PainNeck Painec [Economics]PainPain MeasurementSaskatchewanSocioeconomic FactorsSupport,Non-U.S.Gov'tTimeWhiplash InjuriesWhiplash Injuriesco [Complications]WorkNot in File275286Journal of Clinical Epidemiology543R-R874MedlineJournal of Clinical Epidemiology124Fastest recovery times in those with 1-2 visits to general practitioners in the first month post-injury. Longer claim duration in those with more frequent health care and those seen by chiropractors; general practitioners plus chiropractors; and general practitioners plus specialists. Findings were consistent over both insurance systems.
GP (1-2 days): 1.00
GP (>2 visits): 0.73, (95% CI .61-.87)
DC ( >6 visits): 0.61, (95% CI .46-.81).
GP and Specialist: 0.69, (95% CI .55-.87)
Gen.Med: 0.78, (95% CI .64-.95).
Drottning et al., 2002 ADDIN REFMGR.CITE Drottning20022043Cervicogenic headache (CEH) after whiplash injuryJournal2043Cervicogenic headache (CEH) after whiplash injuryDrottning,M.Staff,P.H.Sjaastad,O.2002/4*Headache Disordersep [Epidemiology]*Whiplash Injuriesep [Epidemiology]AccidentsAdolescentAdultAgedCohort StudiesComparative StudyEmergenciesFemaleHeadacheHeadache Disorderset [Etiology]Headache Disorderspp [Physiopathology]HumanInjuriesMaleMiddle AgedMotionNeckNeck PainNeurologyNorwayPainPatientsProspective StudiesQuestionnaireQuestionnairesUniversitiesWhiplash InjuriesWhiplash Injuriesco [Complications]Whiplash Injuriespp [Physiopathology]Not in File165171Cephalalgia223R-RScientifically AdmissibleClinical DescriptivePrognosis1227MedlineCephalalgia17
Descriptive (Phase I)Patients with possible WAD attending emergency department in Oslo after a traffic collision; 1993-1995. (n=587).Prognostic factors: Initial clinical exam; prior injuries and headaches; symptoms at 4 weeks, intensity of headaches and neck pain at 4 weeks, neurological exam for those with headaches at 6 weeks.
Follow-up at 6 months and 1 year. Outcome: Cervicogenic headache, range of motionCervicogenic headache at one year is predicted by prior car collisions (RR= 1.55), pre-existing headaches (RR= 2.70) and neck pain (RR= 2.9), stiffness (RR= 3.4), and initial reduced range of motion (1.58).Hartling et al., 2002 ADDIN REFMGR.CITE Hartling20021230Derivation of a clinical decision rule for whiplash associated disorders among individuals involved in rear-end collisionsJournal1230Derivation of a clinical decision rule for whiplash associated disorders among individuals involved in rear-end collisionsHartling,L.Pickett,W.Brison,R.J.2002/7*Accidents,Traffic*Decision Trees*Whiplash Injuriesdi [Diagnosis]AdultAgedBackBack PainCanadaClassificationEmergenciesEmergency MedicineExtremitiesFemaleHumanLogistic ModelsMaleMedicineMiddle AgedOntarioOntarioep [Epidemiology]PainPatientsPredictive Value of TestsPrognosisProspective StudiesProspective studyRiskRisk FactorRisk FactorsSensitivity and SpecificitySoftwareSupport,Non-U.S.Gov'tTelephoneUniversitiesUpper ExtremityWhiplash Injuriesep [Epidemiology]Whiplash Injurieset [Etiology]Not in File531539Accident Analysis & Prevention344R-RScientifically admissibleCohort StudyPrognosis1224MedlineAccident Analysis & Prevention127
Cohort (Phase II)
Patients presenting to two emergency departments in Ontario, Canada with traffic-related WAD; between October 1995 and March 1998. (n=380)Prognostic factors: age, gender, BMI, height, prior neck pain, characteristics of the collision, initial pain and symptoms (type, frequency, intensity).Follow-up at 6 months by telephone contact. Outcome was WAD, defined as regular or daily moderate pain or occasional, regular or daily severe pain.Older age (OR= 3.21, 95% CI 1.62-2.18), larger number of initial symptoms (OR= 6.71, 95% CI 2.39- 18.81- 22.67, 95% CI 5.21- 98.72), and early development of upper back pain (OR= 2.91, 95% CI 1.65-5.12), upper extremity numbness/weakness (OR= 2.18, 95% CI 1.22-3.87), and disturbance in vision (OR= 1.96, 95% CI 1.00-3.86) predicted persistent WAD at 6 months.
Holm et al., 1999 ADDIN REFMGR.CITE Holm19991033Impairment and work disability due to whiplash injury following traffic collisions. An analysis of insurance material from the Swedish Road Traffic Injury CommissionJournal1033Impairment and work disability due to whiplash injury following traffic collisions. An analysis of insurance material from the Swedish Road Traffic Injury CommissionHolm,L.Cassidy,J.D.Sjogren,Y.Nygren,A.1999Accidents,TrafficAdolescenceAdultAge FactorsAnalysisCost of IllnessCross-Sectional StudiesDisabled PersonsEmploymentEpidemiologyFemaleHumanInjuriesInjury Severity ScoreInsurance Claim ReportingMaleMiddle AgeSocioeconomic FactorsStatistics & Numerical DataSupport,Non-U.S.Gov'tSwedenTrendsWhiplash InjuriesWorkWork Capacity Evaluation.Not in File116123Scandinavian Journal of Public Health272Y (The list was sent in November 2002)Scientifically admissibleCross-sectional studyPrognosis17MedlineDepartment of Clinical Neuroscience, Karolinska Institute, Stockholm, SwedenScandinavian Journal of Public Health19
Cohort (Phase II)
Population based. Swedish population with a permanent medical impairment of 10% or more due to WAD. (n=184 in 1989 and n=481 in 1994).Prognostic factors: type of injury (WAD, WAD plus other, other injury), year of impairment judgment, age, gender, professional status, and (with work disability outcome only) medical impairment rating
Outcome assessed average of 4 years after injury.
