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Chiropractic Research Review

A Multimodal Approach to Treating Chronic Whiplash

Research suggests that 14-42% of patients with whiplash injuries suffer chronic neck pain, and that 10% of these patients experience constant, severe pain. The authors of this study mention that previous investigations have not considered the potential efficacy of a multifaceted approach to managing this condition, particularly in relation to pain behaviors and return to work.

To address this consideration, they conducted a study on 26 patients (13 men, 13 women, average age 35.8 years) presenting with whiplash symptoms of at least six months duration. Subjects participated in a daily, four-week treatment program designed to restore daily functioning, including complete return to work.

The program consisted of physical training (muscle strength, endurance, aerobic fitness), pain behavior tactics (soft neck collar), sporting activities (swimming, squash) and group sessions with an occupational therapist. Changes in patient status were assessed using a variety of reputable outcome measures, including the
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Quebec Back Pain Disability Scale and the Minnesota Multiphasic Personality Inventory. Results showed that patient symptoms improved significantly at six-month follow up, with improved scores on objective outcome criteria: complete return to work (65%); partial return to work (92%); no use of analgesics in the past six months (58%); and no medical/paramedical treatments in the past six months (81%).

The authors discuss potential limitations to their results, including the lack of a control group and the inability to identify which of the interventions may have been most effective. However, they note that "a multimodal treatment program has the potential to be an effective treatment for patients with chronic symptoms after whiplash injury of the neck."

Vendrig AA, van Akkerveeken PF, McWorter KR. Results of a multimodal treatment program for patients with chronic symptoms after a whiplash injury of the neck. Spine, Jan. 15, 2000:25(2), pp238-44.

Chiropractic Research Review

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