Chronic whiplash associated disorders: best practice management of acute and chronic whiplash associated disorders.Latest update: January 2008. Next update: Not stated. Patient group: Adults with acute or chronic whiplash whiplash n. a common neck and/or back injury suffered in automobile accidents (particularly from being hit from the rear) in which the head and/or upper back is snapped back and forth suddenly and violently by the impact. associated disorders (WAD). Intended audience: General practitioners and other health professionals delivering primary care to adults with acute or chronic neck pain after motor vehicle crashes, e.g. physiotherapists, chiropractors, osteopaths. It is also relevant for medical specialists and those providing secondary and tertiary care tertiary care Managed care The most specialized health care, administered to Pts with complex diseases who may require high-risk pharmacologic regimens, surgical procedures, or high-cost high-tech resources; TC is provided in 'tertiary care centers', often for people with WAD. Additional versions: Nil. These guidelines are reported to be an addition to the NSW NSW New South Wales Noun 1. NSW - the agency that provides units to conduct unconventional and counter-guerilla warfare Naval Special Warfare Motor Accident Authority (MAA) guidelines for the treatment of acute WAD (www.maa.nsw. gov.au), and draws on those guidelines in this area. Expert working group: The project was guided by ten research consultants, and 12 experts in the technical advisory group. Whilst affiliations of those in the working groups were not stated, the expertise included physiotherapy, rehabilitation medicine, and chiropractic professionals from Australia. Funded by: The South Australian Centre for Trauma and Injury Recovery. Consultation: Nil associations stated. Approved by: The Motor Accident Commission of South Australia. Location: www.mac.sa.gov.au/ctp_insurance/ new_initiatives Description: This 75 page document provides direction for the assessment, prognosis and treatment of a WAD injury. It differs from the 2007 MAA whiplash guidelines primarily in presenting recommendations regarding chronic WAD (??12 weeks post accident). Several flowcharts summarise recommendations, including charts outlining the initial assessment of patients presenting with an acute and a chronic WAD. Pathways of care are also detailed for patients presenting with an acute and chronic WAD. Detailed recommendations for assessment and diagnosis are provided and include history taking, physical examination, imaging, and specialised examinations. Evidence for prognostic factors are presented, identifying those predictive of a poor outcome in terms of pain or disability. Finally, recommendations are formed for treatments that should be, may be, and should not be undertaken during the acute and chronic phases. These are summarised in 1 page and the evidence underpinning the recommendations is provided over many pages. The methodology for this document follows NHMRC NHMRC National Health and Medical Research Council guidelines. The guideline has useful appendices, which include copies of 10 outcome measures recommended for use in WAD, such as the Coping Strategies Questionnaire, instructions for patients on how to do a variety of recommended exercises, example wording for advice from health care practitioners to patients with WAD, and a brief overview of what is a cognitive behavioural therapy approach. Sandra Brauer The University of Queensland The University of Queensland (UQ) is the longest-established university in the state of Queensland, Australia, a member of Australia's Group of Eight, and the Sandstone Universities. It is also a founding member of the international Universitas 21 organisation. |
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