Outcomes: medical impairment, reduced or full work disability
Older age (OR= 2.9, 95 % CI 1.8-4.8), greater medical impairment (OR= 8.1, 95% CI 4.9-13.4) and lower professional status (OR= 3.6, 95% CI 1.9-96.9) associated with partial/full work disability at follow-up.
Kasch et al., 2001 ADDIN REFMGR.CITE Kasch20011097Handicap after acute whiplash injury: a 1-year prospective study of risk factorsJournal1097Handicap after acute whiplash injury: a 1-year prospective study of risk factorsKasch,H.Bach,F.W.Jensen,T.S.2001/6/26*Disability Evaluation*Whiplash Injurieset [Etiology]AdultAnalysisAnkleDenmarkDisabilityFemaleFollow-Up StudiesHumanInjuriesMaleMethodsMiddle AgedNeckNeurologic ExaminationNeurologyPainProspective StudiesProspective studyQuestionnaireQuestionnairesRegression AnalysisResearchRiskRisk FactorRisk FactorsSensitivity and SpecificitySupport,Non-U.S.Gov'tSyndromeTime FactorsUniversitiesWhiplash InjuriesWorkWorkloadNot in File16371643Neurology5612R-RScientifically AdmissibleCohort StudyPrognosis/Primary Prevention/Risk1266MedlineNeurology128
Cohort (Phase II)
Patients presenting to emergency units in Aarhus, Denmark, within 2 days of a WAD in a rear-end collision. (n=141). Controls: patients with ankle injuries. (n=40)Prognostic factors for return to work or daily activities: gender, age, BMI, initial pain intensity, number of symptoms, active cervical range of motion, speed difference of cars; and workload.
Prognostic factors for handicap: same as above plus
lawsuit within 1 month of injury, type of therapy chosen at first visit (soft collar, active or passive physiotherapy, manipulation, weak analgesics), health behavior (assessed by the Millon Behavioral Health Inventory)
Follow-up at 1, 3, 6 and 12 months post injury by interview and examination.
Outcome: time to return to work or daily activities; and work capacity or handicap. Handicap defined as self-report of reduced hours and work capacity, job dismissal or change in job due to injury, in job training due to injury or application/receiving disability pension.
Decreased range of motion predicted handicap (HRR= 2.53, 95% CI 1.26-5.11), especially in the presence of high pain intensity and non-painful complaints. Decreased range of motion plus high initial pain predicted failure to recover. More intense pain, greater number of symptoms, and lawsuit during the first month showed a trend toward predicting handicap, but precision was poor.Kivioja et al., 2005 ADDIN REFMGR.CITE Kivioja2005725Early coping strategies do not influence the prognosis after whiplash injuriesJournal725Early coping strategies do not influence the prognosis after whiplash injuriesKivioja,J.Jensen,I.Lindgren,U.2005/8*Adaptation,Psychological*Neck Painpx [Psychology]*Whiplash Injuriespx [Psychology]Acute DiseaseAdolescentAdultAgedArticleAttentioncervical spineChi-Square DistributionDislocationsEmergenciesFemaleFracturesHeadHumansInjuriesMaleMiddle AgedNeckNeck PainOdds RatioPainPatientsPrognosisProspective StudiesProspective studyQuestionnaireQuestionnairesShoulderSpineSwedenUniversitieswhiplashWhiplash InjuriesWomenNot in File935940Injury368R-RScientifically AdmissibleCohort StudyPrognosis1650MedlineInjury129
Cohort (Phase II)
Patients presenting to emergency room in Stockholm with WAD (December 1996-June 1997); 18-65 years old. (n=96)Coping (catastrophizing, as assessed by CSQ) administered within 1 week of injury, prior neck pain, initial neck pain intensity, age, gender.
1-year follow-up.
Outcome: neck pain (Do you have neck pain now: yes/no).When all predictors were included in multivariable analysis, only prior neck pain predicted neck pain at one year (OR=4.5, 95% CI 1.11-8.76).
