Patients with chronic whiplash-associated disorders: relationship between clinical and psychological factors and functional health status.
OBJECTIVE
To examine the relative contribution of cervical impairments and psychosocial factors to perceived disability among people with chronic whiplash-associated disorders.


METHODS
A total of 86 patients with chronic whiplash-associated disorders participated in this observational, cross-sectional study. All patients were presented to outpatient physical therapy clinics. All patients completed the neck disability index. Depression, anxiety, and catastrophizing were measured with the Hospital Anxiety and Depression scale and the pain coping and cognition list, respectively. Cervical function was assessed by measuring the active range of motion. Stepwise and hierarchical regression analysis was used to estimate the contribution of cervical impairment and psychosocial functions to the variance in neck disability.


RESULTS
Depressive symptomatology and catastrophizing explained 61% of the variance in neck disability index scores. Catastrophizing explained 57% of the variance in neck disability index scores and 15% of the variance in the sum scores of active cervical rotations.


CONCLUSIONS
Catastrophizing explained the variance in both perceived neck disability and, to a lesser extent, active range of cervical motion, which suggests that pain-related catastrophizing plays an important role in the physical complaints of patients with chronic whiplash-associated disorders when referred to a physical therapist.
Institute for Master Education in Manual Therapy, SOMT, Amersfoort and University Medical Center Utrecht, The Netherlands.
Maarten A
MA
Schmitt
Nico L
NL
van Meeteren
Anton
A
de Wijer
Frank R
FR
van Genderen
Yolanda
Y
van der Graaf
Paul J
PJ
Helders
D000223:Adaptation, Psychological; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology* / Q000503:physiopathology; D004185:Disability Evaluation; D006304:Health Status; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D009333:Neck / Q000503:physiopathology; D010146:Pain / Q000209:etiology* / Q000503:physiopathology; D010147:Pain Measurement; D011594:Psychometrics; D016059:Range of Motion, Articular; D013315:Stress, Psychological / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014911:Whiplash Injuries / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*