Clinical Outcome Review: A Retrospective Assessment of 171 Patients Referred for Physiotherapy Treatment after Whiplash Injury by Medical Insurance Intermediaries
DOI:
https://doi.org/10.14738/bjhr.1203.18786Keywords:
Clinical Outcome Review, Whiplash Injury, Prediction of treatment, Outcomes, Adapted ReflextherapyAbstract
The purpose of this review is to share outcomes from 171 patients of acute and chronic grade 0-2 whiplash injury referred for physiotherapy treatment by nine insurance intermediaries after a road traffic accident. An unorthodox method of treatment and assessment was used and the review is retrospective. After assessment, a prediction of outcome including proposed method, number of treatments and improvement measured in percentages was delivered to the insurance intermediaries for approval prior to commencing treatment. In effect, the insurance intermediaries became external assessors in all cases with the author acting as the sole physiotherapist carrying out the assessment and treatment. Adapted Reflextherapy was used as the method to assess and treat all patients. Nine patients did not start or complete the treatment leaving 162 patients included in the review. The mean number of treatments per patient was 5.02. Pain levels varied between 0 and 10 on the VAS scale with 65% (106) of patients reporting pain levels between 5 and 10 before treatment, dropping to below 2 after treatment. In 41% (66), fewer treatments were required to achieve the expected outcome. In 30% of patients (48), the prediction of outcome was completely correct. 30% (52) of patients required a few more treatments than predicted requiring approval from the insurance companies.
References
Moore A, Jackson A, Jordan J, Hammersley S, Hill J, Mercer C, Smith C, Thompson J, Woby S, Hudson A (2005), ‘Clinical Guidelines for the physiotherapy management of whiplash associated disorder.’ Chartered Society of Physiotherapy, London
Berry G., ‘Adapted Reflextherapy in treatment of whiplash related injuries – a case for adoption?’ World Physical Therapy Conference 2003, SI-PO-0147.
Berry G., ‘Adapted Reflextherapy in Chronic Whiplash Disorder’ CSP Congress Proceedings 2006. Presentation to CSP 2003.
Berry G., Adapted Reflextherapy: An Approach to Pain, 2017, Honeybee, Dorset.
Sterling M, Jull G, Vincenzio B, Kenardy J, Darnell R., ’Physical and psychological factors predict outcome following whiplash injury’, PAIN 114 (2005): p141-148.
Söderlund A, Lindberg P., ‘Long-term functional and psychological problems in whiplash associated disorders’, Int J of Rehabilitation research (1999), 22:p77-84.
Jones C, Evans H., ‘Prenatal therapy, metamorphosis and the Metamorphic technique’. In Eds: Charman RA: Complementary Therapies for Physical Therapists, Butterworth-Heinemann, Oxford (2000): p162-170.
Butler D, Moseley L., ‘Explain Pain’, Neuro Orthopaedic Institute, NOIgroup Publications, Adeliade, Australia (2003).
Eliav E, Herzberg U, Ruda M, Bennett G., ’Neuropathic pain from an experimental neuritis of the rat sciatic nerve’, PAIN (1999), 83:p169-182.
Berry G., ‘Chronic Pain after reported whiplash injury - a patient case report.’, OBM Integrative and Complementary Medicine (2019), Vol 4 (1), doi: 10:21926/obm.icm.1901xxx.
Marquart H., Reflexotherapy of the Feet, Thieme Verlag Germany (2000).
Lett A, Reflex Zone Therapy for Health Professionals, Churchill Livingstone London (2000).
Bayly D., Reflexology Today, Thorson’s Publishing Group Uk (1982).
Dougans I., Reflexology – the 5 elements and their 12 meridians, a unique approach, Harper Collins Publishers London (2005).
O’Hara C., ‘Core Curriculum for Reflexology in the United Kingdom, Douglas Barry Publications UK (2006).
Brown C, Lido C., ‘Reflexology treatment for patients with lower limb amputations and phantom limb pain: an exploratory pilot study’, Compl Th Clin Pract (2008) 14 (2): p124-131.
