• Pain physician · Sep 2012

    Review

    The efficacy of patient education in whiplash associated disorders: a systematic review.

    • Mira Meeus, Jo Nijs, Veronique Hamers, Kelly Ickmans, and OosterwijckJessica VanJV.
    • Division of Musculoskeletal Physiotherapy, Department of Health Sciences, Artesis University College Antwerp, Belgium. Mira.Meeus@vub.ac.be
    • Pain Physician. 2012 Sep 1; 15 (5): 351-61.

    BackgroundUntil now, there is no firm evidence for conservative therapy in patients with chronic Whiplash Associated Disorders (WAD). While chronic WAD is a biopsychosocial problem, education may be an essential part in the treatment and the prevention of chronic WAD. However, it is still unclear which type of educative intervention has already been used in WAD patients and how effective such interventions are.ObjectiveThis systematic literature study aimed at providing an overview of the literature regarding the currently existing educative treatments for patients with whiplash or WAD and their evidence.Study DesignSystematic review of the literature.MethodsA systematic literature search was conducted in the following databases: Pubmed, Springerlink, and Web of Science using different keyword combinations. We included randomized controlled clinical trials (RCT) that encompass the effectiveness of education for patients with WAD. The included articles were evaluated on their methodological quality.ResultsTen RCT's of moderate to good quality remained after screening. Both oral and written advice, education integrated in exercise programs and behavioral programs appear effective interventions for reducing pain and disability and enhancing recovery and mobility in patients with WAD. In acute WAD, a simple oral education session will suffice. In subacute or chronic patients broader (multidisciplinary) programs including education which tend to modulate pain behavior and activate patients seems necessary.LimitationsBecause of limited studies and the broad range of different formats and contents of education and different outcome measures, further research is needed before solid conclusions can be drawn regarding the use and the modalities of these educational interventions in clinical practice.ConclusionBased on this systematic literature study is seems appropriate for the pain physician to provide education as part of a biopsychosocial approach of patients with whiplash. Such education should target removing therapy barriers, enhancing therapy compliance and preventing and treating chronicity. Still, more studies are required to provide firm evidence for the type, duration, format, and efficacy of education in the different types of whiplash patients.

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