Whiplash Associative Disorder

Question 1

What is Whiplash?

Answer 1

An Abnormal acceleration/deceleration of head, neck, and torso or a non-physiologic movement producing an “S-shaped curve” in the C spine

Question 2

True or False: 40% of pts w/ whiplash will continue to have symptoms at six-months and 25% will have symptoms lasting over 2 years.

Answer 2

True

Question 3

What is the local clinical presentation for whiplash injuries?

Systemic presentation?

Answer 3

Local

• localized pain/tenderness
• limited cervical ROM
• headaches
• muscle weakness

Systemic

• widespread pain
• sensory disturbances
• dizziness
• fear/anxiety

Question 4

What would be a QTF classification grade of 0?

Answer 4

no complaint of neck pain and no physical signs

Question 5

What would be a QTF classification grade of 1?

Answer 5

neck complaints of pain, stiffness, or tenderness only and no physical signs

Question 6

What would be a QTF classification grade of 2?

Answer 6

Neck complaints with MSK signs including decreased ROM and point tenderness

Question 7

What would be a QTF classification grade of 3?

Answer 7

Neck complaints with MSK signs including decreased or absent deep tendon relfex, muscle weakness, or sensory deficits

Question 8

What would be a QTF classification grade of 4?

Answer 8

Neck complaint and fracture or dislocation

Question 9

What are 6 main factors that can indicate poor prognosis of a patient with whiplash?

Answer 9

high Initial pain intensity
Age
females
Poor ROM in C spine
Cold hyperalgesia
Moderate levels of acute post-traumatic stress

Question 10

What psychological factors can contribute to whiplash associative disorder?

Answer 10

• catastrophising pain
• fear of movement
• lower pain self efficacy
• distress

Question 11

True or false: PTs cannot treat for PTSD following a traumatic cervical injury like whiplash and must refer out for mental health professionals.

Answer 11

False, we can perform anxiety management such as deep breathing, cognitive strategies such as coping and self-talk help and help confront their fear

Question 12

What does management of whiplash associative disorder look like in the acute stage?

Answer 12

• assessment
• no psychological debriefing
• assurance
• allow natural recovery
• referral at 6 weeks

Question 13

What does management of whiplash associative disorder look like in the chronic stage?

Answer 13

• screening assessment
• IES
• referral if moderate
• integrate or delay PT