Citation

Walton DM, Elliott JM. J. Orthop. Sports Phys. Ther. 2017; 47(7): 462-471.

Affiliation

Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL.

Copyright

(Copyright © 2017, Orthopaedic Section and Sports Physical Therapy Section of the American Physical Therapy Association)

DOI

10.2519/jospt.2017.7455

PMID

28622487

Abstract

Synopsis The development of persistent symptoms following whiplash injury from a motor vehicle collision (MVC) is common and contributes substantially to societal and personal costs. The popular Quebec Task Force (QTF) classification system of whiplash-associated disorders (WAD) was meant to function as a prognostic and intervention decision aid, but its usefulness has been questioned. Emerging evidence highlights the heterogeneity of WAD by demonstrating physical and psychological impairments that are unique to those who develop persistent symptoms. These impairments are not recognized in the QTF classification system. The purpose of this clinical commentary is to describe an integrated model focusing on how psychological and neurobiological factors interact and are influenced by existing personal and environmental factors to contribute to the development of chronic WAD. The model has been developed through more than 20 years of work in the field, consultation with experts, in depth synthesis of existing evidence, and new evidence from the authors' own research programs. A sub-theme is that a point of convergence currently exists between the psychological, physiological, and social determinants of health literature that can further explain the complex presentation of WAD. The new model is proposed to orient future research towards more interdisciplinary efforts across non-traditional fields including data scientists and consumers to clarify the mystery of WAD. J Orthop Sports Phys Ther, Epub 16 Jun 2017. doi:10.2519/jospt.2017.7455.

Language: en

Keywords

WAD; acute pain; cervical spine; chronic pain; diathesis; neck