Whiplash book cover

Whiplash

evidence base for clinical practice

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.

Paperback,

Published: April 2011

Imprint: Churchill Livingstone

ISBN: 978-0-7295-3946-3

Contents

  • 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

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