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Five years post whiplash injury: symptom and psychological factors in recovered versus non-recovered
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
2010 (English)In: BMC Research Notes, ISSN 1756-0500, Vol. 3, 190- p.Article in journal (Refereed) Published
Abstract [en]

Background Few studies have focused on the differences between persons who are recovered after whiplash injury and those who suffer from persistent disability. The primary aim of this study was therefore to examine differences in symptoms, psychological factors and life satisfaction between subjects classified as recovered and those with persistent disability five years after whiplash injury based on the Neck Disability Index (NDI).

Methods A set of questionnaires was answered by 158 persons (75 men, 83 women) to assess disability (NDI), pain intensity (VAS), whiplash-related symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ), post-traumatic stress (Impact of Event Scale, IES), depression (Beck's depression inventory, BDI) and life satisfaction (LiSat-11).

The participants were divided into three groups based on the results of the NDI: recovered (34.8%), mild disability (37.3%) and moderate/severe disability (27.3%).

Results The moderate/severe group reported significantly higher VAS, BDI and IES scores and lower level of physical health and psychological health compared to the mild and the recovered groups. Less significant differences were reported between the mild and the recovered groups.

Conclusions The group with the highest disability score reported most health problems with pain, symptoms, depression, post-traumatic stress and decreased life satisfaction. These findings indicate that classifying these subjects into subgroups based on disability levels makes it possible to optimize the management and treatment after whiplash injury.

Place, publisher, year, edition, pages
BioMed Central, 2010. Vol. 3, 190- p.
National Category
Other Health Sciences
URN: urn:nbn:se:umu:diva-42867DOI: 10.1186/1756-0500-3-190PubMedID: 20626861OAI: diva2:462952
Available from: 2011-12-08 Created: 2011-04-14 Last updated: 2012-04-25Bibliographically approved
In thesis
1. A follow-up of patients with chronic musculoskeletal pain, focusing on multimodal rehabilitation
Open this publication in new window or tab >>A follow-up of patients with chronic musculoskeletal pain, focusing on multimodal rehabilitation
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Chronic pain is usually defined as pain of more than three months duration. The prevalence of chronic pain among the general population in Sweden is 18%. Compared with the general population, these patients report lower life satisfaction, decreased activity in daily life and higher levels of depression with decreased work ability, and increased sick leave. Research indicates that multimodal rehabilitation (MMR) programmes, including cognitive behavioural approaches for patients disabled by chronic pain, are effective for return to work.

The primary aim of this thesis was to assess outcomes by a long-term follow-up of patients with chronic musculoskeletal pain. Furthermore, the aim was to evaluate two different rehabilitation strategies regarding impact on pain intensity, activity, depression, life satisfactions, and sick leave.

Two groups, comprising 255 (between the years 1999-2002) and 296 (between 2007-2008) patients respectively, from the Pain Rehabilitation Clinic at Umeå University Hospital, Sweden, were all assessed by interdisciplinary teams. They completed questionnaires regarding pain intensity, disability, life satisfaction, anxiety and depression, and sick leave, before intervention, immediately after intervention (only the first group; n=255), and at one-year follow-up, after participating in a MMR programme in a specialist clinic, or after receiving a rehabilitation plan (RP) with follow-up in primary care. Allocation to either of the two groups was based on the initial interdisciplinary team assessment. Furthermore, a five-year follow-up of 158 patients with whiplash injury was conducted.

Pain intensity decreased and life satisfaction increased significantly regarding somatic health in both groups, at follow-up. In addition, depression improved and disability decreased to a higher extent after participating in the MMR programme as compared to RP and subsequent follow-up in primary care. Patients’ positive beliefs about recovery, and positive expectations about work correlated with favourable rehabilitation outcomes. Sick leave at one year follow-up decreased in both groups.

Regarding whiplash injury, patients who reported moderate or severe disability also reported significantly higher pain intensity, depression and post-traumatic stress scores and lower perception of general health compared with patients who reported mild or no disability.

In conclusion, MMR programmes seem to be beneficial by decreasing pain intensity, depression, disability and sick leave among patients with chronic musculoskeletal pain. Furthermore, patients’ positive beliefs correlate with more favourable long-term outcomes. An interdisciplinary team assessment based on a biopsychosocial approach may be of value for selection of rehabilitation strategy.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2012. 48 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1503
Pain, pain measurement, disability, patient satisfaction, cognitive therapy, behaviour therapy, interdisciplinary health teams, motivation, sick leave, multimodal rehabilitation, whiplash injuries, stress disorders, posttraumatic
National Category
Public Health, Global Health, Social Medicine and Epidemiology
urn:nbn:se:umu:diva-54357 (URN)978-91-7459-425-6 (ISBN)
Public defence
2012-05-16, Bergasalen, byggnad 27, Norrlands Universitetssjukhus, Umeå, 13:00 (Swedish)
Available from: 2012-04-25 Created: 2012-04-24 Last updated: 2012-11-08Bibliographically approved

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