BACKGROUND: Little is known about the most effective pattern of clinical care for acute whiplash. We designed a cohort study to determine whether patterns of early clinical care (involving visits to general practitioners, chiropractors, or specialists) were associated with different rates of recovery. METHODS: We studied 2486 Saskatchewan adults with whiplash injuries. We defined 8 initial patterns of care that integrated type of provider and number of visits.
OBJECTIVE: To test the reproducibility of the finding that early intensive care for whiplash injuries is associated with delayed recovery. METHODS: We analyzed data from a cohort study of 1,693 Saskatchewan adults who sustained whiplash injuries between July 1, 1994 and December 31, 1994. We investigated 8 initial patterns of care that integrated type of provider (general practitioners, chiropractors, and specialists) and number of visits (low versus high utilization).
Neck pain is less common than low back pain but still a relatively common reason for seeing a primary care physician. Therefore, it is necessary for the primary care physician to be comfortable with salient points in the history and to be able to perform a basic neurologic examination. Important aspects of the history and physical examination are reviewed. Important clinical syndromes and treatment options are also reviewed.
The literature relevant to the treatment of Whiplash-Associated Disorders (WAD) is extensive and heterogeneous. METHODS: A Participatory Action Research (PAR) approach was used to engage a chiropractic community of practice and stakeholders in a systematic review to address a general question: 'Does chiropractic management of WAD clients have an effect on improving health status?' A systematic review of the empirical studies relevant to WAD interventions was conducted followed by a review of the evidence. RESULTS: The initial search identified 1,155 articles.
BACKGROUND: Some chiropractors and their associations claim that chiropractic is effective for conditions that lack sound supporting evidence or scientific rationale. This study therefore sought to determine the frequency of World Wide Web claims of chiropractors and their associations to treat, asthma, headache/migraine, infant colic, colic, ear infection/earache/otitis media, neck pain, whiplash (not supported by sound evidence), and lower back pain (supported by some evidence).
Pain Research & Management: The Journal of the Canadian Pain Society = Journal De La Société Canadienne Pour Le Traitement De La Douleur
Whiplash-associated disorder (WAD) represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. While many treatments have been advocated for patients with WAD, scientific evidence supporting their effectiveness is often lacking. A systematic review was conducted to evaluate the strength of evidence associated with various WAD therapies.
OBJECTIVE: To determine whether there was a statistical difference for manual muscle test (MMT) findings for cervical muscles in subjects with and without mechanical neck pain (MNP), and to use confidence intervals to evaluate the sensitivity and specificity of the MMT in this group of subjects. CLINICAL FEATURES: Manual muscle strength tests were conducted on two groups of patients who reported to two outpatient chiropractic clinics.
Journal of Manipulative and Physiological Therapeutics
OBJECTIVES: The purpose of this study was to determine the role of standard and novel (cervical) nonorganic signs in patients with chronic whiplash-associated disorder (WAD). METHODS: Chronic WAD I to III patients (>3 months) were recruited from private chiropractic practice in Canada. Subjects completed a Neck Disability Index (NDI), Tampa Scale for Kinesiophobia (TSK), pain visual analog scale, and pain diagram. Clinical and demographic data were also obtained. Nine standard nonorganic pain behavior tests and 4 novel cervical nonorganic simulation signs (C-NOSS) tests were applied.
INTRODUCTION: Beliefs about pain are known to be important factors in recovery, most notably in LBP. Relatively less is known about the role of pain beliefs in Whiplash Associated Disorder (WAD). The widely advocated cognitive-behavioural approach to pain management necessitates cognitive factors such as pain beliefs be examined, even early after injury. The primary purpose of this study was to explore the predictive capacity of early post-injury pain beliefs and catastrophizing in patients with WAD.
BACKGROUND: Implementation strategies for clinical guidelines have shown modest effects in changing health professional's knowledge and practice, however, targeted implementations are suggested to achieve greater improvements. This study aimed to examine the effect of a targeted implementation strategy of the Australian whiplash guidelines on health professionals' knowledge, beliefs and practice and to identify predictors of improved knowledge. METHODS: 94 health professionals (Physiotherapists, Chiropractors and Osteopaths) who manage whiplash participated in this study.