Society of Musculoskeletal Medicine Conference, London, March 2014

Abstract

Assessment and management of WAD in the whiplash capital of Europe: are U.K. physiotherapists divided? Angela Clough1, J. Horne2, F. Earle2, P. Clough3 Clinical Lead Physiotherapist. Hull & East Yorkshire NHS Trust, Dept of Psychology, University of Hull, Dept of Psychology, Manchester Metropolitan University Method: A multi method approach was adopted: An empirical case study design was adopted to investigate the impact of context on diagnosis and classification (n= 182). ‘Almost’ identical case studies were assessed by physiotherapists. Only the cause of the injury was different (sport vs. RTA).An epidemiological approach, examining whiplash reporting. General RTA statistics were compared to collision injuries in Rugby where the impact forces were recorded. In depth interviews were carried out with a range of practitioners (n= 9) focusing on the causes and treatments of whiplash. Specific objective: To investigate variations in the diagnosis and treatment of WAD within the UK physiotherapy community. Results: 1. The case studies showed that physiotherapists were significantly more likely (p< 0.05) to report that an injury was whiplash if it was apparently related to an RTA rather than a sports context. 2. The epidemiological approach showed that WAD could be significantly under reported in contact sports. 3. The interviews showed different treatment approaches were adopted by physiotherapists from differing specialist areas. Conclusions: The present series of studies show that: The context of the injury significantly influences the diagnosis., Whiplash injuries appear to be over reported in RTAs and under reported in sports., The WAD guidelines are available, but do not appear to prevent some of this variation., Practitioners from different domains agree on the causation of whiplash and core principles of clinical problem solving but have differing views on classification and intervention.