Whiplash injuries in Finland--the possibility of some sociodemographic and psychosocial factors to predict the outcome after one year

Miettinen, Timo; Airaksinen, Olavi; Lindgren, Karl-August; Leino, Eeva

doi:10.1080/09638280400000203

Cited by 34 publications

(35 citation statements)

References 27 publications

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“…The increase in neck pain seen with lower education levels is supported by previous studies of whiplash patients [9,[24][25][26], but the mechanism for this association is not clear. It is likely that patients with lower education levels are more likely to have manual jobs, and therefore it is possible that this group of patients had more neck pain prior to the injury due to their occupation.…”

Section: Discussionsupporting

confidence: 66%

Physical and Psychosocial Factors Associated with Neck Pain after Major Accidental Trauma

Harris

Young

Rae

et al. 2007

Eur J Trauma Emerg Surg

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Neck pain after physical trauma is common; but previous research regarding the role of psychological and physical predictors for neck pain is inconsistent. A retrospective survey of consecutive patients presenting to a metropolitan trauma centre with major accidental trauma was performed between 1 and 6 years post injury. Possible predictor variables (demographic, injury severity, and psychosocial factors) were determined from the hospital trauma registry and the questionnaire. The main outcome was a combined score of neck pain severity and functional limitation. Multivariate logistic regression was performed to develop a predictive model for neck pain. A multivariate analysis of 355 patients showed that neck pain was not significantly associated with measures of injury severity. Neck pain was significantly more likely to be severe in patients with a cervical spine fracture, with pre-existing chronic illnesses, those with post-traumatic stress disorder (PTSD) at the time of follow up, those who had retained the services of a lawyer regarding the injury, and those with lower education levels. Psychosocial factors are important predictors of neck pain after major physical trauma. These findings do not support models for post-traumatic neck pain that are restricted to physical factors.

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Section: Discussionsupporting

confidence: 66%

Physical and Psychosocial Factors Associated with Neck Pain after Major Accidental Trauma

Harris

Young

Rae

et al. 2007

Eur J Trauma Emerg Surg

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“…In a recent prospective study, Sterling et al (2005) maintain that both physical factors and psychological distress play a role in the recovery or non-recovery from whiplash injury. According to several studies (e.g., Wallis et al 1996Wallis et al , 1997Richter et al 2004;Miettinen et al 2004;Nederhand et al 2004;Ferrari et al 2005;Hendriks et al 2005;Guez et al 2005), socio-demographic, cultural and psychological factors add to physical factors in aVecting the shortand long-term outcome after whiplash injury, and are listed among the predictive factors for the subjects to develop chronic neck pain disability (see Pain).…”

Section: Involvement Of the Sympathetic Nervous System In Wadmentioning

confidence: 99%

Influence of sympathetic nervous system on sensorimotor function: whiplash associated disorders (WAD) as a model

2006

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There is increasing interest about the possible involvement of the sympathetic nervous system (SNS) in initiation and maintenance of chronic muscle pain syndromes of different aetiology. Epidemiological data show that stresses of different nature, e.g. work-related, psychosocial, etc., typically characterised by SNS activation, may be a co-factor in the development of the pain syndrome and/or negatively affect its time course. In spite of their clear traumatic origin, whiplash associated disorders (WAD) appear to share many common features with other chronic pain syndromes affecting the musculo-skeletal system. These features do not only include symptoms, like type of pain or sensory and motor dysfunctions, but possibly also some of the pathophysiological mechanisms that may concur to establish the chronic pain syndrome. This review focuses on WAD, particular emphasis being devoted to sensorimotor symptoms, and on the actions exerted by the sympathetic system at muscle level. Besides its well-known action on muscle blood flow, the SNS is able to affect the contractility of muscle fibres, to modulate the proprioceptive information arising from the muscle spindle receptors and, under certain conditions, to modulate nociceptive information. Furthermore, the activity of the SNS itself is in turn affected by muscle conditions, such as its current state of activity, fatigue and pain signals originating in the muscle. The possible involvement of the SNS in the development of WAD is discussed in light of the several positive feedback loops in which it is implicated.

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“…Most recently, Carroll et al performed a meta-analysis of the literature pertaining to whiplash injury. When considering all whiplash patients, 44% to 66% of patients had symptoms at one year, but only 12% reported daily neck pain and only 9% reported significant health impairment as a result of the whiplash injury [26][27][28]. Others have shown that 90% of patients presenting with neck pain and neurological signs (WAD III) have continued symptoms at one-year following the injury [29].…”

Section: Discussionmentioning

confidence: 99%

Clinical and Finite Element Analysis of Acute Whiplash

Tannoury¹,

Rihn²,

Wilson³

et al. 2011

TOSPINEJ

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Study Design:A prospective 1-year follow-up study of whiplash patients presenting with neurological signs/or symptoms (WADIII), and whiplash patients with neck pain but no neurologic findings (WADI/II). Objective:We hypothesize that WADI/II and WADIII are distinct entities, with regards to clinical presentation, pathoanatomy, and prognosis.Summary of Background Data: symptoms associated with whiplash injury range from mild neck pain (WADI/II), to injuries associated with neurologic sequellae (WADIII). To date, literature considers whiplash associated disorders (WAD) a single clinical and pathologic entity, with different grades of severity (WADI-IV).Methods: Thirty one subjects were divided into a WADIII study group and a WADI/II comparison group. All subjects underwent H&P, radiographic evaluations, and clinical outcome measures (collected at 3, 6, and 12 months). Statistical analysis was performed (Student T-test, Wilcoxon Signed-Rank test) with significance set at p=0.05. A finite element analysis (FEA) technology (SCOSIA©) was used to predict stresses within the neuraxis.Results: At day 0: Better neurologic assessments, functional performances, and higher quality-of-life measurements were noted in WADI/II compared to WADIII. VAS scores were comparable.At 12 months: Both groups reported improvements in neurologic status and disability symptoms. However functional recovery and quality-of-life measures significantly improved in WADIII, and conversely deteriorated in WADI/II along with notable worsening of pain symptoms. Litigation claims were comparable. FEA predicted higher stress within the neuraxis of WADIII, notably in subjects with preexisting stenosis and odontoid retroflexion. Conclusion:WADI/II and WADIII are distinct entities. Musculoskeletal injury precipitates WADI/II pain symptoms while neuronal stretching leads to WADIII neurologic injuries, which are mostly recoverable.

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Whiplash injuries in Finland--the possibility of some sociodemographic and psychosocial factors to predict the outcome after one year

Abstract: Several sociodemographic and psychosocial factors can have relation to the deterioration of health experienced after whiplash injury but in this prospective study they proved to have only limited prognostic value in the long term symptoms with the exception of the education.

Cited by 34 publications

References 27 publications

Physical and Psychosocial Factors Associated with Neck Pain after Major Accidental Trauma

Physical and Psychosocial Factors Associated with Neck Pain after Major Accidental Trauma

Influence of sympathetic nervous system on sensorimotor function: whiplash associated disorders (WAD) as a model

Clinical and Finite Element Analysis of Acute Whiplash

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