Paget L, Wright P., ‘An exploration study in Adapted Reflextherapy as a treatment for chronic neck pain: a randomised controlled pilot study’, MSc Thesis (2014).
Hall H, Cook F ‘Audit of a GP Practiced Based Physiotherapy Service ‘, Executive Summary, Wiltshire and Swindon Health Care NHS Trust and Swindon & Marlborough NHS Trust, (2000).
Mountcastle V, The Sensory Hand – neural mechanisms of somatic sensation, Harvard Univ Press (2005).
Elliott JM, Walton DM., ‘Quantifying dysfunction in Whiplash Injury – Old Questions, New Methods’, In: Eds. Kasch H, Turk D, Troels J Jensen: Whiplash Injury – Perspectives on the Development of Chronic Pain, Wolters Kluwer Pub, IASP Press (2016).
Nijs J, van Oosterwijck J, De Hertogh W., ’Rehabilitation of chronic whiplash: treatment of cervical dysfunction or chronic pain syndrome?’ Clin Rheumatology (2009) 28: p243-251.
Carstensen TB., The influence of psychosocial factors on recovery following acute whiplash trauma’, Dan Med Journal (2012) Dec 59(12):B4560.
Grzesiak R, Ciccne D, Elliott K., ’Late whiplash syndrome: Current Psychological Theory and Practice. In eds: Malanga GA & Nadler Scott F: Whiplash (2002), Hanley& Belfus.
Curatolo M., ‘Pharmacological and interventional management of pain after whiplash injury’, J Orthop.Sports PhysTherapy (20160 Oct 46 (10)P;845-850, doi:10.2519/lospt.2016.6906. 88 Berry, G. (2025). Clinical Outcome Review: A Retrospective Assessment of 171 Patients Referred for Physiotherapy Treatment after Whiplash Injury
Moore A, Bryant E, Barfield J Burge j, Canby G, Herriott M, Mercer C, Ronchetti M, Smith T, and Wood K., Whiplash Associated Disorder: A 1yr standardised data collection project’ (2006) Univ of Brighton ISBN (13) 978-0-9552750-05.
De Kooning M, Daenen L, Cras P, Gidron Y, Rouseel N, Nijs J., ’Autonomic Response to pain in patients with Chronic Whiplash Associated Disorders’, Pain Physician (2013): 16E277-285, ISSN 2150-1149.
Tournier C, Hours M, Charnay P, Chossegros L, Tardy H., ‘Fiver years after the accident, whiplash casualties still have poorer quality of life in the physical domains than other mildly injured casualties: analysis of the ESPARR cohort’, BMC Public Health; no13 (2015), doi:org/10.1186/s12889-01502647-8.
Waddell G, Burton K, McClune T., The Whiplash Book ISBNo-11-702862-2, TSO (2005).
Carroll LJ, Vakilian F., ‘What is needed to establish valid predictors of WAD recovery?’ In Eds: Kasch H, Turk D, Troels Jensen: Whiplash-Injury, perspectives on development of chronic pain, Wolters Kluwer IASP Press (2016).
Berry G., ‘Adapted Reflextherapy – a treatment for spinal pain and whiplash injury’, Focus on Alternative and Complementary Therapies 12(11):p:7 (2007).
Stemper BD, Corner BD., ‘Morphology and Whiplash Injuries. In Eds: Kasch H, Turk D, Troels Jensen: Whiplash-Injury, perspectives on development of chronic pain, Wolters Kluwer IASP Press (2016).
Sterling M, Kenardy J, Jull G, Vicenzino B., ‘The development of psychological changes following whiplash injury’ PAIN Vol 106, 3, Dec, p:481-489 (2003).
Austin P., Chronic Pain – a resource for effectual manual therapy, Handspring Publishers Scotland (2017).
Chien A, Sterling M.,’ Central hypersensitivity in whiplash: Implications for physiotherapy assessment and management’, Physical Therapy Reviews (2005),10:237-45].
Berry G., ‘Chronic Pain after reported whiplash injury – a patient case report’, OBM – Integrative and Complementary Medicine Vol 4, issue 1 (2019), doi: 10.21926/obm.icm.
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