Research focuses on whiplash

People who suffer whiplash injury in road accidents stand a much better chance of early recovery if they already have decent fitness levels, research has shown.

Mark Geldman, a musculoskeletal physiotherapist who co-authored the study, said its findings on the effect of ‘pre-injury physical fitness’ could have wider significance for other conditions. Whiplash injury affects around 250,000 people each year in the UK and costs around £2.5 billion. Mr Geldman’s research, carried out with colleagues at the University of Brighton, looked at 102 patients in the Metropolitan Police Service referred for physiotherapy with neck pain following whiplash. Their recovery at three- and six-month intervals was investigated based on pre-injury physical fitness. The findings were published recently in the international journal, Clinical Rehabilitation. Although different fitness levels did not affect severity of injury, there was a marked difference in recovery at three and six months. Individuals with medium and high pre-injury fitness showed significantly better recovery and were almost twice as likely to return to work within the first three months than those with low fitness levels. Low physical fitness was a ‘very good predictor’ of failure to recover. Mr Geldman, now a private practitioner based in Nottingham, said the reasons for this weren’t yet clear.  He told Frontline: ‘It’s possible people with high levels of physical fitness have got better capillary density and perhaps a better ability to recover but we can’t say conclusively.’ He suggested there was a case for further research into the effect of fitness on other types of injury such as low back pain. ‘If pre-injury fitness has a beneficial effect on other types of injury then further studies could be aimed at determining the physiological mechanisms which lead to enhanced recovery.’ CSP professional adviser Anne Jackson said: ‘This is a piece of research with potential to impact on service delivery. It emphasises the benefits of healthy lifestyles and possible roles for physiotherapists in public health. ‘Also, if we can predict which patients are likely to experience long-term problems then physiotherapists can design individual treatment programmes most effectively,’ Dr Jackson added. ‘More research of this type, focusing on a range of injuries, is needed to assist managers and practitioners deliver best healthcare.’ 
Matthew Limb

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