Lässt sich bei Patienten nach HWS-Distorsion durch frühe körperliche Aktivierung die Chronifizierungstendenz verringern?[1]

Zusammenfassung

In der Schweiz leiden rund 10 % der Patienten nach einer HWS-Distorsion Grad I und II an chronifizierten Beschwerden. Als wichtigster prognostischer Faktor mit einer engen Korrelation zur Chronifizierung gilt die hohe initiale Schmerzintensität. Das Ziel dieser Arbeit bestand darin herauszufinden, wie sich frühe aktive Therapie auf die Chronifizierungstendenz auswirkt.

Abstract

In Switzerland about 10 % of patients develop chronic complaints after cervical spine distortion grade I and II. The most important prognostic factor with close correlation to development of chronic disorder is considered to be the high intial pain intensity. The purpose of this article was to investigate the effectiveness of early active therapy on the development of chronic symptoms.

HWS-Distorsion - frühe körperliche Aktivierung - prognostische Faktoren

cervical spine distortion - early physical activity - prognositc factors

Literatur

• 1 Abenhaim L, Rossignol M. et al . The role of activity in the therapeutic management of back pain. Report of the International Paris Task Force on Back Pain.  Spine. 2000;  25 (Suppl) 1S-33S
• 2 Barnsley L, Lord S. et al . Whiplash injury.  Pain. 1994;  58 283-307
• 3 Bonk A D, Ferrari R. et al . Prospective randomized controlled study of activity versus collar and the natural history for whiplash injury in Germany.  Journal of Muskuloskeletal Pain. 2000;  8 123-132
• 4 Borchgrevink G E, Kaasa A. et al . Acute treatment of whiplash neck sprain injuries. A randomized trial of treatment during the first 14 days after a car accident.  Spine. 1998;  23 25-31
• 5 Conlin A, Bhogal S. et al . Treatment of whiplash-associated disorders. Part I: Non-invasive interventions.  Pain Res Manag. 2005;  10 21-32
• 6 Crawford J R, Khan R J. et al . Early management and outcome following soft tissue injuries of the neck. A randomised controlled trial.  Injury. 2004;  35 891-895
• 7 Giebel G D, Edelmann M. et al . Sprain of the cervical spine: early functional vs. immobilization treatment.  Zentralbl Chir. 1997;  122 517-521
• 8 Hendriks E JG, Scholten-Peeters G. et al . Prognostic factors for poor recovery in acute whiplash patients.  Pain. 2005;  114 408-416
• 9 McKinney L A. Early mobilisation and outcome in acute sprains of the neck.  Bmj. 1989;  299 1006-1008
• 10 McKinney L A, Dornan J O. et al . The role of physiotherapy in the management of acute neck sprains following road-traffic accidents.  Arch Emerg Med. 1989;  6 27-33
• 11 Mealy K, Brennan H. et al . Early mobilization of acute whiplash injuries.  Br Med J (Clin Res Ed). 1986;  292 656-657
• 12 Miettinen T, Airaksinen O. et al . Whiplash injuries in Finland - the possibility of some sociodemographic and psychosocial factors to predict the outcome after one year.  Disabil Rehabil. 2004;  26 1367-1372
• 13 Ottosson C, Nyren O. et al . Outcome after minor traffic accidents: a follow-up study of orthopedic patients in an inner-city area emergency room.  J Trauma. 2005;  58 (3) 553-560
• 14 Pennie B H, Agambar L J. Whiplash injuries. A trial of early management.  J Bone Joint Surg Br. 1990;  72 277-279
• 15 Physiotherapy Evidence Database (PEDro) .Centre for Evidence-Based Physiotherapy (CEBP). Australia; University of Sydney www.pedro.fhs.usyd.edu.au/index.html
• 16 Rosenfeld M, Gunnarsson R. et al . Early intervention in whiplash-associated disorders: a comparison of two treatment protocols.  Spine. 2000;  25 1782-1787
• 17 Rosenfeld M, Seferiadis A. et al . Active intervention in patients with whiplash-associated disorders improves long-term prognosis: a randomized controlled clinical trial.  Spine. 2003;  28 2491-2498
• 18 Schnabel M, Vassiliou T. et al . Results of early mobilisation of acute whiplash injuries.  Schmerz. 2002;  16 15-21
• 19 Schnabel M, Ferrari R. et al . Randomised, controlled outcome study of active mobilisation compared with collar therapy for whiplash injury.  Emerg Med J. 2004;  21 306-310
• 20 Scholten-Peeters G G, Verhagen A. et al . Prognostic factors of whiplash-associated disorders: a systematic review of prospective cohort studies.  Pain. 2003;  104 303-322
• 21 Schweizerischer Versicherungsverband .Jahresbericht 2004/05: 5.1 Halswirbelsäulen-Problematik. www.svv.ch/index.cfm?id = 5807
• 22 Seferiadis A, Rosenfeld M. et al . A review of treatment interventions in whiplash-associated disorders.  Eur Spine J. 2004;  13 387-397
• 23 Söderlund A, Olerud C. et al . Acute whiplash-associated disorders (WAD): the effects of early mobilization and prognostic factors in long-term symptomatology.  Clin Rehabil. 2000;  14 457-467
• 24 Spitzer W O, Skovron M L. et al . Scientific Monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining „whiplash” and its management.  Spine. 1995;  20 (8 Suppl) 1S-73S
• 25 Sterling M. Kinaesthetic exercise does not improve outcome (or kinaesthesia) in patients with acute whiplash.  Aust J Physiother. 2001;  47 67
• 26 Sterner Y, Toolanen G. et al . The incidence of whiplash trauma and the effects of different factors on recovery.  J Spinal Disord Tech. 2003;  16 195-199
• 27 Verhagen A, Scholten-Peeters G G. et al .Conservative treatments for whiplash. Cochrane Database Syst Rev. 2004 1 DOI: CD003338
• 28 www.pedro.fhs.usyd.edu.au/scale_item.html

1 Die Arbeit wurde als Bestandteil der OMT-SVOMP-Ausbildung 2003 - 2005 erstellt.