Popular physical therapy modalities in the management of whiplash-associated disorders
Objectives. The aim of this study was to determine current physiotherapy practice in private clinics across the UK in the management of whiplash-associated disorder (WAD) injuries. Design. All treatment reports provided to a private health care company between January 2008 and July 2010 (N=365) were included and analysed to determine the following: the treatments favoured in the management of whiplash; the number of sessions used on average; and the main reasons for discharge. Results. Joint mobilisations, stretches and mobility exercises were favoured in the management of acute whiplash treatment and were used in 74%, 68% and 61% of cases, respectively. The most popular treatments in chronic whiplash, in order of preference, were: stretches (73%), joint mobilisations (69%) and soft-tissue massage (63%). On average, physiotherapists used 4.46 sessions and 7.21 modalities per patient. Although the outcome measures were limited to reason for discharge, the majority of patients were discharged because of ‘treatment complete/self management sufficient’, which may be assumed to be a favourable recovery for 79% of patients. Conclusion. This study found that physical therapists across the UK generally use evidence-based modalities in the treatment of whiplash. However, there remains a need to emphasise and embrace a more educational and active approach to the management of these injuries. The study recommends a protocol for treating WAD that includes supplementing therapeutic modalities with an exercise component, and routinely providing information and advice to ‘act as usual’.