Comparison of the relative benefits of 2 versus 10 days of soft collar cervical immobilization after acute whiplash injury.
OBJECTIVE
To investigate the effects of 2-day and 10-day immobilization of the cervical spine on pain, range of motion (ROM), and disability of patients with Quebec Task Force (QTF) grade II whiplash injuries.


METHODS
Randomized controlled trial.


METHODS
University hospital emergency department.


METHODS
Seventy patients with acute QTF grade II whiplash injuries.


METHODS
At the intake examination within 24 hours after the whiplash trauma, the patients were randomized to 2 therapy groups (2-d or 10-d immobilization with a soft cervical collar). All patients received pain drugs (nonsteroidal anti-inflammatory drugs) and after 7 days, all patients started a standardized physiotherapy program 2 to 3 times a week.


METHODS
Patients' pain and disability scores were assessed using visual analog scales and ROM was assessed using a goniometer. All parameters were measured within 24 hours after injury and after 2 and 6 months.


RESULTS
After 2 months, the different periods of immobilization (2d or 10d) were associated with comparable improvements in pain symptoms (median, 4.60 vs 4.65), ROM (median, 100.0 degrees vs 117.5 degrees ), and disability score (median, 4.90 vs 5.15). No statistically significant differences could be identified between the 2 treatment groups. After 6 months, persistent pain was reported by 4 patients in each group (12.5%).


CONCLUSIONS
In patients with QTF grade II whiplash injuries, there is no short- or long-term difference between 2-day and 10-day immobilization with a cervical collar in terms of pain, ROM, or disability.
Dehner
Christoph
C
Department for Trauma, Hand and Reconstructive Surgery, University of Ulm, Ulm, Germany. christoph.dehner@uniklinik-ulm.de
Hartwig
Erich
E
Strobel
Philipp
P
Scheich
Matthias
M
Schneider
Florian
F
Elbel
Martin
M
Kinzl
Lothar
L
Kramer
Michael
M
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002574:Cervical Vertebrae; D004185:Disability Evaluation; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007103:Immobilization; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D059408:Pain Management; D016059:Range of Motion, Articular; D013997:Time Factors; D014911:Whiplash Injuries / Q000150:complications / Q000534:rehabilitation*
D000894:Anti-Inflammatory Agents, Non-Steroidal