Are Measures of Physical Function of the Neck Region Associated With Poor Prognosis Following a Whiplash Trauma?: A Systematic Review.
Level 1 - systematic review of randomized trials
Systematic review of prospective observational cohort studies
PubMed 34954730 · doi:10.1097/AJP.0000000000001015
What was done
Authors conducted a systematic review searching MEDLINE, EMBASE, CINAHL, PsycINFO, Scopus, Web of Science, and gray literature through July 2020. Two independent reviewers selected observational cohort studies of acute whiplash-associated disorders (WAD) with at least 3 months of follow-up that evaluated objective or self-reported neck physical function measures as prognostic indicators. Evidence quality was assessed and data were synthesized qualitatively because data could not be pooled.
What was found
The review included 14 studies representing 13 cohorts. Low to very low quality evidence indicated that initial higher pain-related disability and higher WAD grade were associated with poor outcome. Evidence was inconclusive regarding whether neck range of motion, joint position error, superficial neck muscle activity, muscle strength/endurance, and perceived functional capacity predict outcome. Contemporary measures of neck function (smoothness of movement, movement variability, muscle coactivation) were not assessed in any included study. No numeric effect sizes were reported in the abstract.
Why it matters
Clinicians often assess neck physical function after whiplash, but current research provides little support for using baseline physical function metrics to predict long-term recovery.
Limits
Meta-analysis could not be performed due to study heterogeneity. The underlying evidence base was limited to low or very low quality observational studies, contemporary functional biomechanical measures were unassessed, and total participant counts and numeric risk estimates were not reported in the abstract.
Cited by
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