Recommendations for a core outcome measurement set for clinical trials in whiplash associated disorders

Sterling, Michele; Andersen, Tonny Elmose; Carroll, Linda; Connelly, Luke B.; Côté, Pierre; Curatolo, Michele; Grant, Genevieve; Jull, Gwendolen; Kasch, Helge; Ravn, Sophie Lykkegaard; MacDermid, Joy C.; Malmström, Eva-Maj; Rebbeck, Trudy; Söderlund, Anne; Treleaven, Julia; Walton, David M.; Westergren, Hans

doi:10.1097/j.pain.0000000000002926

Cited by 4 publications

(2 citation statements)

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“…In a recent article, Sterling et al discussed the inconsistency of reporting of outcomes in clinical trials of treatments for WAD. 118 They suggested the lack of consistency reduced opportunities for data pooling and therefore conclusions regarding the efficacy of treatments. To address this, a steering committee developed a set of core outcomes in six different domains which included psychological functioning, quality of life, and work and social functioning.…”

Section: Discussionmentioning

confidence: 99%

“… 119 The authors recommend that the instruments identified in this process should be used as standard in all clinical trials examining the effectiveness of interventions for WAD. 118 Similar attention to the scope and consistency of outcome measure used in other MSK injury treatment interventions (eg, MSK/orthopaedic trauma rehabilitation) settings is desirable.…”

Section: Discussionmentioning

confidence: 99%

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Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: a scoping review of systematic reviews

Sim,

McNeilage,

Gholamrezaei

et al. 2024

BMJ Open

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BackgroundMusculoskeletal injuries can cause distress, and distress is associated with delayed recovery. Numerous interventions have been developed to facilitate recovery from injury, and several systematic reviews evaluate the efficacy of these interventions for reducing psychological distress.ObjectivesThis scoping review aims to map the synthesised evidence for the relationship between treatment interventions and distress-related outcomes following acute injury. The objectives were (1) to describe the types of interventions that have been evaluated in relation to distress-related outcomes following accidental injury, (2) to examine the scope of distress-related outcomes that have been measured in relation to these interventions and (3) to explore the range of clinical professions that deliver these interventions.DesignWe searched nine electronic databases and grey literature (to 21 April 2022). We included any systematic review reporting on the relationship between interventions delivered in the time following injury and distress-related outcomes. Data relevant to the specific objectives of this scoping review were extracted and described using narrative synthesis.ResultsFrom 8412 systematic reviews imported for screening, 8266 unique records were screened. 179 were selected for full-text review. 84 systematic reviews were included in the study. Interventional types were pharmacological, psychological, exercise based, physical/manual therapies, virtual reality based, multimodal and workplace based. Interventions were delivered digitally, face to face and using virtual reality by a variety of healthcare professionals, including doctors, nurses, psychologists and physiotherapists. The most frequently reported distress-related variables included anxiety, depression, post-traumatic stress disorder diagnosis.ConclusionA wide range of interventions may help to mitigate distress following acute accidental musculoskeletal or orthopaedic injury. Even interventions that were not designed to reduce distress were found to improve distress-related outcomes. In view of the important role of distress in recovery from injury, it is recommended that distress-related variables are measured as core outcomes in the evaluation of treatments for acute injuries.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: a scoping review of systematic reviews

Sim,

McNeilage,

Gholamrezaei

et al. 2024

BMJ Open

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Effectiveness of Interventions on Work Outcomes After Road Traffic Crash-Related Musculoskeletal Injuries: A Systematic Review and Meta-analysis

Brakenridge,

Smits,

Gane

et al. 2024

J Occup Rehabil

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Background Musculoskeletal injuries are common after road traffic crash (RTC) and can lead to poor work-related outcomes. This review evaluated the impact of interventions on work-related (e.g. sick leave), health, and functional outcomes in individuals with a RTC-related musculoskeletal injury, and explored what factors were associated with work-related outcomes. Methods Searches of seven databases were conducted up until 9/03/2023. Eligible interventions included adults with RTC-related musculoskeletal injuries, a comparison group, and a work-related outcome, and were in English. Meta-analyses were conducted using RevMan and meta-regressions in Stata. Results Studies (n = 27) were predominantly conducted in countries with third-party liability schemes (n = 26), by physiotherapists (n = 17), and in participants with whiplash injuries (94%). Pooled effects in favour of the intervention group were seen overall (SMD = − 0.14, 95% CI: − 0.29, 0.00), for time to return to work (− 17.84 days, 95% CI: − 24.94, − 10.74), likelihood of returning to full duties vs. partial duties (RR = 1.17, 95% CI: 1.01, 1.36), decreased pain intensity (− 6.17 units, 95% CI: − 11.96, − 0.39, 100-point scale), and neck disability (− 1.77 units, 95% CI: − 3.24, − 0.30, 50-point scale). Discussion Interventions after RTC can reduce time to return to work and increase the likelihood of returning to normal duties, but the results for these outcomes were based on a small number of studies with low-quality evidence. Further research is needed to evaluate a broader range of interventions, musculoskeletal injury types, and to include better quality work-related outcomes.

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Trajectories of cold but not mechanical sensitivity correspond with disability trajectories after whiplash injury

Farrell,

Armfield,

Kristjansson

et al. 2024

Pain

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Developmental trajectories for neck disability after whiplash injury have been identified. Their relationship to cold and mechanical sensitivity trajectories is not known. We aimed to (1) identify recovery trajectories of cold and mechanical sensitivity, (2) explore their codevelopment with disability trajectories, (3) identify predictors of sensitivity trajectories, and (4) explore codevelopment of cold and mechanical sensitivity trajectories. Participants (n = 233) were assessed at <1, 3, 6, and 12 months after whiplash injury. Outcomes were cold pain detection threshold (CPT at neck), pressure pain detection thresholds (PPT, neck C5, and tibialis anterior), and the Neck Disability Index. We used group-based trajectory models to identify postinjury recovery trajectories and multinominal logistic regression to explore associations between baseline characteristics and trajectory membership. We identified the following trajectory groups: CPT (low [50.0%], moderate [29.7%], and high [20.4%] sensitivity); PPT C5 (low [10.8%] and high [89.2%] sensitivity); and PPT tibialis anterior (low [23.9%], moderate [39.0%], and high [37.1%] sensitivity); all were stable over the 12 months. There was good correspondence between disability and cold sensitivity trajectory groups but not for mechanical sensitivity; cold and mechanical sensitivity trajectories were not well associated. Higher baseline pain predicted membership of the high cold sensitivity trajectory (RR 1.27, 95% CI 1.01-1.59) and hyperarousal symptoms predicted membership of the moderate cold sensitivity trajectory (RR 1.17, 95% CI 1.01-1.36). We found no associations between baseline characteristics and mechanical sensitivity. There is an interplay between cold allodynia, pain, and hyperarousal symptoms in development of ongoing disability after whiplash injury. Different mechanisms likely underlie cold and mechanical sensitivity.

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Recommendations for a core outcome measurement set for clinical trials in whiplash associated disorders

Cited by 4 publications

References 37 publications

Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: a scoping review of systematic reviews

Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: a scoping review of systematic reviews

Effectiveness of Interventions on Work Outcomes After Road Traffic Crash-Related Musculoskeletal Injuries: A Systematic Review and Meta-analysis

Trajectories of cold but not mechanical sensitivity correspond with disability trajectories after whiplash injury

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