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• W2069131451 abstract "Why do people with whiplash attend an accident and emergency department? In The Lancet, Sarah Lamb and colleagues 1 Lamb SE Gates S Williams MA et al. on behalf of the Managing Injuries of the Neck Trial (MINT) Study TeamEmergency department treatments and physiotherapy for acute whiplash: a pragmatic, two-step, randomised controlled trial. Lancet. 2012; (published online Dec 18, 2012.)http://dx.doi.org/10.1016/S0140-6736(12)61304-X Google Scholar advance the evidence base on treatment of whiplash injury in the emergency department setting. Their results show that provision of an active management consultation in the emergency department brings no additional benefit for acute whiplash injury—in a cluster-randomised trial in which 3851 patients with whiplash were treated in UK hospitals, there was no significant advantage in active management versus usual care as measured by the neck disability index at 12 months (difference between groups 0·5, 95% CI −1·5 to 2·5). Also, additional physiotherapy, beyond an initial advice session, provided a modest but not cost-effective advantage. Examining the outcomes, one could argue that this study also shows that whatever is done in the setting of the emergency department is not particularly helpful. For the self-reported outcomes of change in neck symptoms, 37% of patients in the usual care group and 42% of patients in the active management group reported feeling “much better” or “better” 1 year after collision. It is remarkable that such proportions of patients showed this level of improvement at 1 year post-collision in that these numbers mean the majority have made little recovery overall. Being “better” is not necessarily recovered. That is, reporting being “better” may still mean that patients feel they have not recovered. Emergency department treatments and physiotherapy for acute whiplash: a pragmatic, two-step, randomised controlled trialProvision of active management consultation did not show additional benefit. A package of physiotherapy gave a modest acceleration to early recovery of persisting symptoms but was not cost effective from a UK NHS perspective. Usual consultations in emergency departments and a single physiotherapy advice session for persistent symptoms are recommended. Full-Text PDF" @default.
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• W2069131451 date "2013-02-01" @default.
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• W2069131451 title "Rewriting the book on whiplash" @default.
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• W2069131451 doi "https://doi.org/10.1016/s0140-6736(12)61416-0" @default.
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