Whiplash disorder

Question 1

most common mechanism for WAD

Answer 1

MVA (rear end specifically)

Question 2

when does hyperextension occur in a rear end compred to ant neck musculature

Answer 2

hyperextensuin within first 250ms

neck muscles take atleast 220ms, too late

Question 3

at what vertebral lvl is the center of force for hyperext

Answer 3

C5-6

Question 4

the use of a hard seat back can decrease horizontal acceleration by

Answer 4

70%

Question 5

the the incident is less than 15mph what can the driver do

Answer 5

the pt may be aware and can brace on the steering wheel, activate front neck muscles and put foot on break (decreasing acceleration)

Question 6

what is the best indicator for injury likelihood

Answer 6

chance V= change in velocity undergone by a given vehicle

Question 7

C spine kinematics @44ms and @110ms

Answer 7

@44- cspine thrusts upwards

@110- upper is flexed and lower in extended (s shape)

Question 8

are males or female more susceptible to WAD

Answer 8

females (mainly lighter mass)

Question 9

how much do head restraints reduce extension by (and how many are properly pos)

Answer 9

24%

10% properly pos

Question 10

what angle should the seat not be extended beyond

Answer 10

> 30

Question 11

seat belts are most effective in these types of accidents

Answer 11

rear
front
far sided

Question 12

serious injury is less likely if speeds are under

Answer 12

20mph (30kph)

Question 13

when type of MVA cause hyper flex injuries

Answer 13

usually a frontal collision

Question 14

rear end impact with a change of velocity below ______ appear to be within normal tissue tollerence

Answer 14

less than 8km/h

Question 15

top 3 symptoms of WAD

Answer 15

Neck pain + stiffness
Headaches
Lowback pain

Question 16

4 grades of WAD

Answer 16

pain, tenderness, stiffnes AND

1. no physical signs
2. just MSK signs
3. Neuro signs
4. fracture or dislocation

Question 17

what diagnosis method has best validity in detecting cervical trauma

Answer 17

CT

Question 18

Canadian C spine rules

Answer 18

• > 65
• parestetia
• not simple MOI
• midline tenderness
• unable to sit
• unable to rot 45

Question 19

what % of cases become chronic

Answer 19

20-67% of cases become chronic

Question 20

What are some predictors of chronicity

Answer 20

hx of neck pain

• fear avoidance
• belief it is serious
• females
• depression etc.

Question 21

stage 1 and 2 of tx + goals

Answer 21

1. goals of pain control, educate, light ex- ice, ifc, tens, maybeee SMT
2. goal to start rehab- physio, education, active rehab

Question 22

stage 3 + 4 of Tx and goals

Answer 22

3- goal to restore function, return to work adds

4- focus on independent coping traits, longest phase, little residual pain

Question 23

How many people return to work in 3-6m and 1 year according to quebec task force

Answer 23

3-6-> 70%

1 year-> 80%

Question 24

Neck pain task force found effective tx to be

Answer 24

• low lvl laser
• combined exercise + SMT
• education, mobs, manual therapy, accu

Question 25

OPTIM colab found these to be effective

Answer 25

supervised qigong
lyengar yoga
combined programs (ROM, ex)

Question 26

Natural hx of WAD

Answer 26

75% will recover in 6m-2y

Question 27

5 evidence based tx by quebec task force

Answer 27

manip
pain control
ex
education
rea\assurance

Question 28

factors that have effect on prognosis

Answer 28

symptoms beyond 6-12 m
sig injury
delay in implementing tx
older
etc