Developing clinical guidelines for the physiotherapy management of whiplash associated disorder (WAD)

Abstract 

Objectives

To produce evidence-based guidelines for the physiotherapy management of whiplash associated disorder (WAD).

Methods

A guideline development group was established to examine the evidence relating to the physiotherapy treatment of whiplash. A literature search in July 2002 was updated in March 2004, searching for studies from 1995. The databases searched were: Medline, Embase, AMED, CINAHL, PEDro, BIDS, and the Cochrane library. Before 1995, the studies were sourced from the Quebec Task Force document.

Study selection

Included studies considered adults with WAD, presented separate results for this group, compared interventions with another treatment, or with a placebo or control group, were written in English, and were randomised controlled trials (RCT) or systematic reviews.

Data extraction

Studies were assessed using the PEDro scale. From an initial 1016 papers, 84 were selected, of which 11 were used to formulate the clinical guidelines.

Conclusions

There is evidence that the following may be helpful in treating people with WAD: exercise, advice to stay active, return to normal activity, multimodal interventions, and manual therapy. This review also highlights the need for larger, high quality studies into the management of people with WAD.

Keywords: Whiplash associated disorder, Neck pain, Clinical guidelines, Physiotherapy