Fitness training, rehabilitation don’t improve whiplash recovery

In brief

  • Fitness training and rehabilitation didn't add any benefit over the usual health care that whiplash patients receive.
  • One explanation might be that, in this study, these programs were put in place too late, ranging from 63 to 171 days after the injury.
  • Rehabilitation programs should be tested in randomized trials before clinicians recommend them to treat patients with whiplash.

Why was this study done?

Whiplash is a painful injury that is a common result from traffic collisions. Multidisciplinary rehabilitation is a popular treatment for whiplash injury, and its costs are often covered through insurance policies. However, there is limited research on how effective it is. In this study, researchers looked at the impact of rehabilitation and fitness training in addition to the usual care that whiplash patients receive.

How was the study done?

Over a two-year period, researchers studied 6,021 adults from Saskatchewan who were treated for whiplash. They compared recovery among three different sets of patients. One group of 833 patients had been referred to fitness training in health clubs by their health-care provider. Another group had been referred to rehabilitation programs. Within this group, 468 attended as outpatients and 133 were inpatients. (Rehabilitation could include education about coping with pain, aerobic exercises, weight training or counselling.) The third group received usual care from health-care providers such as physicians, chiropractors, massage therapists or physical therapists.

What did the researchers find?

Recovery was 32 per cent slower in patients who received fitness training within 69 days of their injury, compared to those who didn’t attend. For people who had outpatient rehabilitation within 119 days of injury, recovery was 50 per cent slower than those who didn’t attend. During the follow-up period, inpatient rehabilitation had no impact on how quickly people recovered. Compared to those receiving usual care, patients referred to any program were more likely to have poorer health, a full-time job, a past injury claim and work absence, activity limitations, more intense pain, and symptoms related to the collision or depression.

What are some strengths and weaknesses of the study?

The study included a large number of patients. Attendance at programs was high. One weakness was that patients may have been referred to treatment programs at different stages after their injury. They could have had different levels of chronic pain or disability when they started rehabilitation.

Publication Information

Title: 

Does multidisciplinary rehabilitation benefit whiplash recovery?

Author(s): 

Cassidy D, Carroll L, Côté P, Frank J

Journal: 

Spine, 2007: vol. 32, no. 1, pp. 126-131