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The efficacy of patient education in whiplash associated disorders: a systematic review

Mira Meeus UGent, Jo Nijs, Veronique Hamers, Kelly Ickmans and Jessica Van Oosterwijck UGent (2012) PAIN PHYSICIAN. 15(5). p.351-361
abstract
Background: Until now, there is no firm evidence for conservative therapy in patients with chronic Whiplash Associated Disorders (WAD). While chronic WAD is a biopsychosocial problem, education may be an essential part in the treatment and the prevention of chronic WAD. However, it is still unclear which type of educative intervention has already been used in WAD patients and how effective such interventions are. Objective: This systematic literature study aimed at providing an overview of the literature regarding the currently existing educative treatments for patients with whiplash or WAD and their evidence. Study Design: Systematic review of the literature Methods: A systematic literature search was conducted in the following databases: Pubmed, Springerlink, and Web of Science using different keyword combinations. We included randomized controlled clinical trials (RCT) that encompass the effectiveness of education for patients with WAD. The included articles were evaluated on their methodological quality. Results: Ten RCT's of moderate to good quality remained after screening. Both oral and written advice, education integrated in exercise programs and behavioral programs appear effective interventions for reducing pain and disability and enhancing recovery and mobility in patients with WAD. In acute WAD, a simple oral education session will suffice. In subacute or chronic patients broader (multidisciplinary) programs including education which tend to modulate pain behavior and activate patients seems necessary. Limitations: Because of limited studies and the broad range of different formats and contents of education and different outcome measures, further research is needed before solid conclusions can be drawn regarding the use and the modalities of these educational interventions in clinical practice. Conclusion: Based on this systematic literature study is seems appropriate for the pain physician to provide education as part of a biopsychosocial approach of patients with whiplash. Such education should target removing therapy barriers, enhancing therapy compliance and preventing and treating chronicity. Still, more studies are required to provide firm evidence for the type, duration, format, and efficacy of education in the different types of whiplash patients.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (review)
publication status
published
subject
keyword
whiplash, rehabilitation, chronic pain, systematic review, education, RANDOMIZED CONTROLLED-TRIAL, CHRONIC-FATIGUE-SYNDROME, QUALITY-OF-LIFE, LOW-BACK-PAIN, PROGNOSTIC-FACTORS, NECK PAIN, NEUROPHYSIOLOGY EDUCATION, TASK-FORCE, INJURY, DISABILITY
journal title
PAIN PHYSICIAN
Pain Physician
volume
15
issue
5
pages
351 - 361
Web of Science type
Review
Web of Science id
000312498100017
ISSN
1533-3159
language
English
UGent publication?
yes
classification
A1
copyright statement
I have retained and own the full copyright for this publication
id
2998596
handle
http://hdl.handle.net/1854/LU-2998596
alternative location
http://www.painphysicianjournal.com/2012/september/2012;15;351-361.pdf
date created
2012-09-24 15:13:49
date last changed
2013-07-10 16:42:31
@article{2998596,
  abstract     = {Background: Until now, there is no firm evidence for conservative therapy in patients with chronic Whiplash Associated Disorders (WAD). While chronic WAD is a biopsychosocial problem, education may be an essential part in the treatment and the prevention of chronic WAD. However, it is still unclear which type of educative intervention has already been used in WAD patients and how effective such interventions are. 
Objective: This systematic literature study aimed at providing an overview of the literature regarding the currently existing educative treatments for patients with whiplash or WAD and their evidence. 
Study Design: Systematic review of the literature 
Methods: A systematic literature search was conducted in the following databases: Pubmed, Springerlink, and Web of Science using different keyword combinations. We included randomized controlled clinical trials (RCT) that encompass the effectiveness of education for patients with WAD. The included articles were evaluated on their methodological quality. 
Results: Ten RCT's of moderate to good quality remained after screening. Both oral and written advice, education integrated in exercise programs and behavioral programs appear effective interventions for reducing pain and disability and enhancing recovery and mobility in patients with WAD. In acute WAD, a simple oral education session will suffice. In subacute or chronic patients broader (multidisciplinary) programs including education which tend to modulate pain behavior and activate patients seems necessary. 
Limitations: Because of limited studies and the broad range of different formats and contents of education and different outcome measures, further research is needed before solid conclusions can be drawn regarding the use and the modalities of these educational interventions in clinical practice. 
Conclusion: Based on this systematic literature study is seems appropriate for the pain physician to provide education as part of a biopsychosocial approach of patients with whiplash. Such education should target removing therapy barriers, enhancing therapy compliance and preventing and treating chronicity. Still, more studies are required to provide firm evidence for the type, duration, format, and efficacy of education in the different types of whiplash patients.},
  author       = {Meeus, Mira and Nijs, Jo and Hamers, Veronique and Ickmans, Kelly and Van Oosterwijck, Jessica},
  issn         = {1533-3159},
  journal      = {PAIN PHYSICIAN},
  keyword      = {whiplash,rehabilitation,chronic pain,systematic review,education,RANDOMIZED CONTROLLED-TRIAL,CHRONIC-FATIGUE-SYNDROME,QUALITY-OF-LIFE,LOW-BACK-PAIN,PROGNOSTIC-FACTORS,NECK PAIN,NEUROPHYSIOLOGY EDUCATION,TASK-FORCE,INJURY,DISABILITY},
  language     = {eng},
  number       = {5},
  pages        = {351--361},
  title        = {The efficacy of patient education in whiplash associated disorders: a systematic review},
  url          = {http://www.painphysicianjournal.com/2012/september/2012;15;351-361.pdf},
  volume       = {15},
  year         = {2012},
}

Chicago
Meeus, Mira, Jo Nijs, Veronique Hamers, Kelly Ickmans, and Jessica Van Oosterwijck. 2012. “The Efficacy of Patient Education in Whiplash Associated Disorders: a Systematic Review.” Pain Physician 15 (5): 351–361.
APA
Meeus, M., Nijs, J., Hamers, V., Ickmans, K., & Van Oosterwijck, J. (2012). The efficacy of patient education in whiplash associated disorders: a systematic review. PAIN PHYSICIAN, 15(5), 351–361.
Vancouver
1.
Meeus M, Nijs J, Hamers V, Ickmans K, Van Oosterwijck J. The efficacy of patient education in whiplash associated disorders: a systematic review. PAIN PHYSICIAN. 2012;15(5):351–61.
MLA
Meeus, Mira, Jo Nijs, Veronique Hamers, et al. “The Efficacy of Patient Education in Whiplash Associated Disorders: a Systematic Review.” PAIN PHYSICIAN 15.5 (2012): 351–361. Print.