Krafft et al., 2000 ADDIN REFMGR.CITE Krafft20001443How crash severity in rear impacts influences short- and long-term consequences to the neckJournal1443How crash severity in rear impacts influences short- and long-term consequences to the neckKrafft,M.Kullgren,A.Tingvall,C.Bostrom,O.Fredriksson,R.2000/3AccelerationAccidents,TrafficAdultEtiologyFemaleFollow-Up StudiesHumanInjuriesMaleManikinsNeckNeck InjuriesPrevention & ControlPrevention & Control.ResearchRiskRisk FactorsSwedenWhiplash InjuriesNot in File187195Accident Analysis & Prevention322Y (The list was sent in November 2002)Scientifically admissibleCohortPrognosis11MedlineFolksam Research, Stockholm, Sweden. maria.krafft@folksam.seAccident Analysis & Prevention130
Cohort (Phase I)Insurance claimants with Folksam, Sweden; AIS 1 neck injuries after rear impact; random sample of injuries between 1990 and 1993. For long-term portion of study, at least one passenger sustained loss of function, pain and/or mental dysfunction assessed at one year. (n=659 for short term and 501 for long term consequences)
Prognostic factors were tow-bar presence on the stricken vehicle and peak accelerations in the crash.One year follow-up. Outcome was medical assessment of pain, function and/or mental dysfunction.Presence of tow-bars on cars is associated with long term consequences (RR= 1.22), but not short-term consequences.Krafft et al., 2002 ADDIN REFMGR.CITE Krafft20021802Influence of crash pulse characteristics on whiplash associated disorders in rear impacts - crash recording in real life crashesJournal1802Influence of crash pulse characteristics on whiplash associated disorders in rear impacts - crash recording in real life crashesKrafft,M.Kullgren,A.Ydenius,A.Tingvall,C.2002InjuriesNot in File141149Traffic Injury Prevention3Scientifically AdmissibleCohortPrimary Prevention/Risk592Traffic Injury Prevention131
Cohort (Phase I)
Insurance (Folksam, Sweden) claimants with Grades 0-III WAD after a rear impact involving car models with crash recorders; crashes occurred after 1996, car models were 1995 and later. (n=66 crashes with 94 WAD injuries)
Prognostic factor was crash pulse readingsAt least 6 month follow-up. Outcomes: duration of symptoms (less than one month vs. more than one month; more than 6 months), recorded on medical notes.Symptoms had longer duration with greater mean acceleration.Miettinen et al., 2004 ADDIN REFMGR.CITE Miettinen20042110Whiplash injuries in Finland--the possibility of some sociodemographic and psychosocial factors to predict the outcome after one yearJournal2110Whiplash injuries in Finland--the possibility of some sociodemographic and psychosocial factors to predict the outcome after one yearMiettinen,T.Airaksinen,O.Lindgren,K.A.Leino,E.2004/12/2*Whiplash Injuriesrh [Rehabilitation]AccidentsAccidents,TrafficAdultEducationFemaleFinlandHealthHealth StatusHumansInjuriesMaleMedicineNeckNeck InjuriesPrognosisProspective StudiesProspective studyQuestionnaireQuestionnairesRehabilitationResearchResearch Support,Non-U.S.Gov'tRisk FactorsSeat BeltsSick LeaveStress,Psychologicalet [Etiology]UniversitiesWhiplash InjuriesWhiplash Injuriespx [Psychology]Not in File13671372Disability & Rehabilitation2623R-RScientifically AdmissibleCohort StudyPrognosis1417Disability & Rehabilitation113
Cohort (Phase I)
Insurance claimants with neck pain after a motor vehicle collision in Finland in 1998. (n=330)Age, gender, education, marital status, collision factors, WAD classification, self-reported depression (BDI), general distress (GHQ).1-year follow-up:
Outcomes: self-reported change in health due to the collision, length of sick leave due to the collision.At one year, low education predicted impaired health (OR for primary school = 4.6, 95% CI 1.3-15.9), being divorced or widowed (OR=3.5, 95% CI 0.8-15.9, n.s.). GHQ and BDI each predicted impaired health in crude analyses.
Predictors of longer sick leave (unadjusted) were being female and married/divorced/widowed marital status.
At 3 years, WAD classification predicted change in health. For significant change in health (compared with no change) RR=3.28 (95% CI 1.07-10.03) for WAD III compared with WAD I.
Nederhand et al., 2003 ADDIN REFMGR.CITE Nederhand20031525Chronic neck pain disability due to an acute whiplash injuryJournal1525Chronic neck pain disability due to an acute whiplash injuryNederhand,M.J.Hermens,H.J.IJzerman,M.J.Turk,D.C.Zilvold,G.2003/3*Electromyographymt [Methods]*Muscle,Skeletalpp [Physiopathology]*Neck Painet [Etiology]*Whiplash Injuriesco [Complications]Accidents,TrafficAdolescentAdultAnalysisAnalysis of VarianceChronic DiseaseComparative StudyDisabilityDisability EvaluationElectromyographyExerciseFearFemaleHumanInjuriesMaleMiddle AgedMusclesNeckNeck PainNeck Painpp [Physiopathology]Neck Painrh [Rehabilitation]NetherlandsPainProspective StudiesResearchShoulderSyndromeTimeWhiplash InjuriesWhiplash Injuriespp [Physiopathology]Whiplash Injuriesrh [Rehabilitation]Not in File6371Pain1021-2R-RScientifcally AdmissibleCohort StudyDiagnosis/Prognosis1190MedlinePain132
Cohort (Phase I)
Nederhand et al., 2004 ADDIN REFMGR.CITE Nederhand20042119Predictive value of fear avoidance in developing chronic neck pain disability: consequences for clinical decision makingJournal2119Predictive value of fear avoidance in developing chronic neck pain disability: consequences for clinical decision makingNederhand,M.J.IJzerman,M.J.Hermens,H.J.Turk,D.C.Zilvold,G.2004/3*Disability Evaluation*Fear*Neck Paindi [Diagnosis]AdultBehaviorChronic DiseaseCohort StudiesDecision MakingDisabilityEmergenciesFearFemaleHeadHead MovementsHumansMaleMiddle AgedMovementNeckNeck Injuriesco [Complications]Neck Injuriesrh [Rehabilitation]Neck PainNeck Painet [Etiology]NetherlandsPainPatientsPredictive Value of TestsProbabilityRecovery of FunctionResearchResearch Support,Non-U.S.Gov'tTreatment OutcomeNot in File496501Archives of Physical Medicine & Rehabilitation853R-RScientifically AdmissibleCohort StudyPrognosis1437Archives of Physical Medicine & Rehabilitation133
Cohort (Phase I)
Admissions to general hospital emergency department between July 1999 and December 2001 with neck pain after motor vehicle collision. (N=82)Prognostic factors assessed an average of 8 days post-injury: disability (Neck Disability Index), pain intensity (VAS) fear of movement (Tampa Scale), catastrophizing (Pain cognition List Experimental version), surface electromyography.
