Are physical factors associated with poor prognosis following a whiplash trauma?: a protocol for a systematic review and data synthesis

Abstract

IntroductionMitigating the transition from acute to chronic whiplash-associated disorders (WAD) is fundamental, and this could be achieved through early identification of individuals at risk. Several physical factors such as angular velocity, smoothness of neck movement and coactivation of neck flexors and extensors, have been observed in patients with WAD, but their predictive ability after a whiplash injury have not been considered in previous reviews. Therefore, the aim of the current protocol is to outline the protocol for a systematic review that synthesises the current evidence of which physical factors can predict ongoing pain and disability following a whiplash trauma.Methods and analysisTwo independent reviewers will search for studies in several electronic databases including MEDLINE, Embase, CINAHL, PsycINFO, Scopus and Web of Science as well as grey literature. Observational cohort studies will be considered if they involve participants with acute WAD followed for at least 3 months post-injury. Studies will be required to assess the prognostic ability of one or more physical factors that directly involve a body function and/or structure and can be measured objectively. Further, patient-reported outcomes of physical function will be considered. The primary outcome for this review is Neck Disability Index, while all other validated measures will be considered as secondary outcomes. Risk of bias across individual studies will be assessed using the Quality In Prognostic Studies tool along with the Grades of Recommendation, Assessment, Development and Evaluation method to assess the quality of evidence. A meta-analysis will be conducted depending on homogeneity and the number of available studies. If appropriate, data will be pooled and presented as odds ratios, otherwise, a qualitative synthesis will be conducted.Ethics and disseminationEthical approval is not required for this systematic review. The result from this review will be published in peer-reviewed journals.PROSPERO registration numberCRD42019122559

Are Measures of Physical Function of the Neck Region Associated With Poor Prognosis Following a Whiplash Trauma?

“…35 The protocol for this review was registered prospectively on PROSPERO (International Prospective Register of Systematic Reviews) (CRD42019122559) on the 05/08/2019 and was published in advance. 36…”

“…This review was planned according to the guidelines for conducting prognostic reviews32 and reported according to the guidelines from Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement,33 the Cochrane Back Review Group guidelines,34 and the Cochrane Handbook 35. The protocol for this review was registered prospectively on PROSPERO (International Prospective Register of Systematic Reviews) (CRD42019122559) on the 05/08/2019 and was published in advance 36…”

“…In addition, potential studies were searched in gray literature through ZETOC database, complemented by a hand search of reference lists of relevant published reviews 5,10,21–31. A complete search strategy example was provided in the published protocol 36…”

Assessment of Neuromuscular and Psychological Function in People with Recurrent Neck Pain during a Period of Remission: Cross-Sectional and Longitudinal Analyses

“…Additionally, the predictive ability of these features in people with RNP has not been previously investigated in people who have sustained a whiplash injury. Yet this is highly relevant since the identification of physical and psychological factors that may increase the risk of developing future episodes of neck pain would provide more specific direction for appropriate treatment for the prevention of repeated episodes of pain [ 34 , 35 ].…”