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Abstract
Background Persistent pain and disability of whiplash injury associated disorders (WAD) cause high burden for the individual and costs for healthcare.
Objectives The aim of this study was to determine state and change of health and working-capacity five years after a standardized inpatient pain management program of four weeks.
Methods This prospective cohort study quantified health and quality of life by the generic Short Form 36 (SF-36, 100=best), the neck-specific Northern American Spine Society (NASS) form, and the Coping Strategies Questionnaire (CSQ). SF-36 data were compared to age-, sex-, and comorbidity-specific German population norms (1). Changes of health were determined using effect sizes (ES) at the 6 month and the 60 month follow-up. Changes of health were determined using effect sizes (ES) (2).
Results The 59 participants had mean age of 40.3 years (sd=12.3), 83% were women, and 37% had one or more comorbidites. At 5 years, health was worse on all SF-36 scales when compared to the norms (p<0.001), varying from mean 41.5, norm 82.3 on role physical to mean 65.7, norm 71.0 on mental health (all p<0.001).
Median working capacity improved from 0 at entry to 21 at 6 months and to 30 hours/week at 5 years.
Conclusions Moderate to large long-term effects were observed. Substantial improvements still occurred between 6 and 60 months after start of the pain program, especially in pain, catastrophizing, and physical role performance. Improvements observed after the inpatient pain program can be maintained and expanded in the long-term at home (3).
References
Kurth BM, Ellert U. The SF-36 questionnaire and its usefulness in population studies: Results of the German Health Interview and Examination Survey 1998. Soz Praeventivmed 2002;47:266–277.
Kazis ES, Anderson JJ, Meenan RF. Effect sizes for interpreting changes in health status. Med Care 1989;27(3 Suppl):S178–89.
Haiduk P, Benz T, Lehmann S, Gysi-Klaus F, Aeschlimann A, Michel BA, Angst F. Interdisciplinary rehabilitation after whiplash injury: An observational prospective five year outcome study. Medicine 2017;in press.
References
Disclosure of Interest None declared