The course and factors associated with recovery of whiplash-associated disorders: an updated systematic review by the Ontario protocol for traffic injury management (OPTIMa) collaboration

Abstract

Purpose

To update the findings of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders (Neck Pain Task Force) on prognostic factors for whiplash-associated disorder (WAD) outcomes.

Materials and methods

We conducted a systematic review and best-evidence synthesis. We systematically searched MEDLINE, EMBASE, CINAHL and PsycINFO from 2000–2017. Random pairs of reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria.

Results

We retrieved 10,081 articles. Of those, 100 met inclusion criteria. After critical appraisal, 74 were judged to have low risk of bias. This adds to the 47 admissible studies found by the Neck Pain Task Force. Twenty-two related to course of recovery; 59 to prognostic factors in recovery; and 16 reported other WADs outcomes. Some studies related to more than one category. Findings suggest that half of those with WADs will experience substantial improvement within three months and cessation of symptoms within six months. Among factors associated with recovery are post-crash psychological factors, including expectations for recovery and coping.

Conclusions

Our review adds to the Neck Pain Task Force by clarifying the role of prognostic factors. Evidence supports the important role of post-crash psychological factors in WADs recovery.

Systematic Review Registration Number

CRD42013004610

Keywords:

• Systematic review
• whiplash
• prognosis
• recovery
• neck pain

Acknowledgements

The authors acknowledge and thank all of the individuals who have made important contributions to this review: Carlo Ammendolia, Richard Bohay, Robert Brison, J. David Cassidy, Michel Lacerte, Gail Lindsay, John Stapleton, Angela Verven, and Leslie Verville. The authors also thank Trish Johns-Wilson at the University of Ontario Institute of Technology for her review of the search strategy.

Disclosure statement

Dr Linda Carroll has received reimbursement for travel expenses to attend meetings for the study and grants from CIHR and Workers’ Compensation Boards in Manitoba and Alberta. Dr Pierre Côté has received a grant from the Ontario Government, Ministry of Finance, and a grant from Aviva Canada. The remaining authors report no declarations of interest

Additional information

Funding

This work was funded by the Ontario Ministry of Finance and the Financial Services Commission of Ontario (RFP No.: OSS_00267175). The funding agency was not involved in the collection of data, data analysis, interpretation of the data or drafting of the manuscript. This research was undertaken, in part, thanks to funding from the Canada Research Chairs program and from Alberta Innovates – Health Solutions through a Health Senior Scholar Award.