Epidemiology of Whiplash-Associated Disorders

Ioppolo, Francesco; Rizzo, Rosaria Sabrina

doi:10.1007/978-88-470-5486-8_2

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…doi:10.2519/ jospt.2016.6846 W hiplash injuries resulting from low-velocity automotive impacts continue to be a significant cause of neck pain and disability in the general population. 104 Despite considerable research effort, the incidence of acute injury 41 and rate of individuals transitioning to chronic pain symptoms have not remarkably changed over the past 30 years. 64,98 to loading experienced during automotive impacts.…”

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confidence: 99%

Whiplash-Associated Disorders: Occupant Kinematics and Neck Morphology

Stemper¹,

Corner²

2016

J Orthop Sports Phys Ther

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FIGURE 1.Initial phases of head-neck response to automotive rear impacts. The rear impact initiates with the occupant in a neutral upright position. As the thorax is accelerated anteriorly, the head remains stationary during the retraction phase, producing an S-shaped cervical spine curvature. Eventually, loads from the thorax are transferred up the cervical spine and the head-neck complex transitions into extension, with the cervical spine in an overall C-shaped extension curvature. The head eventually rebounds forward (not shown), and the cervical spine then transitions into flexion. Used with permission from Stemper et al. 93 Copyright ©2011 Wiley-Liss, Inc. foam/springs and rearward deflection, which absorb energy and decrease impact severity for the occupant. The magnitude of seatback deformation and deflection is dependent on the occupant's torso mass and center of gravity. Greater mass and higher center of gravity contribute to greater deflection and decreased overall impact severity. Average female body mass is 20% lighter and torso height is 8% shorter. 30,31 Therefore, the ability to deflect the seatback is decreased in females, who would experience more severe loading on the head-neck complex during a given rear impact.This section highlighted the role of body size on cervical spine injury risk during automotive rear impacts, advancing the theory that size-based mismatches between the vehicle seat and occupant anthropometrics contribute to greater injury risk for smaller occupants. This concept would hold true for either males or females, but may help explain the preponderance of whiplash injuries in females due to their generally smaller body size. Shorter sitting height can result in head interaction with the bottom of the head restraint, which increases injury risk. However, taller occupants with incorrectly adjusted head restraints also experience increased injury risk due to the head rotating over the head restraint and increasing extension moments on the cervical spine. Decreased body mass and shorter center-of-torso mass in smaller occupants also contribute to decreased dynamic energy absorption of the seatback. While these differences illustrate mechanisms of increased injury risk for smaller occupants, other morphological differences may also contribute. Differences in Head and Neck MorphologyGiven that a majority of injuries resulting from automotive rear impacts affect the cervical spine, 9 differences in headneck morphology can influence injury risk. Once again, sex-based differences will be used to demonstrate this concept. Neck slenderness, a mechanical term body sizes farther from those standards may not be protected as well.Research studies report that head-tohead restraint backset is lower in females than in males due to rearward incline of automotive seats and decreased sitting height for average females compared to males.12 Sitting height for average females is approximately 6 cm shorter than that for average males. 30,31 This means that the posterior aspect of the head for the comp...

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confidence: 99%

Whiplash-Associated Disorders: Occupant Kinematics and Neck Morphology

Stemper¹,

Corner²

2016

J Orthop Sports Phys Ther

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“…Internationally, the proportion of patients with chronic WAD is now around 20%–40%. 72 The increase in the proportion of patients with chronic WAD in Group B reflects an increase in the number of patients with multiple complaints (>7), more unfavorable prognostic factors (Waddell’s sign >3), greater use of passive coping, and more fear avoidance. This shift conflicts with one of the primary goals of patient management in primary care, namely prevention of WAD chronicity.…”

Section: Discussionmentioning

confidence: 98%

Has the quality of physiotherapy care in patients with Whiplash-associated disorders (WAD) improved over time? A retrospective study using routinely collected data and quality indicators

