A Systematic Review of Chiropractic Management of Adults with Whiplash Associated Disorders: Recommendations for Advancing Evidence-based Practice and Research

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SOURCE:   Journal of the Academy of Chiropractic Orthopedists 2011 (Mar); 8 (1)

By: Lynn Shaw, Martin Descarreaux, Roland Bryans, Mireille Duranleau, Henri Marcoux, Brock Potter, Rick Ruegg, Robert Watkin, Eleanor White

The literature relevant to the treatment of Whiplash Associated Disorders (WAD) is extensive and heterogeneous.

Methods: A Participatory Action Research (PAR) approach was used to engage a chiropractic community of practice and stakeholders in a systematic Review to address a general question: ‘Does chiropractic management of WAD clients have an effect on improving health status?’ A systematic review of the empirical studies relevant to WAD interventions was conducted followed by a review of the evidence.

Results: The initial search identified 1155 articles. Ninety-two of the articles were retrieved, and 27 articles consistent with specific criteria of WAD intervention were analyzed in-depth. The best evidence supporting the chiropractic management of clients with WAD is reported. For the review identified ways to overcome gaps needed to inform clinical practice and culminated in the development of a proposed care model: The WAD-Plus Model.

Conclusions: There is a baseline of evidence that suggests chiropractic care improves the cervical range of motion (cROM) and pain in the management of WAD. However, the level of this evidence relevant to clinical practice remains low or draws on clinical consensus at this time. The WAD-Plus Model has implications for use by chiropractors and interdisciplinary professionals in the assessment and management of acute, sub-acute and chronic pain due to WAD. Furthermore, the WAD-Plus Model can be used in the future study of interventions and outcomes to advanced evidenced-based care in the management of WAD.

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Background

  • Whiplash Associated Disorder (WAD) is a clinical condition that occurs with acceleration or deceleration of the head and neck in relation to other parts of the body. This typically occurs during motor vehicle collisions or other mishaps.
  • There are major health concerns that have a disruptive effect on the daily lives of many people around the world [1]. The chiropractic community has provided leadership with respect to interventions that support the clinical management of those suffering from WAD injuries [2, 3]. Over the past several years, there has been a paradigm shift in the body of knowledge that is used to guide management of WAD injuries. Evidence-based knowledge is being used more vehemently to guide treatment management and decision-making practices in the profession.

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