Interdisciplinary rehabilitation after whiplash injury: an observational prospective outcome study.

Abstract

OBJECTIVE: To examine the state of, and change in, biopsycho-social health and quality of life of patients after whiplash injury, before and after an inpatient interdisciplinary pain management programme. METHODS: Observational, prospective cohort study (n = 103) using medical record data and standardized self-assessments to compare health state with general population norms and to determine effects by means of standardized effect sizes. The therapy programme consisted of drug adaptation, graded activity exercise, relaxation therapies, and behavioural therapy. RESULTS: Compared with population norms, patients' health was significantly deteriorated in all dimensions of the Short Form 36, depression and anxiety at all examined times. After rehabilitation, pain improved by effect sizes up to 0.65, function/role performance up to 0.87, vitality up to 0.67 and coping up to 0.41. At the 6-month follow-up, these effects remained, with effect sizes between 0.45 and 0.87. The median working capacity improved from 8 h per week at baseline to 21 h at follow-ups. CONCLUSION: The rehabilitation programme showed moderate to large mid-term improvements in important health dimensions, medication reduction and working capacity. Further controlled studies are required to quantify and attribute these improvements more precisely.