10/12-2018 
 
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Injuries

Whiplash treatment - Multidisciplinary

Road accidents with whiplash effect have increased in recent years with serious health, economic and medical insurance implications.

Prevention of whiplash, also known as Whiplash Associated Disorder (WAD) is attempted through traffic regulation, individual traffic behavior and via the construction of new cars with an increased passive and active safety.

When the injury happened, however, a question arises whether or not to order treatment, and if so, what treatment? The subject is very controversial, and there is a lack of robust scientific evidence for optimal treatment.

Different institutions (The National Boad of health, the Quebec report, Cochrane Library, the World WAD conference) have all stressed that treating the more chronic cases where the patients health and work ability seems threatened, should be organized in a multidisciplinary framework.

This consensus that multidisciplinary treatment is necessary is to some degree supported by scientific data. Similarly, there seems to be scientific evidence of what treatments are ineffective and therefore should be omitted.

With multidisciplinary treatment is meant an effort involving several therapists in close cooperation and intended to reduce the health problems which typically accompany a whiplash injury:- pain, impaired physical performance, depression and reduced self-esteem, dependency on drugs as well as social, professional and economic problems .

There are no precise instructions in the professional medical literature on how multidisciplinary treatment should be carried out in terms of composition, dosage and duration and therefore interdisciplinary treatment is practiced in various ways.

Center for Spinal Surgery in Denmark has during the period 1998-2005 treated more than 100 injured with whiplash after multidisciplinary principles. The multidisciplinary treatment plan included the following:
 

Medical examination:

  • Examination by a specialist in rheumatology - 1 ½ hours
  • Examination by pain therapist - 1 ½ hours
  • Function examination by a physiotherapist
  • Possibly. X-ray or MRI
Based on the multidisciplinerary conclusions and consutations with the patient the treatment plan is decided upon as follows:
 

Treatment

  • Outpatient attendance 2 to 3 times per week for 1 hour for 8-10 weeks
  • Physical training
  • Hot water basin once a week
  • Realaxation therapi
  • Pain psychology (by psychologist)
  • Ergonomic guidance (by occupational therapist)
  • Possibly. social therapy support
  • Possibly. dietician support

Final examination:

  • Status report by Rheumatologist, physiotherapist and psychologist
  • Assessment of treatment efficacy
  • Social medical plan (in consultation with the patient and possibly. municipal officer and insurance)
The treatment is completed and the patient is transferred to self training - When needed a follow up examination takes place after 3 and 6 months.
 

Treatment Effect:

Center for Spinal Surgery has carried out studies of the overall effect of the multidisciplinary treatment of Whiplash Associated Disorder. The conclusion is that the multidisciplinary approach has a significant positive influence and show better and faster patient improvement.

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