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Schnabel, M., Ferrari, D., Vassiliou, T. & Kaluza, G. (2004). Randomized, controlled outcome study of active mobilization compared with collar therapy for whiplash injury. Emergency Medicine Journal, 21(3), 306-310
Abstract:
Objectives: Standard therapy in Germany for acute whiplash injury has traditionally included a soft collar, an approach which is passive compared to early exercise and mobilization. The purpose of this study is to examine the rate of recovery in the first 6 weeks of groups of acute whiplash injury patients subjected to two different treatment approaches, the traditional approach of a collar versus active, early mobilization.
Methods: Between August 1997 and February 2000 a prospective randomized clinical trial with a total of 200 patients was performed. A total of 97 were randomly assigned to a collar therapy group, and 103 to the exercise group, treated by a physiotherapist. Study participants documented average pain and disability twice (baseline and six week follow-up) during a one week period by diary, using numeric visual analog (VAS) rating scales ranging from 0 to 10
Results: The initial mean VAS pain intensity and VAS disability reported by the collar therapy group and the exercise group showed no statistical difference. The mean VAS pain rating reported by the collar therapy group after 6 weeks was 1.60 and mean VAS disability rating was 1.56. The mean VAS pain intensity indicated by the exercise group was 1.04 and mean VAS disability was 0.92. These differences between the groups were both significant, as was the reduction in the prevalence of symptoms in the exercise therapy group versus the collar group at 6 weeks.
Conclusions: Early exercise therapy is superior to the collar therapy in reducing pain intensity and disability. We conclude that exercise should be recommended, and collars avoided in the treatment of acute whiplash injury.
Keywords: whiplash injury, traffic accidents, neck pain, cervical spine, cervical collar, physiotherapy.
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