Verhagen Arianne P, Lewis Martyn, Schellingerhout Jasper M, Heymans Martijn W, Dziedzic Krysia, de Vet Henrica C W, Koes Bart W
Erasmus MC, Department General Practice, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Man Ther. 2011 Oct;16(5):456-62. doi: 10.1016/j.math.2011.02.009. Epub 2011 Mar 13.
We evaluated whether patients with self-reported whiplash differed in perceived pain, functional limitation and prognosis from patients with other painful neck complaints. Data from three Dutch trials and an English trial were used all evaluating conservative treatment in neck pain patients in primary care. All patients had non-specific neck pain. Information on any trauma or injury came from self-report at baseline. We compared frequencies of baseline variables and outcome at short-term and long term for whiplash and non-trauma neck pain patients separately. The total study population consisted of 804 neck pain patients. Of these patients 133 reported (16.5%) that an injury was the cause of their neck pain. In all trials there were 17-18% more male patients in the whiplash group. At follow-up pain decreased between 12 and 28%, function 10%, and 25-50% of patients recovered in all trials. Post-treatment improvements in pain, function and recovery were comparable between whiplash and non-trauma patients. We also found no different prognostic factors between whiplash and non-trauma patients. Overall we found in a population with mild to moderate pain no clinically relevant differences between patients with self-reported whiplash and patients with other painful neck complaints. The findings suggest that whiplash patients with mild to moderate pain should not be considered a specific subgroup of patients with non-specific neck pain.
我们评估了自我报告有挥鞭样损伤的患者与其他颈部疼痛患者在疼痛感知、功能受限及预后方面是否存在差异。使用了来自三项荷兰试验和一项英国试验的数据，所有这些试验均评估了初级保健中颈部疼痛患者的保守治疗。所有患者均患有非特异性颈部疼痛。关于任何创伤或损伤的信息来自基线时的自我报告。我们分别比较了挥鞭样损伤患者和非创伤性颈部疼痛患者基线变量的频率以及短期和长期的结局。总研究人群包括804名颈部疼痛患者。其中133名患者（16.5%）报告称损伤是其颈部疼痛的原因。在所有试验中，挥鞭样损伤组男性患者比其他组多17 - 18%。在随访中，所有试验中疼痛减轻了12%至28%，功能改善了10%，25%至50%的患者康复。挥鞭样损伤患者和非创伤性患者在治疗后疼痛、功能及恢复方面的改善相当。我们还发现挥鞭样损伤患者和非创伤性患者之间不存在不同的预后因素。总体而言，我们发现在轻度至中度疼痛人群中，自我报告有挥鞭样损伤的患者与其他颈部疼痛患者之间不存在临床相关差异。这些发现表明，轻度至中度疼痛的挥鞭样损伤患者不应被视为非特异性颈部疼痛患者中的一个特定亚组。
