Expectations for Recovery Important in the Prognosis of Whiplash Injuries

English version České info

Background:
Individuals' expectations on returning to work after an injury have been shown to predict the duration of time that a person with work-related low back pain will remain on benefits; individuals with lower recovery expectations received benefits for a longer time than those with higher expectations. The role of expectations in recovery from traumatic neck pain, in particular whiplash-associated disorders (WAD), has not been assessed to date to our knowledge. The aim of this study was to investigate if expectations for recovery are a prognostic factor after experiencing a WAD.

Methods and Findings:
We used a prospective cohort study composed of insurance claimants in Sweden. The participants were car occupants who filed a neck injury claim (i.e., for WAD) to one of two insurance companies between 15 January 2004 and 12 January 2005 (n = 1,032). Postal questionnaires were completed shortly (average 23 d) after the collision and then again 6 mo later. Expectations for recovery were measured with a numerical rating scale (NRS) at baseline, where 0 corresponds to “unlikely to make a full recovery” and 10 to “very likely to make a full recovery.” The scale was reverse coded and trichotomised into NRS 0, 1–4, and 5–10. The main outcome measure was self-perceived disability at 6 mo postinjury, measured with the Pain Disability Index, and categorised into no/low, moderate, and high disability. Multivariable polytomous logistic regression was used for the analysis. There was a dose response relationship between recovery expectations and disability. After controlling for severity of physical and mental symptoms, individuals who stated that they were less likely to make a full recovery (NRS 5–10), were more likely to have a high disability compared to individuals who stated that they were very likely to make a full recovery (odds ratio [OR] 4.2 [95% confidence interval (CI) 2.1 to 8.5]. For the intermediate category (NRS 1–4), the OR was 2.1 (95% CI 1.2 to 3.2). Associations between expectations and disability were also found among individuals with moderate disability.

Conclusions:
Individuals' expectations for recovery are important in prognosis, even after controlling for symptom severity. Interventions designed to increase patients' expectations may be beneficial and should be examined further in controlled studies.

Vyšlo v časopise: Expectations for Recovery Important in the Prognosis of Whiplash Injuries. PLoS Med 5(5): e105. doi:10.1371/journal.pmed.0050105
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.0050105

Souhrn

Zdroje

1. SpitzerWSkovronMSalmiLCassidyJDuranceauJ

1995

Scientific monograph of the Quebec Task Force on whiplash-associated disorders: redefining “whiplash” and its management.

Spine

73S

2. CôtéPCassidyJDCarrollLFrankJWBombardierC

2001

A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature.

Spine

E445

E458

3. AthertonKWilesNJLeckyFEHawesSJSilmanAJ

2006

Predictors of persistent neck pain after whiplash injury.

Emerg Med J

195

201

4. CarrollLJCassidyJDCoteP

2006

Frequency, timing, and course of depressive symptomatology after whiplash.

Spine

E551

E556

5. CarrollLJCassidyJDCoteP

2006

The role of pain coping strategies in prognosis after whiplash injury: passive coping predicts slowed recovery.

Pain

6. BerglundABodinLJensenIWiklundAAlfredssonL

2006

The influence of prognostic factors on neck pain intensity, disability, anxiety and depression over a 2-year period in subjects with acute whiplash injury.

Pain

125

244

256

7. HendriksEJScholten-PeetersGGvan der WindtDANeeleman-van der SteenCWOostendorpRA

2005

Prognostic factors for poor recovery in acute whiplash patients.

Pain

114

408

416

8. MiettinenTAiraksinenOLindgrenKALeinoE

2004

Whiplash injuries in Finland–the possibility of some sociodemographic and psychosocial factors to predict the outcome after one year.

Disabil Rehabil

1367

1372

9. FerrariRObelienieneDRussellADarlingtonPGervaisR

2002

Laypersons' expectation of the sequelae of whiplash injury. A cross-cultural comparative study between Canada and Lithuania.

Med Sci Monit

728

734

10. FerrariRConstantoyannisCPapadakisN

2001

Cross-cultural study of symptom expectation following minor head injury in Canada and Greece.

Clin Neurol Neurosurg

103

254

259

11. JanzenJASilviusJJacobsSSlaughterSDalzielW

2006

What is a health expectation? Developing a pragmatic conceptual model from psychological theory.

Health Expect

12. MondlochMColeDFrankJ

2001

Does how you do depend on how you think you'll do? A systematic review of the evidence for a relation between patients' recovery expectations and health outcomes.

CMAJ

165

174

179

13. KuijerWGroothoffJWBrouwerSGeertzenJHDijkstraPU

2006

Prediction of sickness absence in patients with chronic low back pain: a systematic review.

J Occup Rehabil

430

458

14. TaitRCPollardCAMargolisRBDuckroPNKrauseSJ

1987

The Pain Disability Index: psychometric and validity data.

Arch Phys Med Rehabil

438

441

15. MargolisRTaitRKrauseS

1986

A rating system for use with patient pain drawing.

Pain

16. ZigmondASSnaithRP

1983

The hospital anxiety and depression scale.

Acta Psychiatr Scand

361

370

17. BjellandIDahlAAHaugTTNeckelmannD

2002

The validity of the Hospital Anxiety and Depression Scale. An updated literature review.

J Psychosom Res

18. HorowitzMWilnerNAlvarezW

1979

Impact of Event Scale: a measure of subjective stress.

Psychosom Med

209

218

19. SundinECHorowitzMJ

2003

Horowitz's Impact of Event Scale evaluation of 20 years of use.

Psychosom Med

870

876

20. Swinburne Centre for Neuropsychology, Swinburne University, Australia

2005

Impact of Event Scale

Available: http://www.swin.edu.au/victims/resources/assessment/ptsd/ies.html. Accessed 8 April 2008.

21. BrownGKNicassioPM

1987

Development of a questionnaire for the assessment of active and passive coping strategies in chronic pain patients.

Pain

22. Snow-TurekALNorrisMPTanG

1996

Active and passive coping strategies in chronic pain patients.

Pain

455

462

23. HosmerDLemeshowS

1989

Applied logistic regression

New York

John Wiley & Sons

24. RothmanK

2002

Epidemiology: an introduction

New York

Oxford University Press Inc

25. SPSS

2006

SPSS 14.0 for Windows

Chicago

SPSS

26. PeetersGGVerhagenAPde BieRAOostendorpRA

2001

The efficacy of conservative treatment in patients with whiplash injury: a systematic review of clinical trials.

Spine

E64

E73

27. OliveiraAGevirtzRHubbardD

2006

A psycho-educational video used in the emergency department provides effective treatment for whiplash injuries.

Spine

1652

1657

28. OttossonCPetterssonHJohanssonSENyrenOPonzerS

2007

Recovery after minor traffic injuries: a randomized controlled trial.

PLoS Clin Trials

e14

doi:10.1371/journal.pctr.0020014

29. ColeDMondlochMHogg-JohnsonS

2002

Listening to injured workers: how recovery expectations predict outcomes - a prospective study.

CMAJ

166

749

754

30. HeymansMWde VetHCKnolDLBongersPMKoesBW

2006

Workers' beliefs and expectations affect return to work over 12 months.

J Occup Rehabil

685

695

31. BuchbinderRJolleyDWyattM

2001

2001 Volvo Award Winner in Clinical Studies: effects of a media campaign on back pain beliefs and its potential influence on management of low back pain in general practice.

Spine

2535

2542

32. BuchbinderRJolleyD

2005

Effects of a media campaign on back beliefs is sustained 3 years after its cessation.

Spine

1323

1330