A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD): Part 4 – Noninvasive Interventions for Chronic WAD

Whiplash-associated disorder (WAD) represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. While many treatments have been advocated for patients with WAD, scientific evidence supporting their effectiveness is often lack...

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Main Authors: Robert W Teasell, J Andrew McClure, David Walton, Jason Pretty, Katherine Salter, Matthew Meyer, Keith Sequeira, Barry Death
Format: Article
Language:English
Published: Wiley 2010-01-01
Series:Pain Research and Management
Online Access:http://dx.doi.org/10.1155/2010/487279
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author Robert W Teasell
J Andrew McClure
David Walton
Jason Pretty
Katherine Salter
Matthew Meyer
Keith Sequeira
Barry Death
author_facet Robert W Teasell
J Andrew McClure
David Walton
Jason Pretty
Katherine Salter
Matthew Meyer
Keith Sequeira
Barry Death
author_sort Robert W Teasell
collection DOAJ
description Whiplash-associated disorder (WAD) represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. While many treatments have been advocated for patients with WAD, scientific evidence supporting their effectiveness is often lacking. A systematic review was conducted to evaluate the strength of evidence for various WAD therapies. Multiple databases (including Web of Science, EMBASE and PubMed) were searched to identify all studies published from January 1980 through March 2009 that evaluated the effectiveness of any clearly defined treatment for acute (less than two weeks), subacute (two to 12 weeks) or chronic (longer than 12 weeks) WAD. The present article, the fourth in a five-part series, evaluates the evidence for noninvasive interventions initiated during the chronic phase of WAD. Twenty-two studies that met the inclusion criteria were identified, 12 of which were randomized controlled trials with ‘good’ overall methodological quality (median Physiotherapy Evidence Database score of 6). For the treatment of chronic WAD, there is evidence to suggest that exercise programs are effective in relieving whiplash-related pain, at least over the short term. While the majority of a subset of nine studies supported the effectiveness of interdisciplinary interventions, the two randomized controlled trials provided conflicting results. Finally, there was limited evidence, consisting of one supportive case series each, that both manual joint manipulation and myofeedback training may provide some benefit. Based on the available research, exercise programs were the most effective noninvasive treatment for patients with chronic WAD, although many questions remain regarding the relative effectiveness of various exercise regimens.
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spelling doaj-art-05ecc92fc47641d7be52607da04d92f72025-02-03T05:45:10ZengWileyPain Research and Management1203-67652010-01-0115531332210.1155/2010/487279A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD): Part 4 – Noninvasive Interventions for Chronic WADRobert W Teasell0J Andrew McClure1David Walton2Jason Pretty3Katherine Salter4Matthew Meyer5Keith Sequeira6Barry Death7Lawson Health Research Institute, St Joseph’s Health Care, CanadaLawson Health Research Institute, St Joseph’s Health Care, CanadaSchool of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, CanadaLawson Health Research Institute, St Joseph’s Health Care, CanadaLawson Health Research Institute, St Joseph’s Health Care, CanadaLawson Health Research Institute, St Joseph’s Health Care, CanadaDepartment of Physical Medicine and Rehabilitation, Parkwood Hospital, St Joseph’s Health Care, CanadaDepartment of Physical Medicine and Rehabilitation, Parkwood Hospital, St Joseph’s Health Care, CanadaWhiplash-associated disorder (WAD) represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. While many treatments have been advocated for patients with WAD, scientific evidence supporting their effectiveness is often lacking. A systematic review was conducted to evaluate the strength of evidence for various WAD therapies. Multiple databases (including Web of Science, EMBASE and PubMed) were searched to identify all studies published from January 1980 through March 2009 that evaluated the effectiveness of any clearly defined treatment for acute (less than two weeks), subacute (two to 12 weeks) or chronic (longer than 12 weeks) WAD. The present article, the fourth in a five-part series, evaluates the evidence for noninvasive interventions initiated during the chronic phase of WAD. Twenty-two studies that met the inclusion criteria were identified, 12 of which were randomized controlled trials with ‘good’ overall methodological quality (median Physiotherapy Evidence Database score of 6). For the treatment of chronic WAD, there is evidence to suggest that exercise programs are effective in relieving whiplash-related pain, at least over the short term. While the majority of a subset of nine studies supported the effectiveness of interdisciplinary interventions, the two randomized controlled trials provided conflicting results. Finally, there was limited evidence, consisting of one supportive case series each, that both manual joint manipulation and myofeedback training may provide some benefit. Based on the available research, exercise programs were the most effective noninvasive treatment for patients with chronic WAD, although many questions remain regarding the relative effectiveness of various exercise regimens.http://dx.doi.org/10.1155/2010/487279
spellingShingle Robert W Teasell
J Andrew McClure
David Walton
Jason Pretty
Katherine Salter
Matthew Meyer
Keith Sequeira
Barry Death
A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD): Part 4 – Noninvasive Interventions for Chronic WAD
Pain Research and Management
title A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD): Part 4 – Noninvasive Interventions for Chronic WAD
title_full A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD): Part 4 – Noninvasive Interventions for Chronic WAD
title_fullStr A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD): Part 4 – Noninvasive Interventions for Chronic WAD
title_full_unstemmed A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD): Part 4 – Noninvasive Interventions for Chronic WAD
title_short A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD): Part 4 – Noninvasive Interventions for Chronic WAD
title_sort research synthesis of therapeutic interventions for whiplash associated disorder wad part 4 noninvasive interventions for chronic wad
url http://dx.doi.org/10.1155/2010/487279
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