Whiplash

evidence base for clinical practice

Michele Sterling, PhD MPhty BPhty Grad Dip Manip Physio FACP, Associate Director, Centre for National Research on Disability and Rehabilitation Medicine (CONROD) and Director of the Rehabilitation (Medical and Allied Health) Research Program (CONROD), Associate Professor in the Division of Physiotherapy, School of Health and Rehabilitation Sciences and the School of Medicine.
Justin Kenardy, PhD, clinical health psychologist and Deputy Director of the Centre of National Research on Disability and Rehabilitation Medicine (CONROD), and Professor in Clinical Psychology a the School of Psychology

An exceptional medical resource for all professions involved in the management of whiplash patients

Whiplash is one of the most debated and controversial musculoskeletal conditions. This is, in part, due to the often compensable nature of whiplash injuries and the fact that a precise pathoanatomical diagnosis is not usually achievable.

Whiplash: Evidence base for clinical practice presents the evidence underpinning the complexity of whiplash associated disorders (WADs).

This ranges from the specifics of current physiological and psychological manifestations of whiplash to broader issues such as compensation and litigation.

This new medical textbook turns the spotlight on whiplash injuries and makes essential reading for anyone involved in the management whiplash patients.

This includes physiotherapy, chiropractic, osteopathy, occupational therapy and health psychology practitioners and postgraduate students, as well as practitioners in rehabilitation therapies and primary care.

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Paperback,

Published: April 2011

Imprint: Churchill Livingstone

ISBN: 978-0-7295-3946-3

Contributor list
Reviewer list
Preface
Acknowledgments
Introduction
Structure of the book
Chapter 1 Epidemiology of whiplash associated disorders
Definitions
Cumulative incidence of and risk factors for WAD
Course and prognosis of WAD after a motor vehicle crash
An epidemiological approach to aetiology
The economic burden of WAD
Summary
Chapter 2 Clinical presentation of whiplash associated disorders
Patterns of recovery
Physical and psychological characteristics
Classification systems for WAD
Conclusions
Chapter 3 Mechanism of injury
Head-neck kinematics: global and segmental
Injury theories
Injury metrics
Influencing factors for injury potential
Summary
Chapter 4 The evidence for pathoanatomical lesions
Introduction
Pathomechanics of whiplash injury
Pathological lesions in whiplash injury
Conclusion
Chapter 5 Pain-processing mechanisms in whiplash associated disorders
Introduction
Mechanisms for post-injury central hyperexcitability
Evidence for central hyperexcitability in chronic WAD
Evidence for central hyperexcitability in acute WAD and in the transition to chronicity
Relationships between sensory hypersensitivity and psychological distress
Implications for clinical management of whiplash
Conclusion
Chapter 6 Neuromuscular dysfunction in whiplash associated disorders
Changes in the properties of the cervical muscles
Altered neuromuscular control in WAD
Implications for the management of the patient with whiplash
Conclusion
Chapter 7 Dizziness, visual and sensorimotor control disturbances following whiplash injury
Aetiology of dizziness, visual disturbances and sensorimotor control
Disturbances in whiplash associated disorders
Signs and symptoms of sensorimotor disturbance following a whiplash injury
Implications for assessment
Implications for management
Conclusion
Chapter 8 Psychological aspects of whiplash associated disorders
Accident-related psychological factors
Coping
Catastrophising and kinesiophobia
Attributions, beliefs and expectations
Conclusion
Chapter 9 Potential role of stress systems in the pathogenesis of whiplash associated disorders
Sympathetic nervous system
Neuropeptide Y
Serotonin
Clinical implications
Current research needs and future research directions
Chapter 10 Prognostic indicators of non-recovery following whiplash injury
Prognostic factors for non-recovery
Prediction of outcomes other than pain and disability
Clinical implications
Conclusion
Chapter 11 Primary care management of acute whiplash injury
Current evidence for the management of acute WAD
The provision of advice and education
Is pain control important?
Physical characteristics of acute WAD and implications for management
Psychological characteristics of acute WAD and implications for management
Early multidisciplinary management
Summary
Chapter 12 Evidence-based management of chronic whiplash associated disorders
Evidence base for management of chronic whiplash
Evidence for physical interventions
Evidence for psychological interventions
Evidence for medical interventions
Implementation of evidence in clinical practice
Summary
Chapter 13 Psychological management of chronic whiplash associated disorders
Theory-derived psychological interventions
Evidence-based practice
Remaining issues and future prospects
Conclusion
Chapter 14 Compensation and health outcomes
Introduction
Compensation and related concepts
Compensation: empirical considerations
Health: the concept and its measurement
Conclusions
Chapter 15 Whiplash and the law
The test for compensability
Canadian Transport Accident
Compensation
Conclusions
Chapter 16 Malingering and symptom magnification in whiplash
Associated disorders
Why study malingering in the area of whiplash?
What is meant by malingering?
Approaches to detection of malingering
Differential diagnosis of psychological disorders where symptom production or magnification is a feature
Empirical studies of malingering and symptom magnification in pain
A decision-making template for possible and probable malingering
Chapter 17 Case descriptions
Case description 1: acute whiplash
Case description 2: acute whiplash
Summary of cases 1 and 2
Case description 3: chronic whiplash
Conclusion
Chapter 18 Future directions
Intervention trials
Do some patients have a pre-existing risk of developing chronic pain after whiplash injury?
Improving prognostic models
Identification of a peripheral lesion
Conclusion

Whiplash

evidence base for clinical practice

Contents