Citation

Kasch H, Qerama E, Kongsted A, Bach FW, Bendix T, Jensen TS. Spine 2011; 36(25 Suppl): S263-7.

Affiliation

The Danish Pain Research Center, Dept. of Neurology, Aarhus University Hospital, DK-8000 Aarhus, Denmark; Dept of Neurophysiology, Aarhus University Hospital, DK-8000 Aarhus, Denmark; Nordic Institute of Chiropractic and Clinical Biomechanics part of Clinical Locomotion Science Network, University of Southern Denmark, DK-8230 Odense, Denmark; Dept. of Neurology, Aalborg University Hospital, Aarhus University, DK-9100 Aalborg, Denmark; Copenhagen Spine Center, Glostrup Hospital, DK-2600 Glostrup, Denmark.

Copyright

(Copyright © 2011, Lippincott Williams and Wilkins)

DOI

10.1097/BRS.0b013e31823881d6

PMID

22020622

Abstract

Study Design. 1-year prospective study of 141 acute whiplash patients (WLP) and 40 acute ankle injured controlsObjective. This study investigates a priori determined potential risk factors in order to develop a risk assessment tool, for which the expediency was examinedSummary of Background Data. The Whiplash Associated Disorders (WAD) grading system that emerged from The Quebec Task-force-on-Whiplash has been of limited value for predicting work-related recovery and for explaining bio-psychosocial disability after whiplash and new predictive factors e.g. risk criteria that comprehensively differentiate acute WLP in a bio-psycho-social manner are needed.Methods. Consecutively 141 acute WLP and 40 ankle injured recruited from emergency units were examined after 1 week, 1, 3, 6, 12 months obtaining neck/head VAS score, number-of-non-painful complaints, epidemiological, social, psychological data and neurological examination, active neck mobility, and furthermore muscle tenderness and pain response, strength and duration of neck muscles. Risk factors derived (reduced CROM, intense neckpain/headache, multiple non-pain complaints) were applied in a Risk Assessment Score and divided into 7 risk-strata.Results. A ROC curve for the Risk Assessment Score and 1-year work disability showed an area of 0.90. Risk strata and number of sick days showed a log-linear relationship. In stratum 1 full recovery was encountered, but for high risk patients in stratum 6 only 50% and 7 only 20% had returned to work after 1-yr (p < 5.4 * 10). Strength measures, psychophysical pain measurements and psychological and social data (reported elsewhere) showed significant relation to risk strata.Conclusion. The Risk Assessment score is suggested as a valuable tool for grading WLP early after injury. It has reasonable screening power for encountering work disability and reflects the bio-psycho-social nature of whiplash injuries.

Language: en