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The Effectiveness of Conservative Management for Acute Whiplash Associated Disorder (WAD) II: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

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  • Taweewat Wiangkham
  • Joan Duda
  • Sayeed Haque
  • Mohammad Madi
  • Alison Rushton

Abstract

Objective: To evaluate the effectiveness of conservative management (except drug therapy) for acute Whiplash Associated Disorder (WAD) II. Design: Systematic review and meta-analysis of Randomised Controlled Trials (RCTs) using a pre-defined protocol. Two independent reviewers searched information sources, decided eligibility of studies, and assessed risk of bias (RoB) of included trials. Data were extracted by one reviewer and checked by the other. A third reviewer mediated any disagreements throughout. Qualitative trial and RoB data were summarised descriptively. Quantitative syntheses were conducted across trials for comparable interventions, outcome measures and assessment points. Meta-analyses compared effect sizes with random effects, using STATA version 12. Data Sources: PEDro, Medline, Embase, AMED, CINAHL, PsycINFO, and Cochrane Library with manual searching in key journals, reference lists, British National Bibliography for Report Literature, Center for International Rehabilitation Research Information & Exchange, and National Technical Information Service were searched from inception to 15th April 2015. Active researchers in the field were contacted to determine relevant studies. Eligibility Criteria for Selecting Studies: RCTs evaluating acute ( 10 days) interventions, there were no statistically significant differences in all outcome measures between interventions at any time. Conclusions: Conservative and active interventions may be useful for pain reduction in patients with acute WADII. Additionally, cervical horizontal mobility could be improved by conservative intervention. The employment of a behavioural intervention (e.g. act-as-usual, education and self-care including regularly exercise) could have benefits for pain reduction and improvement in cervical movement in the coronal and horizontal planes. The evidence was evaluated as low/very low level according to the Grading of Recommendations Assessment, Development and Evaluation system.

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  • Taweewat Wiangkham & Joan Duda & Sayeed Haque & Mohammad Madi & Alison Rushton, 2015. "The Effectiveness of Conservative Management for Acute Whiplash Associated Disorder (WAD) II: A Systematic Review and Meta-Analysis of Randomised Controlled Trials," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-22, July.
    • Handle: RePEc:plo:pone00:0133415
    DOI: 10.1371/journal.pone.0133415
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    References listed on IDEAS

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    1. Leth-Petersen, Søren & Rotger, Gabriel Pons, 2009. "Long-term labour-market performance of whiplash claimants," Journal of Health Economics, Elsevier, vol. 28(5), pages 996-1011, September.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    3. Kenneth F Schulz & Douglas G Altman & David Moher & for the CONSORT Group, 2010. "CONSORT 2010 Statement: Updated Guidelines for Reporting Parallel Group Randomised Trials," PLOS Medicine, Public Library of Science, vol. 7(3), pages 1-7, March.
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    Cited by:

    1. Kazuhiro Hayashi & Kenji Miki & Tatsunori Ikemoto & Takahiro Ushida & Masahiko Shibata, 2020. "Associations between the injustice experience questionnaire and treatment term in patients with acute Whiplash-associated disorder in Japan: Comparison with Canadian data," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-14, April.
    2. Taweewat Wiangkham & Joan Duda & M Sayeed Haque & Jonathan Price & Alison Rushton, 2019. "A cluster randomised, double-blind pilot and feasibility trial of an active behavioural physiotherapy intervention for acute whiplash-associated disorder (WAD)II," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-25, May.

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