A review of the definitions of 'recovery' used in prognostic studies on whiplash using an ICF framework.
OBJECTIVE
The purpose of this article is to review the various definitions of recovery used in the prognostic whiplash literature to date, and to evaluate them from the framework of the International Classification of Functioning, Disability and Health (ICF).


METHODS
Reference lists of previous systematic reviews and meta-analyses on the topic were reviewed and citations were retrieved. An updated Medline search was performed. Recovery rates and the method for operationalising recovery were extracted and evaluated for their fit within the ICF model of health. Descriptive statistics were calculated and presented.


RESULTS
Thirty-one independent cohorts were identified. In total, 30 different primary methods for defining recovery were described in the sample of literature. Eighty-three percent of the primary outcomes fit within the body structure and function domain of the ICF. Restricted participation was the second most common domain represented, followed by activity limitations. Even within each domain, there is wide variability in the cut-off values for dichotomising a group as recovered or not.


CONCLUSIONS
The wide range of recovery rates reported in the literature can be at least partly accounted for by the lack of a standardised definition of recovery after acute whiplash. The emphasis on symptoms in the current literature neglects other important aspects of health as described by the ICF.
Walton
David
D
The University of Western Ontario, School of Physical Therapy, London, Ontario, Canada N6G 1H1. dwalton5@uwo.ca
D006801:Humans; D011379:Prognosis; D014911:Whiplash Injuries / Q000534:rehabilitation*