Thoracic dysfunction in whiplash-associated disorders: a systematic review and meta-analysis protocol

Area of Science:

• Orthopedics
• Physical Therapy
• Rehabilitation Medicine

Background:

• Whiplash-associated disorder (WAD) research predominantly focuses on cervical spine injuries.
• Thoracic spine pain is prevalent in acute WAD (~66%) and persists in a significant portion of chronic WAD cases (23% at 1 year).
• The thoracic spine's role in neck mobility suggests its involvement in WAD pathophysiology.

Purpose of the Study:

• To systematically review and synthesize existing evidence on thoracic spine dysfunction following whiplash injury.
• To provide new insights into the scope and nature of thoracic dysfunction in WAD.
• To inform future research and clinical practice regarding under-investigated thoracic involvement in WAD.

Main Methods:

• Systematic review conducted following PRISMA-P guidelines.
• Comprehensive literature search across databases, grey literature, and registers.
• Data extraction and risk of bias assessment (Newcastle-Ottawa Scale); meta-analysis for homogenous data, narrative summaries otherwise.
• Strength of evidence assessed using GRADE criteria.

Main Results:

• This review is the first to consolidate evidence on thoracic dysfunction in WAD.
• Identifies the scope and nature of thoracic dysfunction related to whiplash.
• Highlights the under-investigated role of the thoracic spine in WAD.

Conclusions:

• Thoracic dysfunction is a significant, yet under-recognized, component of WAD.
• Current WAD management often overlooks thoracic involvement, potentially contributing to chronicity.
• This review calls for increased research and clinical attention to the thoracic spine in WAD management.