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Patients with chronic whiplash-associated disorders. Relationship between clinical and psychological factors and functional health status

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Author: Schmitt, M.A. · Meeteren, N.L. van · Wijer, A. de · Genderen, F.R. van · Graaf, Y.D. van · Helders, P.J.
Institution: TNO Kwaliteit van Leven
Source:American Journal of Physical Medicine and Rehabilitation, 3, 88, 231-238
Identifier: 279999
doi: doi:10.1097/PHM.0b013e318198b684
Keywords: Health · Neck disability · Neck function · Psychosocial factors · Whiplash injury · Adult · Aged · Anxiety · Cognition · Coping behavior · Cross-sectional study · Depression · Hospital Anxiety and Depression Scale · Major clinical study · Neck injury · Observational study · Outpatient · Pain · Physiotherapist · Pysiotherapy · Range of motion · Regression analysis · Social psychology · Symptomatology


Schmitt MA, van Meeteren NL, de Wijer A, van Genderen FR, van der Graaf Y, Helders PJ: Patients with chronic whiplash-associated disorders: Relationship between clinical and psychological factors and functional health status. Am J Phys Med Rehabil 2009;88:231-238. Objectives: To examine the relative contribution of cervical impairments and psychosocial factors to perceived disability among people with chronic whiplash-associated disorders. Design: A total of 86 patients with chronic whiplash-associated disorders participated in this observational, cross-sectional study. All patients were presented to outpatient physical therapy clinics. All patients completed the neck disability index. Depression, anxiety, and catastrophizing were measured with the Hospital Anxiety and Depression scale and the pain coping and cognition list, respectively. Cervical function was assessed by measuring the active range of motion. Stepwise and hierarchical regression analysis was used to estimate the contribution of cervical impairment and psychosocial functions to the variance in neck disability. Results: Depressive symptomatology and catastrophizing explained 61% of the variance in neck disability index scores. Catastrophizing explained 57% of the variance in neck disability index scores and 15% of the variance in the sum scores of active cervical rotations. Conclusions: Catastrophizing explained the variance in both perceived neck disability and, to a lesser extent, active range of cervical motion, which suggests that pain-related catastrophizing plays an important role in the physical complaints of patients with chronic whiplash-associated disorders when referred to a physical therapist. Copyright © 2009 by Lippincott Williams & Wilkins.