24 week follow-up. Outcome was non-d i s a b l e d ( d e f i n e d a s N D I s c o r e d" 1 5 ) v s . d i s a b l e d ( N D I s c o r e > 1 5 ) . M e a n b a s e l i n e N D I s c o r e f o r n o n - d i s a b l e d , 1 4 . 2 ( 1 0 t h , 9 0 t h % i l e , 4 . 6 - 2 5 . 4 ) v s . d i s a b l e d , 2 7 . 9 ( 1 5 . 4 - 4 0 . 0 ) ; m e a n
b a s e l i n e n e c k p a i n V A S f o r n o n - d i s a b l e d , ( 3 3 . 6 , s . d . 2 0 . 5 ) v s . d i s a b l e d , ( 6 0 .7s.d. 19.4); mean baseline fear of movement for non-disabled, 35.0 (10th, 90th %ile 26.0-45.0) vs. disabled, 41.5 (33.8-50.4); mean baseline catastrophizing for non-disabled vs. disabled (28.6s.d. 22.2 vs. 53.2s.d. 24.4)
No elevated muscle reactivity (hyper reactivity) at baseline or follow-up. Isometric muscle activity, disabled (141.2 s.d. 70.3) vs. non-disabled (96 s.d. 50.1) No changes over time. All individually predicted recovery. Combining baseline neck disability with fear of movement improves the prediction of outcome.
Norris et al., 1983 ADDIN REFMGR.CITE Norris1983200The prognosis of neck injuries resulting from rear-end vehicle collisionsJournal200The prognosis of neck injuries resulting from rear-end vehicle collisionsNorris,S.H.Watt,I.1983/11Accidents,TrafficAdultAgedClassificationDiagnosisEnglandFemaleFollow-Up StudiesHumanInjuriesInsurance BenefitsInsurance,AccidentMaleMiddle AgeNeckNeck InjuriesPrognosisRadiography.SpasmWhiplash InjuriesNot in File608611Journal of Bone & Joint Surgery - British Volume655Y (This list was sent in July 2003)Scientifically admissibleCohort Prognosis 92MedlineJournal of Bone & Joint Surgery - British Volume115
Cohort (Phase I)
Presentation to a British accident department with neck injury from rear-end MVC between September 1977 and May 1980 (n=61). WAD severity: Group 1 symptoms but no physical findings (n=27); Group 2 symptoms and reduced range of movement, no neurological signs (n=24); Group 3 symptoms, reduced movement and neurological loss on examination (n=10). These groups were similar to the subsequent WAD Grades I-III.
Average follow-up times in months: Group 1: 19.7; Group 2: 23.9; Group 3: 24.7. Follow-up data at clinic visit through self-report and physical examination.
Outcomes: symptoms, time off work, neurological abnormalities.Severity of injury at baseline predicted poorer recovery of neck pain (Grp1 vs. Grp2, RR=1.84, Grp2 vs. Grp3, rr= 1.11, Grp1 vs. Grp3, RR= 2.05). Group membership also predicted headaches, parasthesias; more time off work and interference with leisure activities at follow-up. Richter et al.; 2004 ADDIN REFMGR.CITE Richter20041470Correlation of clinical findings, collision parameters, and psychological factors in the outcome of whiplash associated disordersJournal1470Correlation of clinical findings, collision parameters, and psychological factors in the outcome of whiplash associated disordersRichter,M.Ferrari,R.Otte,D.Kuensebeck,H.W.Blauth,M.Krettek,C.2004/5*Accidents,Traffic*Whiplash Injuriesco [Complications]*Whiplash Injuriespx [Psychology]0 (Anti-Inflammatory Agents) <71>Acute DiseaseAdultAgedAnti-Inflammatory Agentstu [Therapeutic Use]Chronic DiseaseDepressionFemaleFollow-Up StudiesGermanyHumansInjuriesMaleMethodsMiddle AgedPainPain MeasurementPaindi [Diagnosis]Painet [Etiology]PatientsQuality of LifeQuestionnaireQuestionnairesSeverity of Illness IndexVision Disordersdi [Diagnosis]Whiplash InjuriesWhiplash Injuriesdt [Drug Therapy]Not in File758764Journal of Neurology, Neurosurgery & Psychiatry755R-RScientifically AdmissibleCohort StudyPrognosis1468Journal of Neurology, Neurosurgery & Psychiatry134
Cohort Study (Phase II)
Patients with WAD presenting to the Hanover trauma centre in Germany.
N= 43Gender, collision factors, medical history, symptoms (presence, location, time of onset and severity of neck stiffness, neck restriction, presence of vertigo, nausea, dysphagia, auditory and/or visual disturbance), clinical findings (neck or occipital tenderness or pain, spinous processes, axial compression pain, active/passive range of motion), radiological and neurological findings, treatment, psychological factors (SF36, depression, impact of event, everyday life quality), collision factors (change in velocity, time and location of collision, position in vehicle, airbag deployment, restraint use, collision type, vehicles involved)6 month follow-up.
Outcomes: Duration and severity of symptoms (11-point VAS). Other outcomes were changes in SF-36, everyday quality of life, depression and impact of event.Initial SF-36 scores and initial anxiety predicted duration and severity of neck pain (no effect sizes available). Age, gender, clinical, radiological findings and collision parameters did not predict severity and duration of symptoms.
Sterner et al., 2003 ADDIN REFMGR.CITE Sterner20031772The incidence of whiplash trauma and the effects of different factors on recoveryJournal1772The incidence of whiplash trauma and the effects of different factors on recoverySterner,Y.Toolanen,G.Gerdle,B.Hildingsson,C.2003/4IncidenceNot in File195199Journal of Spinal Disorders & Techniques2Scientifically AdmissibleCohortPrognosis + Primary Prevention/Risk271Journal of Spinal Disorders & Techniques135
Cohort (Phase II)
All persons seeking health care from physicians in Ume (Sweden) after WAD in MVC. Population-based Excludes those on sick leave for neck pain prior to injury. (n=356)Rear-end vs. other collision; prior headache, prior neck and prior low back pain (none vs. sometimes/often), age, gender, marital status, university vs. lower education, occupation, WAD severity (WAD 0-1 vs. 2-3).
