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Risk Factors for Prolonged Treatment of Whiplash-Associated Disorders.

Oka H, Matsudaira K, Fujii T, Okazaki H, Shinkai Y, Tsuji Y, Tanaka S, Kato R - PLoS ONE (2015)

Bottom Line: Female sex, the severity of the collision, poor expectations of recovery, victim mentality, dizziness, numbness or pain in the arms, and lower back pain were associated with a poor recovery from WAD.In the present study, the baseline symptoms (dizziness, numbness or pain in the arms, and lower back pain) had the strongest associations with prolonged treatment for WAD, although the psychological and behavioral factors were also important.These risk factors should be considered when evaluating patients who may have the potential for poor outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan.

ABSTRACT

Objectives: Whiplash-associated disorders (WAD) are the most common injuries that are associated with car collisions in Japan and many Western countries. However, there is no clear evidence regarding the potential risk factors for poor recovery from WAD. Therefore, we used an online survey of the Japanese population to examine the association between potential risk factors and the persistence of symptoms in individuals with WAD.

Materials and methods: An online survey was completed by 127,956 participants, including 4,164 participants who had been involved in a traffic collision. A random sample of the collision participants (n = 1,698) were provided with a secondary questionnaire. From among the 974 (57.4%) respondents to the secondary questionnaire, we selected 183 cases (intractable neck pain that was treated over a period of 6 months) and 333 controls (minor neck pain that was treated within 3 months). Multivariable logistic regression analysis was used to evaluate the potential risk factors for prolonged treatment of WAD.

Results: Female sex, the severity of the collision, poor expectations of recovery, victim mentality, dizziness, numbness or pain in the arms, and lower back pain were associated with a poor recovery from WAD.

Conclusions: In the present study, the baseline symptoms (dizziness, numbness or pain in the arms, and lower back pain) had the strongest associations with prolonged treatment for WAD, although the psychological and behavioral factors were also important. These risk factors should be considered when evaluating patients who may have the potential for poor outcomes.

No MeSH data available.


Related in: MedlinePlus

Study flow chart.WAD, whiplash-associated disorders.
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pone.0132191.g001: Study flow chart.WAD, whiplash-associated disorders.

Mentions: All participants completed the original questionnaire, which included items regarding their demographical and social characteristics, as well as any traffic collisions that they had experienced. However, for our analysis we only evaluated the questionnaires from participants who had been in a traffic collision (n = 4,164). From among this sample, 1,698 participants were randomly selected to participate in a secondary survey. Among the 974 respondents (57.4%) for the secondary questionnaire, we excluded 44 participants who were not wearing a seatbelt when the collision occurred, as these participants were likely to have sustained serious injuries. From the 930 remaining subjects, we included 183 participants in the cases group (neck pain that was treated over a period of 6 months) and 333 participants in the control group (minor neck pain that was treated within 3 months) (Fig 1). We defined the self-reported presence of WAD in this study as a response to the internet questionnaire that indicated 1) an obvious instance of an injury that was sustained during a rear-end collision, or 2) an established diagnosis of WAD by a medical doctor.


Risk Factors for Prolonged Treatment of Whiplash-Associated Disorders.

Oka H, Matsudaira K, Fujii T, Okazaki H, Shinkai Y, Tsuji Y, Tanaka S, Kato R - PLoS ONE (2015)

Study flow chart.WAD, whiplash-associated disorders.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492561&req=5

pone.0132191.g001: Study flow chart.WAD, whiplash-associated disorders.
Mentions: All participants completed the original questionnaire, which included items regarding their demographical and social characteristics, as well as any traffic collisions that they had experienced. However, for our analysis we only evaluated the questionnaires from participants who had been in a traffic collision (n = 4,164). From among this sample, 1,698 participants were randomly selected to participate in a secondary survey. Among the 974 respondents (57.4%) for the secondary questionnaire, we excluded 44 participants who were not wearing a seatbelt when the collision occurred, as these participants were likely to have sustained serious injuries. From the 930 remaining subjects, we included 183 participants in the cases group (neck pain that was treated over a period of 6 months) and 333 participants in the control group (minor neck pain that was treated within 3 months) (Fig 1). We defined the self-reported presence of WAD in this study as a response to the internet questionnaire that indicated 1) an obvious instance of an injury that was sustained during a rear-end collision, or 2) an established diagnosis of WAD by a medical doctor.

Bottom Line: Female sex, the severity of the collision, poor expectations of recovery, victim mentality, dizziness, numbness or pain in the arms, and lower back pain were associated with a poor recovery from WAD.In the present study, the baseline symptoms (dizziness, numbness or pain in the arms, and lower back pain) had the strongest associations with prolonged treatment for WAD, although the psychological and behavioral factors were also important.These risk factors should be considered when evaluating patients who may have the potential for poor outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan.

ABSTRACT

Objectives: Whiplash-associated disorders (WAD) are the most common injuries that are associated with car collisions in Japan and many Western countries. However, there is no clear evidence regarding the potential risk factors for poor recovery from WAD. Therefore, we used an online survey of the Japanese population to examine the association between potential risk factors and the persistence of symptoms in individuals with WAD.

Materials and methods: An online survey was completed by 127,956 participants, including 4,164 participants who had been involved in a traffic collision. A random sample of the collision participants (n = 1,698) were provided with a secondary questionnaire. From among the 974 (57.4%) respondents to the secondary questionnaire, we selected 183 cases (intractable neck pain that was treated over a period of 6 months) and 333 controls (minor neck pain that was treated within 3 months). Multivariable logistic regression analysis was used to evaluate the potential risk factors for prolonged treatment of WAD.

Results: Female sex, the severity of the collision, poor expectations of recovery, victim mentality, dizziness, numbness or pain in the arms, and lower back pain were associated with a poor recovery from WAD.

Conclusions: In the present study, the baseline symptoms (dizziness, numbness or pain in the arms, and lower back pain) had the strongest associations with prolonged treatment for WAD, although the psychological and behavioral factors were also important. These risk factors should be considered when evaluating patients who may have the potential for poor outcomes.

No MeSH data available.


Related in: MedlinePlus