Oostendorp¹,

Elvers²,

Trijffel³

et al. 2018

PPA

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PurposeTo develop valid quality indicators (QIs) for physiotherapy care based on best available evidence, and to use these QIs to explore trends in the quality of physiotherapy care of patients with Whiplash-associated disorders (WAD) using guideline-based routinely collected data (RCD) gathered between 1996 and 2011.Materials and methodsThe study consisted of two phases: 1) development of QIs and 2) analysis of patient records. A set of QIs was developed based on recommendations in the scientific literature and the Dutch Clinical Practice Guideline (CPG) “Physiotherapy Management and WAD”. QIs were expressed as percentages, allowing target performance levels to be defined (≥80% or ≤30% depending on whether desired performance required a high or low score on a QI). We then analyzed WAD patient data (N = 810) collected over a period of 16 years in two physiotherapy practices, separating patients into two groups defined as before (Group A 1996–2002; n = 353) and after (Group B 2003–2011; n = 457) implementation and transition to the Dutch CPG “Physiotherapy Management and WAD”.ResultsUsing an iterative process and input from both experts and users, 28 QIs were developed and subsequently classified per step of the clinical reasoning process for physiotherapy care. Based on 16 years of RCD, we found that the clinical reasoning process differed significantly (P ≤ 0.05) between the groups, in favor of Group B. Twelve of the 25 indicators (48.0%) in Group A and 19 of 26 indicators (73.1%) in Group B met predetermined performance targets. The number of target indicators also differed significantly between groups, favoring Group B (P ≤ 0.05).ConclusionA preliminary set of novel QIs was developed. Using RCD and these QIs, we conclude that physiotherapy care in our study setting improved over the period 1996–2011. Furthermore, the QIs met the performance targets set for the clinical reasoning process after the transition to the Dutch CPG “Physiotherapy Management and WAD”.

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“…The incidence of whiplash injury varies greatly between different parts of the world with significant monetary burden on the individual as well as the wider community. The cumulative incidence of patients seeking healthcare for whiplash arising from a road traffic accident has increased during the last 30 years to recent estimates of >3/1000 inhabitants in North America and Western Europe [ 6 ]. In addition, whiplash may indirectly damage the temporomandibular joint.…”

Section: Introductionmentioning

confidence: 99%

Are Whiplash-Associated Disorders and Temporomandibular Disorders in a Trauma Related Cause and Effect Relationship? A Review

Montemurro,

Trilli,

Bordea

et al. 2023

Medicina

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Background: Whiplash is associated with a wide variety of clinical manifestations, including headache, neck pain, cervical rigidity, shoulder and back pain, paresthesia, vertigo, and temporomandibular disorders (TMDs). Previous studies reported that TMDs are more common in individuals with chronic whiplash-associated disorders (WAD) than in the general population; however, the pathophysiology and mechanism of this relationship are still not well understood. Methods: A PubMed and Ovid EMBASE review was performed to identify all studies addressing the trauma related cause and effect relationship between WAD and TMDs from January 2003 to March 2023. Results: After screening for eligibility and inclusion criteria, a total of 16 articles met the selection criteria. The various included studies discussed different aspects of the association between WDA and TMDs, including changes in the coordination and amplitude of jaw opening, the severity of the associated symptoms/signs in cases of WAD, the degree of fatigue and psychological stress, difficulty in feeding, cervical and myofascial pain, changes in the MRI signal at various muscle points, muscle tenderness, and quality of life. Conclusions: In this review, we summarized the clinical evidence of any trauma related cause and effect relationship between whiplash and TMDs. An accurate screening of the previous literature showed that, in conclusion, the relationship between whiplash and TMDs is still unclear.

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Epidemiology of Whiplash-Associated Disorders

Cited by 8 publications

References 19 publications

Whiplash-Associated Disorders: Occupant Kinematics and Neck Morphology

Whiplash-Associated Disorders: Occupant Kinematics and Neck Morphology

Has the quality of physiotherapy care in patients with Whiplash-associated disorders (WAD) improved over time? A retrospective study using routinely collected data and quality indicators

Are Whiplash-Associated Disorders and Temporomandibular Disorders in a Trauma Related Cause and Effect Relationship? A Review

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