16-month follow-up through questionnaire.
Outcomes: disability: none/minor or major affecting work or leisure. (296 responded to follow-up)
Predictors of WAD-related disability were: female gender (OR= 2.02, 95% CI 1.13-3.63), lower education (OR= 2.08, 95% CI 1.09-3.98), more severe WAD Grades II-III) (OR=2.03, 95% CI 1.08-3.88) and prior neck complaints (OR= 3.17, 95% CI 1.34-7.46).
Suissa et al., 1995 ADDIN REFMGR.CITE Suissa19951538The Quebec Whiplash-Associated Disorders Cohort StudyJournal1538The Quebec Whiplash-Associated Disorders Cohort StudySuissa,S.Harder,S.Veilleux,M.1995/4/15Accidents,TrafficCanadaClassificationDiagnosisEconomicsEpidemiologyEtiologyFemaleHumanIncidenceMalePractice GuidelinesPrognosisQuebecResearchSpineTherapyWhiplash InjuriesWhiplash Injuries.Cohort StudiesNot in File12S20SSpine208 SupplY (The list was sent in November 2002)Scientifically admissibleCohortPrognosis + Primary Prevention/Risk + Economic Costs43MedlineDepartment of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, CanadaSpine119
Cohort (Phase I)
Harder et al., 1998 ADDIN REFMGR.CITE Harder19981255The effect of socio-demographic and crash-related factors on the prognosis of whiplashJournal1255The effect of socio-demographic and crash-related factors on the prognosis of whiplashHarder,S.Veilleux,M.Suissa,S.1998/5Accidents,TrafficAdolescenceAdultAgedCanadaChildCohort StudiesDatabasesDemographyEmploymentEpidemiologyFemaleHumanInjuriesMaleMiddle AgeMultivariate AnalysisNeck InjuriesPrognosisProportional Hazards ModelsQuebecRegression AnalysisRiskRisk FactorsSocioeconomic FactorsStatistics & Numerical DataSupport,Non-U.S.Gov'tSurvival Analysis.Whiplash InjuriesNot in File377384Journal of Clinical Epidemiology515Y (The list was sent in November 2002)Scientifically admissibleCohortPrognosis23MedlineDepartment of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, CanadaJournal of Clinical Epidemiology136
Cohort (Phase II)
Suissa et al., 2003 ADDIN REFMGR.CITE Suissa20031839Risk factors of poor prognosis after whiplash injuryJournal1839Risk factors of poor prognosis after whiplash injurySuissa,S.2003InjuriesPrognosisRiskWhiplash InjuriesQuebecNot in File6975Pain Research and Management82Scientifically AdmissibleCohortPrognosis794Pain Research and Management137
Cohort (Phase II)
Suissa 2001 ADDIN REFMGR.CITE Suissa20012056The relation between initial symptoms and signs and the prognosis of whiplashJournal2056The relation between initial symptoms and signs and the prognosis of whiplashSuissa,S.Harder,S.Veilleux,M.2001/2*Whiplash Injuriesdi [Diagnosis]Accidents,TrafficAdultArmCanadaClassificationCohort StudiesDatabasesEpidemiologyFemaleFollow-Up StudiesHandHeadacheHumanInjuriesMaleNeckNeck PainNeck Painep [Epidemiology]PainPalpationPatientsPrognosisQuebecQuebecep [Epidemiology]Risk FactorsShoulderTimeTime FactorsUniversitiesVictoriaWhiplash InjuriesWhiplash Injuriesep [Epidemiology]Not in File4449European Spine Journal101R-RScientifically AdmissibleCohort StudyPrognosis1272MedlineEuropean Spine Journal138
Cohort (Phase II)
Population based: all motor vehicle crash subjects who sustained WAD (ICD-9 diagnosis code of 847.0) in 1987 in Qubec and who were compensated by the Socit dassurance automobile du Qubec. Recurrences excluded. N=2843 for analyses of signs and symptoms at 1 year; N=2810 with an available police accident report for analyses of crash characteristics. N=2627 at 7 years.
Age, gender, number of dependents, marital status, employment status, severity of collision, vehicle type, driver/passenger, collision with stationary/moving object, direction of collision, seatbelt use, speed limit, neck pain, tenderness on palpation, decreased neck mobility, neck pain on mobilization, muscle pain, stiffness, spasms, radiating numbness, dizziness/vertigo, loss of consciousness, vision or ENT problems, anxiety or insomnia
Followed until time of claim closure or one year and seven years post-crash, via administrative records of SAAQ in Qubec. For one-year follow-up, subjects recovering within 7 days were assigned a median recovery time of 3.5 days. For 7 year follow-up, injuries not eligible for compensation were assigned a mean recovery time of 305 days.
Outcome: time in days between collision and last date of compensation. From Harder et al 1998: Longer time on benefits predicted by: female gender (RR= .86, 95% CI .77-.96), older age (RR for > 50 years= .86, 95% CI .83-.90), having dependents (RR= .84, 95% CI .74-.96), not being employed full time (RR= .86, 95% CI .76-.98), being injured in a truck or bus (RR= .48 ,95% CI .39-.59), being a passenger (RR= .85, 95% CI .74-.97), collision other than rear-end (RR= .85, 95% CI .76-.95) and collision with a moving object (RR= .84, 95% CI .72-.99).
From Suissa 2003: Signs and symptoms associated with slower recovery were neck pain on palpation (RR= .86, 95% CI .77-.99), muscle pain (RR= .76, 95% CI .76-.1.00), radiating pain or numbness and headache (RR= .55, 95% CI .55-.98) and (RR=.82, 95% CI .72-.94). Greater number of risk factors associated with greater time on benefits.
