Cognitive symptoms, cervical range of motion and pain as prognostic factors after whiplash trauma

Borenstein, P., Rosenfeld, M., and Gunnarsson, R. (2010) Cognitive symptoms, cervical range of motion and pain as prognostic factors after whiplash trauma. Acta Neurologica Scandinavica, 122 (4). pp. 278-285.

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Abstract

Objectives - To evaluate pain, cervical range of motion (CROM) and cognitive symptoms as predictors for poor prognosis defined as sick leave 3 years later.

Material and methods - In 97 patients CROM, pain intensity and cognitive symptoms were measured immediately following trauma, at 6 months and 3 years. Patients were also asked at 3 years if they had been on sick leave the last 6 months.

Results - Pain intensity and reduced CROM were not clinically useful as predictors of later sick leave. The best predictors were presence within 96 h after injury of the two cognitive symptoms 'being easily distracted' (odds ratio 8.7-50) and 'easily irritated' (odds ratio 5.3-31).

Conclusions - Initial pain and reduced CROM may be related to minor tissue damage which often heals while late functionality is more dependent on other factors such as cognitive dysfunction. For patients with whiplash-associated disorders two simple questions should be asked; 'Are you currently easily irritated?' and 'Are you currently easily distracted (e.g. is it difficult for you to follow a conversation if several people are talking in the room at the same time)?'. An affirmative answer to any of these questions indicates an increased risk for poor prognosis defined as sick leave 3 years later.

Item ID: 27610
Item Type: Article (Research - C1)
ISSN: 1600-0404
Keywords: neurobehavioral manifestations, whiplash injuries, treatment, pain intensity, range of motion, sick leave
Date Deposited: 07 Jun 2013 09:13
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1109 Neurosciences > 110903 Central Nervous System @ 30%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111705 Environmental and Occupational Health and Safety @ 20%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110321 Rehabilitation and Therapy (excl Physiotherapy) @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920111 Nervous System and Disorders @ 30%
92 HEALTH > 9202 Health and Support Services > 920203 Diagnostic Methods @ 50%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920409 Injury Control @ 20%
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