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Conservative treatment for whiplash.
A P Verhagen1, G G Peeters, R A de Bie
1Department of General Practice, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, Netherlands. Verhagen@hag.fgg.eur.nl
The Cochrane Database of Systematic Reviews
|November 1, 2001
Summary
Active treatments may benefit whiplash-associated disorder patients, but evidence is limited. Rest and collars are not recommended; maintaining usual activities might be effective. More high-quality studies are needed for definitive conclusions.
Area of Science:
- Orthopedics
- Physical Medicine and Rehabilitation
- Evidence-Based Medicine
Background:
- Numerous treatments exist for whiplash injuries, but their effectiveness remains largely unproven.
- Whiplash-Associated Disorders (WAD) I and II represent common injury classifications.
Purpose of the Study:
- To systematically review the efficacy of conservative treatments for whiplash-associated disorders (WAD) I or II.
- To evaluate interventions aimed at improving pain, perceived recovery, and daily activity participation.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (Medline, Embase, Cinahl, Psychlit, Cochrane) up to June 1998.
- Included studies were randomized clinical trials (RCTs) of conservative interventions for whiplash injuries, assessing pain, global perceived effect, or daily activities.
- Methodological quality was assessed using the Maastricht-Amsterdam list, with a focus on studies scoring at least 50% on two of three quality metrics.
Main Results:
- Eleven studies met the inclusion criteria, evaluating diverse conservative interventions.
- Only three studies demonstrated adequate methodological quality, indicating a general lack of high-quality research.
- Active treatments showed a beneficial effect on primary outcomes, particularly pain reduction.
Conclusions:
- Active interventions, such as advising patients to maintain usual activities, appear more effective than rest or immobilization (e.g., collars) for whiplash.
- The paucity of high-quality studies necessitates caution when interpreting the efficacy of conservative whiplash treatments.
- No firm conclusions can be drawn regarding the optimal therapy for chronic whiplash patients due to limited evidence.