From Suissa 2001: At 7 years follow -up, Neck pain on palpation (RR= .85, 95% CI .76-.96), muscle pain (RR= .85, 95% CI .74-.97), Pain or numbness radiating from neck to arms or hands (RR= .64, 95% CI .55-.76) and shoulders (RR= .83, 95% CI .71-.97) and headache (RR= .82, 95% CI .73-.92) associated with slower recovery (adjusted for age and gender.)Table 3. Prognostic factors for other outcomes after WAD
Author(s), Year, Study DesignSetting and Subjects
Number (n) EnrolledPrognostic Factors ConsideredFollow-up and Outcomes MeasuredKey FindingsBuskila et al., 1997 ADDIN REFMGR.CITE Buskila19971371Increased rates of fibromyalgia following cervical spine injury. A controlled study of 161 cases of traumatic injury. [see comments]Journal1371Increased rates of fibromyalgia following cervical spine injury. A controlled study of 161 cases of traumatic injury. [see comments]Buskila,D.Neumann,L.Vaisberg,G.Alkalay,D.Wolfe,F.1997/3AdultArticleCervical Spine InjuryCervical VertebraeChronic PainComplications.Controlled StudyEpidemiologyEtiologyExtremitiesFemaleFibromyalgiaFracturesHumanIncidenceInjuriesIsraelLegMaleMethodsMiddle AgeNeckNeck InjuriesPainPalpationPatientsQuality of LifeRheumatologySpinal InjuriesSpineSyndromeThumbTimeUniversitiesNot in File446452Arthritis & Rheumatism403R-RScientifically AdmissibleCohort StudyDiagnosis/\primary Prevention/Risk1485MedlineBen-Gurion University of the Negev, Beer Sheva, IsraelArthritis & Rheumatism139
Cohort (Phase I)
Adults with soft tissue injury to the neck reporting to an occupational clinic between July 1994 and December 1995. Excluded fractures, dislocations, subluxations and repetitive strain injuries. (n=102, of whom 74 injuries were traffic related and 28 were work related). Controls were patients with leg fractures (n=59). Prognostic factor: soft-tissue neck injury or leg fracture; making an insurance claims. Follow-up 6-18 months post-trauma
Outcomes: tender point count and tenderness threshold, symptoms of pain, anxiety, depression, fatigue, morning stiffness and global well being (11-point scale); presence of other symptoms; Quality of Life; physical functioning from Fibromyalgia Impact Questionnaire.
At follow-up, neck injury patients had a higher prevalence of poor concentration, blurred vision, dizziness, sleep disturbance, headaches, parasthesias and subjective joint swelling; greater severity of fatigue, anxiety, depression, pain, morning stiffness and poor global well-being; more tender points, lower pain threshold, greater prevalence of fibromyalgia syndrome (13 times greater), poorer quality of life and poorer physical functioning. Neck injury patients with fibromyalgia syndrome had more symptoms. Neck injured patients making insurance claims had lower quality of life (5.6 vs. 5.0 on an 11point VAS, p= 0.039).
Carroll et al., 2006 ADDIN REFMGR.CITE Carroll20066426Frequency, timing, and course of depressive symptomatology after whiplashJournal6426Frequency, timing, and course of depressive symptomatology after whiplashCarroll,L.J.Cassidy,J.D.Côté,P.2006/7/15*Depressionep [Epidemiology]*Depressionet [Etiology]*Whiplash Injuriespx [Psychology]Accidents,TrafficAdultArticleCanadaCanadaep [Epidemiology]Chronic DiseasecohortCohort StudiesDepressionpx [Psychology]FemaleFollow Upfollow-upGov'tHeadacheHealthHumansIncidenceInjuriesInsurance,AccidentMaleMental Disordersco [Complications]Mental HealthMethodsMiddle AgedNeckNeck PainPainPublic HealthQuestionnairesRecurrenceResearchRiskScienceSymptomatologyTelephoneTimeTime FactorsUniversitieswhiplashWhiplash Injuriesco [Complications]Not in FileSpine.31(16):E551-6,Scientifically AdmissibleCohortPrognosis1665Spine.31(16):E551-6,140
Cohort (Phase I)
Adults with traffic injuries in Saskatchewan, Canada between December 1997 and November 1999; reporting neck pain after the collision. (n=6013)Self-reported prior mental health problems, age, gender.Follow-up at 6 weeks and 3, 6, 9 and 12 months by telephone interview.
Outcomes: Timing and frequency of depressive symptoms (measured by CES-D); course of depressive symptomatology
42% developed depressive symptoms within 6 weeks of WAD injury, with 38% of these having recurrent or persistent depression throughout follow-up. Self-reported prior mental health problems predict persistent (17.5%; 95% CI, 14.1-21.3) and recurrent (25.6%; 95% CI, 21.6-29.9) depressive symptoms, as well as later onset of depressive symptoms.
Holm et al, 2007 ADDIN REFMGR.CITE Holm20076402Widespread pain following whiplash-associated disorders: Incidence, course, and risk factorsJournal6402Widespread pain following whiplash-associated disorders: Incidence, course, and risk factorsHolm,L.W.Carroll,L.J.Cassidy,J.D.Skillgate,E.Ahlbom,A.2007*Pain*Whiplash InjuryAdultArticleBackacheCenter for Epidemiological Studies Depression ScalecohortDepressionDisease CourseEpidemiologyFemaleHeadacheHumanIncidenceInjuriesMajor Clinical StudyMaleMedicineMethodsNeckNeck InjuriesNeck PainPainPriority JournalQuestionnaireQuestionnairesRiskRisk FactorRisk FactorsSwedenTraffic AccidentVisual Analog ScaleNot in File193200Journal of Rheumatology341Scientifically Admissible CohortPrognosis1725Journal of Rheumatology141
Cohort (Phase I)
All personal injury claimants after motor vehicle injury in Saskatchewan, Canada, July 1994 to December 1995; 18 years or older; self-reported neck or shoulder pain after collision, and localized neck injury with or without head or back pain. (n=266)Prognostic factors: gender, age, education, prior health, prior neck pain, prior headache, post-injury symptoms, neck pain intensity, number of areas in pain, depressive symptoms (CES-D)Follow-up at 6 weeks, 4, 8 and 12 months.
