Can long-term impairment in general practitioner whiplash patients be predicted using screening and patient-reported outcomes?

Abstract

The objective of this prospective pilot study was to investigate the predictors of outcome at 6 months for whiplash-associated disorder in a general practitioner primary care population. Psychosocial screening questionnaires, patient-reported outcomes of cervical functional impairment, demographic and accident-specific data have been indicated as predictive of future recovery status and treatment requirements. Participants (n=30, age=37±14 years, 77% females) from eight general practitioners were initially screened with a modified Orebro Musculoskeletal Pain Questionnaire, and had recovery status monitored and classified for 6 months using both patient-reported outcomes, quantitatively (Neck Disability Index) and qualitatively (patient status self-classification). Analysis at two separate cutoff levels showed 30% of participants nonrecovered and 17% with moderate/severe impairment. Nonrecovery status and increased treatment was predicted by a 109-point screening score cutoff while moderate/severe impairment was predicted by including the presence of cervical rotation at impact. Initial cervical functional impairment status measured with the Neck Disability Index was sensitive but not specific for prediction. A larger population study investigating these protocols is warranted.