Whiplash Clinical Prediction Rule (CPR)
More than half of people with a whiplash injury recover well and are free of pain or disability 6 months after injury. However, this means that many others have more trouble recovering from their injuries. If health care providers could quickly identify which patients would improve naturally over time and which ones would not, they could better manage the patient’s treatment in the early stages of recovery.
Ritchieet al. (2015) provided new insights which can help improve decision making for providers and outcomes for patients.
Previous work invented a whiplash clinical prediction rule (CPR) to consolidate previously established prognostic factors for poor recovery from a whiplash injury and predicted 2 recovery pathways;
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Prognostic factors for full recovery were, being less than 35 years of age and having an initial Neck Disability Index (NDI) score of 32% or less.
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Prognostic factors for ongoing moderate/severe pain and disability were, being 35 years of age or older, having an initial NDI score of 40% or more, and the presence of hyperarousal symptoms.
To validate the reproducibility and accuracy of CPR, Ritchieet al. (2015) recruited 101 individuals with acute whiplash-associated disorder who had previously participated in either a randomized controlled clinical trial or prospective cohort study was performed using accuracy statistics.
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Full recovery was defined as NDI score at 6 months of 10% or less.
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Ongoing moderate/severe pain and disability was defined as an NDI score at 6 months of 30% or greater.
The result was encouraging;
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The positive predictive value of ongoing moderate/severe pain and disability was 90.9%
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The positive predictive value of full recovery was 80.0%.
This research confirmed the reproducibility and accuracy of this dual-pathway tool for individuals with acute whiplash-associated disorder. However, the authors agreed that further research is needed to assess the impact of inclusion on practice, and to examine the efficacy of linking treatment strategies with predicted prognosis.
Ritchie C, Hendrikz J, Jull G, Elliott J, Sterling M., External Validation of a Clinical Prediction Rule to Predict Full Recovery and Ongoing Moderate/Severe Disability Following Acute Whiplash Injury, Orthop Sports Phys Ther 2015;45(4):242–250. doi:10.2519/jospt.2015.5642
PERSPECTIVE FOR PATIENTS
http://www.jospt.org/doi/full/10.2519/jospt.2015.0501#
Read More: http://www.jospt.org/doi/abs/10.2519/jospt.2015.5642#.VZrJi_lVhBd
SELF HELP RECOVERY GUIDE
http://www.maic.qld.gov.au/injury-management/whiplash-injury-recovery-booklet-Oct-2013.pdf