Outcome: onset of widespread body pain (using a liberal case definition for widespread body pain)21% developed widespread body pain at some point during the one year follow-up. 64% of these subsequently improved, and of these, 22% had recurrences. Onset of widespread pain was more common in women (OR= 1.6, 95% CI 1.1-2.1), greater number of painful body areas initially (OR= 2.6, 95% CI 1.3-5.4), greater initial neck pain intensity (OR= 3.2, 95% CI 1.3-8.0), and more depressive symptoms (OR= 3.2, 95% CI 1.6-6.3).
Kasch et al, 2001 ADDIN REFMGR.CITE Kasch20011040Pain thresholds and tenderness in neck and head following acute whiplash injury: a prospective study.[see comment]Journal1040Pain thresholds and tenderness in neck and head following acute whiplash injury: a prospective study.[see comment]Kasch,H.Stengaard-Pedersen,K.Arendt-Nielsen,L.Staehelin,Jensen T.2001/4*Headache Disorderspp [Physiopathology]*Neck Painpp [Physiopathology]*Pain Thresholdph [Physiology]*Whiplash Injuriespp [Physiopathology]Acute DiseaseAdultAgedAnkle Injuriespp [Physiopathology]Comparative StudyDenmarkFemaleFollow-Up StudiesHeadHumanInjuriesMaleMiddle AgedNeckNeurologyPainPain ThresholdPalpationPatientsPressureProspective StudiesProspective studyReference ValuesSupport,Non-U.S.Gov'tSyndromeUniversitiesWhiplash InjuriesNot in File189197Cephalalgia.213R-RScientifically AdmissibleCohort StudyControlled Trial of Interventions1263MedlineCephalalgia.142
Cohort (Phase II)
Patients presenting to emergency units in Aarhus, Denmark, within 2 days of neck injury in a rear-end collision. (n=123). Controls: patients with ankle injuries. (n=36).Prognostic factors: type of injury.
Follow-up at 1 week, 3 and 6 months.
Outcome: Musculoskeletal sensitization, determined by pressure-pain-detection thresholds and palpation-score.At 1 week to 3 months, WAD patients had greater focal sensitization (lower pressure pain thresholds, mean difference = -.3, p=.008 and greater tenderness, mean difference = 1.6, p = <.05) than controls. No differences were present by 6 months.
Kasch et al., 2005 ADDIN REFMGR.CITE Kasch20052211Reduced cold pressor pain tolerance in non-recovered whiplash patients: a 1-year prospective studyJournal2211Reduced cold pressor pain tolerance in non-recovered whiplash patients: a 1-year prospective studyKasch,H.Qerama,E.Bach,F.W.Jensen,T.S.2005/10*Nociceptorsph [Physiology]*Pain Thresholdph [Physiology]*Painet [Etiology]*Painpp [Physiopathology]*Whiplash Injuriesco [Complications]*Whiplash Injuriespp [Physiopathology]Accidents,TrafficAdolescentAdultAgedArticleCentral Nervous Systempp [Physiopathology]Chronic Diseasepx [Psychology]Chronic PainColdColdae [Adverse Effects]DenmarkFemaleHandHealthHumansInjuriesMaleMiddle AgedNeural Pathwayspp [Physiopathology]NeurologyObservationPainPain MeasurementPainth [Therapy]PatientsPhysical Therapy Modalitiessn [Statistics & Numerical Data]Prospective StudiesProspective studyQuestionnaireRecovery of Functionph [Physiology]ResearchResearch Support,Non-U.S.Gov'tSyndromeTimeUniversitiesWaterwhiplashWhiplash InjuriesNot in File561569European Journal of Pain95R-RScientifically AdmissibleCohort StudyPrognosis1649MedlineEuropean Journal of Pain143
Cohort (Phase II)
Adult WAD patients attending emergency units in Aarhus after rear-end collision, with initial complaints. (n=141 at baseline, 99 by 1 year). Comparison Group: Adult patients with non-sport ankle injuries. (n=40 at baseline, 21 by 1 year. Initial assessment 1 week after injury.
Type of injury (WAD vs. ankle)Follow-up at 1, 3, 6 and 12 months post-injury. Outcome: pain (VAS, numeric scale and McGill Pain Questionnaire); self-reported work capacity; and time to pressure pain tolerance in cold pressure test. Outcomes stratified by recovered WAD; non-recovered WAD; and ankle injury.No differences in time to peak pain between recovered WAD and ankle injuries at baseline or follow-up. Unrecovered WAD had reduced time to peak pain at baseline (59.1 30.8 vs. 29.15 10.5, p<.001) and 6 months (55.1 30.2 vs. 26.5 14.9, p< .001) but not at 12 months. Unrecovered WAD had higher pain than recovered WAD at all time points (no adjustment for initial pain analysis).Nederhand et al., 2003 ADDIN REFMGR.CITE Nederhand20031525Chronic neck pain disability due to an acute whiplash injuryJournal1525Chronic neck pain disability due to an acute whiplash injuryNederhand,M.J.Hermens,H.J.IJzerman,M.J.Turk,D.C.Zilvold,G.2003/3*Electromyographymt [Methods]*Muscle,Skeletalpp [Physiopathology]*Neck Painet [Etiology]*Whiplash Injuriesco [Complications]Accidents,TrafficAdolescentAdultAnalysisAnalysis of VarianceChronic DiseaseComparative StudyDisabilityDisability EvaluationElectromyographyExerciseFearFemaleHumanInjuriesMaleMiddle AgedMusclesNeckNeck PainNeck Painpp [Physiopathology]Neck Painrh [Rehabilitation]NetherlandsPainProspective StudiesResearchShoulderSyndromeTimeWhiplash InjuriesWhiplash Injuriespp [Physiopathology]Whiplash Injuriesrh [Rehabilitation]Not in File6371Pain1021-2R-RScientifcally AdmissibleCohort StudyDiagnosis/Prognosis1190MedlinePain132
Cohort (Phase I)
Admissions to general hospital emergency department between July 1999 and December 2001 with neck pain after motor vehicle collision. (N=92 completing both baseline and follow-up for EMG and disability portion; n=82 for fear of movement study)
Time since injury, baseline neck disability (measured by NDI), fear of movement (Tampa Scale for Kinesiophobia).Follow-up at 1, 4, 8, 12 and 24 weeks. Outcomes were upper trapezius EMG (muscle reactivity to exercise, isometric and dynamic muscle activity) and disability status. Disability status assessed by Neck Disability Index (NDI), categorized into recovered, mild, moderate and severe/complete.
