title: Interdisciplinary rehabilitation after whiplash injury: An observational prospective 5 years outcome study.
abstract: Whiplash injury associated disorders (WAD) cause high costs for public health care. Neck pain is number 16 on the global prevalence lists for the 50 most common sequelae. It is of importance to obtain long-term data on disability and working capacity outcomes after rehabilitation. Long-term prospective data of the outcome course of whiplash are sparse. The aim of this study was to quantify improvements of pain, function/role performance, vitality, and working capacity 5 years after whiplash injury and to compare the state of health to normative values at 5 years after rehabilitation.In this naturalistic, observational, prospective cohort study, 115 patients were assessed 5 years (60 months) after a multidisciplinary rehabilitation program. The assessment set consisted of the Short Form 36 (SF-36), parts of the North American Spine Society's cervical spine assessment questionnaire (NASS) and the coping strategies questionnaire (CSQ). The effects were quantified by effect size (ES) and standardized response mean (SRM). Score differences over the course were tested by the Wilcoxon-Mann-Whitney U test for significance.Comparing data between entry and 60 months after rehabilitation 8 of 15 parameters improved with large ES/SRM. Outcome between 6 and 60 months showed small to moderate ES/SRM. Working capacity increased from 0 at entry to rehabilitation to 21 h/wk at 6 months and to 30 h/wk at 60 months follow-up.After large improvements in health and working capacity in the mid-term, further important improvements were observed in the long-term course. It can be hypothesized that part of those can be attributed to the interventions during inpatient rehabilitation, for example, due to better coping strategies.
authors.affiliation: Research Department, RehaClinic Zurzach, Bad Zurzach Clinic of Rheumatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Philipp
authors.initials: P
authors.lastname: Haiduk
authors.forename: Thomas
authors.initials: T
authors.lastname: Benz
authors.forename: Susanne
authors.initials: S
authors.lastname: Lehmann
authors.forename: Francoise
authors.initials: F
authors.lastname: Gysi-Klaus
authors.forename: André
authors.initials: A
authors.lastname: Aeschlimann
authors.forename: Beat A
authors.initials: BA
authors.lastname: Michel
authors.forename: Felix
authors.initials: F
authors.lastname: Angst
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D020127:Recovery of Function; D014911:Whiplash Injuries / Q000534:rehabilitation*; D014938:Work Capacity Evaluation