• Maarten A Schmitt, Nico L van Meeteren, Anton de Wijer, Frank R van Genderen, Yolanda van der Graaf, and Paul J Helders.
• Institute for Master Education in Manual Therapy, SOMT, Amersfoort and University Medical Center Utrecht, The Netherlands.
• Am J Phys Med Rehabil. 2009 Mar 1;88(3):231-8.

ObjectivesTo examine the relative contribution of cervical impairments and psychosocial factors to perceived disability among people with chronic whiplash-associated disorders.DesignA total of 86 patients with chronic whiplash-associated disorders participated in this observational, cross-sectional study. All patients were presented to outpatient physical therapy clinics. All patients completed the neck disability index. Depression, anxiety, and catastrophizing were measured with the Hospital Anxiety and Depression scale and the pain coping and cognition list, respectively. Cervical function was assessed by measuring the active range of motion. Stepwise and hierarchical regression analysis was used to estimate the contribution of cervical impairment and psychosocial functions to the variance in neck disability.ResultsDepressive symptomatology and catastrophizing explained 61% of the variance in neck disability index scores. Catastrophizing explained 57% of the variance in neck disability index scores and 15% of the variance in the sum scores of active cervical rotations.ConclusionsCatastrophizing explained the variance in both perceived neck disability and, to a lesser extent, active range of cervical motion, which suggests that pain-related catastrophizing plays an important role in the physical complaints of patients with chronic whiplash-associated disorders when referred to a physical therapist.

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