Elliott James M, Kerry Roger, Flynn Timothy, Parrish Todd B
Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave., Suite 1100, Chicago, IL, USA; School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
Man Ther. 2013 Dec;18(6):578-82. doi: 10.1016/j.math.2013.02.002. Epub 2013 Mar 5.
Whiplash associated disorder (WAD) represents an enormous economic, social and personal burden. Five out of 10 people with WAD never fully recover and up to 25% continue to have moderate to severe pain-related disability. Unfortunately, clear and definitive reasons as to why half of individuals with WAD recover uneventfully and the other half do not, remain elusive. Identifying the factors that can reliably predict outcome holds considerable importance for not only WAD, but arguably for other acute musculoskeletal traumas. The precise pathology present in WAD has been controversial and often biased by outdated models. Fortunately, a combination of new measurement technology that illuminates pain processing, physical and social functioning and post-traumatic stress responses (and possibly markers of altered muscle size/shape/physiology) is providing a clearer picture of the multisystem pathophysiology in individuals with persistent WAD. The aim of this professional issues paper is to illuminate the clinical and research communities with regards to the growing body of knowledge for determining the trajectory of a patient with whiplash.
挥鞭样损伤相关障碍(WAD)带来了巨大的经济、社会和个人负担。每10名WAD患者中有5人无法完全康复,高达25%的患者会持续存在中度至重度的疼痛相关残疾。不幸的是,对于为何一半的WAD患者能顺利康复而另一半不能,尚无明确且确切的原因。确定能够可靠预测预后的因素不仅对WAD非常重要,对其他急性肌肉骨骼创伤可能也同样重要。WAD中存在的精确病理一直存在争议,且常常受到过时模型的影响。幸运的是,新的测量技术相结合,能够阐明疼痛处理、身体和社会功能以及创伤后应激反应(可能还有肌肉大小/形状/生理改变的标志物),这正在为患有持续性WAD的个体的多系统病理生理学提供更清晰的图景。本专业问题论文的目的是让临床和研究界了解关于确定挥鞭样损伤患者病程的越来越多的知识。
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