No elevated muscle reactivity at any point. Surface EMG of upper trapezius muscle inversely related to neck pain disability, but no time-related changes in EMG. Baseline neck disability predicts EMG findings at 24 weeks. Effect sizes not provided.
Richter et al.,2004 ADDIN REFMGR.CITE Richter20041470Correlation of clinical findings, collision parameters, and psychological factors in the outcome of whiplash associated disordersJournal1470Correlation of clinical findings, collision parameters, and psychological factors in the outcome of whiplash associated disordersRichter,M.Ferrari,R.Otte,D.Kuensebeck,H.W.Blauth,M.Krettek,C.2004/5*Accidents,Traffic*Whiplash Injuriesco [Complications]*Whiplash Injuriespx [Psychology]0 (Anti-Inflammatory Agents) <71>Acute DiseaseAdultAgedAnti-Inflammatory Agentstu [Therapeutic Use]Chronic DiseaseDepressionFemaleFollow-Up StudiesGermanyHumansInjuriesMaleMethodsMiddle AgedPainPain MeasurementPaindi [Diagnosis]Painet [Etiology]PatientsQuality of LifeQuestionnaireQuestionnairesSeverity of Illness IndexVision Disordersdi [Diagnosis]Whiplash InjuriesWhiplash Injuriesdt [Drug Therapy]Not in File758764Journal of Neurology, Neurosurgery & Psychiatry755R-RScientifically AdmissibleCohort StudyPrognosis1468Journal of Neurology, Neurosurgery & Psychiatry134
Cohort (Phase II)Patients with WAD presenting to the Hanover trauma centre in Germany.
N= 43Gender, collision factors, medical history, symptoms, clinical findings, radiological and neurological findings, treatment, psychological factors, collision mechanism6 month follow-up.
Outcomes: SF36, everyday quality of life (EDLQ), depression (CES-D), and impact of event (IES).Initial pain intensity score >5, duration of symptoms more than 28 days had significant changes in SF36, EDLQ, CES-D, and IES scores at 6 months. Initial scores on these predicted later scores. Effect sizes not provided.
Wynne-Jones et al., 2006 ADDIN REFMGR.CITE Wynne-Jones20066316Predicting new onset of widespread pain following a motor vehicle collision.[see comment]Journal6316Predicting new onset of widespread pain following a motor vehicle collision.[see comment]Wynne-Jones,G.Jones,G.T.Wiles,N.J.Silman,A.J.Macfarlane,G.J.2006/5*Accidents,Traffic*Painet [Etiology]*Painpp [Physiopathology]AdolescentAdultAgedArticleAutomobile DrivingBehaviorCanadaChronic DiseasecohortCohort StudiesConfidence IntervalsEnvironmentFemaleGov'tHealthHumansInjuriesInjury Severity ScoreMaleMethodsMiddle AgedMultivariate AnalysisMusculoskeletal Systemin [Injuries]Musculoskeletal Systempp [Physiopathology]Neck Painet [Etiology]Neck Painpp [Physiopathology]Neck Painpx [Psychology]PainPainpx [Psychology]Patient Care ManagementPrevalenceProspective StudiesQuestionnaireQuestionnairesResearchRiskRisk FactorsSocial EnvironmentStress,PsychologicalUniversitiesNot in FileJournal of Rheumatology.33(5):968-74,16740315-162XJournal of Rheumatology.33(5):968-74,144
Cohort (Phase II)Adult traffic-injury claimants to one UK based insurance company; with no widespread body pain in the month before the collision. Widespread pain defined as pain both above and below the waist, in both sides of body and in the axial skeleton. N=957 enrolled and 695 at follow-up (39 had pre-collision neck pain, 153 had post-collision neck pain and 37 had both).Gender; age; prior health, prior psychological health, collision factors, post-collision symptoms, pain and health. 12-month follow-up of pain data. Outcome: New onset of widespread body pain (same definition as at baseline)54 (7.8%) had widespread body pain at one year. After adjusting for age and gender, in comparison with no neck pain, pre-collision only neck pain RR=2.0 (95% CI 0.7-5.5); post-collision only neck pain RR=2.8 (95% CI 1.6-5.0); pre- and post-collision neck pain RR=3.3 (95% CI 1.5-6.8). Neck pain was not associated with onset after also adjusting for all other potential prognostic factors.
ADDIN REFMGR.REFLIST Reference List
1. Berglund A, Alfredsson L, Cassidy JD et al. The association between exposure to a rear-end collision and future neck or shoulder pain: a cohort study. Journal of Clinical Epidemiology 2000;53:1089-94.
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