Does multidisciplinary rehabilitation benefit whiplash recovery?: results of a population-based incidence cohort study.
METHODS
Population-based, incidence cohort.


OBJECTIVE
To evaluate a government policy of funding community and hospital-based fitness training and multidisciplinary rehabilitation for whiplash.


BACKGROUND
Although insurance benefits commonly include rehabilitation for whiplash, its effectiveness is unknown.


METHODS
All Saskatchewan adults treated for whiplash (n = 6,021) over a 2-year period were followed up at 6 weeks, 3, 6, 9, and 12 months. Recovery was defined by self-report of improvement. Recovery times were compared between those attending fitness training at health clubs (n = 833), multidisciplinary outpatient rehabilitation (n = 468), and multidisciplinary inpatient rehabilitation (n = 135) to those receiving usual insured individual care.


RESULTS
Recovery was 32% slower in those receiving fitness training within 69 days of injury (P = 0.001) and 19% slower when received within 119 days of injury (P = 0.041). Recovery was 50% slower in those receiving outpatient rehabilitation within 119 days of injury (P = 0.001). Attending inpatient rehabilitation did not influence recovery rates during the follow up (P = 0.131). Multivariable adjustment for important prognostic factors did not change these results.


CONCLUSIONS
We found no evidence to support the effectiveness of a population-based program of fitness training and multidisciplinary rehabilitation for whiplash. Rehabilitation programs should be tested in randomized trials before being recommended to injured populations.
Cassidy
J David
JD
University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, Ontario, Canada. dcassidy@uhnresearch.ca
Carroll
Linda J
LJ
Côté
Pierre
P
Frank
John
J
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness / Q000502:physiology; D011153:Population; D020127:Recovery of Function; D014911:Whiplash Injuries / Q000453:epidemiology* / Q000503:physiopathology / Q000534:rehabilitation*