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Physiotherapy and management in early whiplash-associated disorders (WAD) -- a review
Lundmark H, Persson AL
Advances in Physiotherapy 2006;8(3):98-105
systematic review

The aim of the current review was to examine which management physiotherapists in primary healthcare should provide patients with early whiplash-associated disorders (WAD) grades I to III, to minimize chronic pain and disability. PubMed, Medline, PEDro, CINAHL and EIRA, were searched from 1980 and forward, using combinations of keywords. In all, eight randomized controlled trials (RCTs) and clinical trials (CTs) were accepted. The results in the majority of the accepted studies showed that instruction and advice to act as usual and active treatment are preferred in the early WAD grades I to III. The pain decreased and the cervical range of movement increased. A deficiency in the studies is that there are no measurements used for disability due to neck pain. The studies suggest that active intervention, and advice to 'act as usual' is preferred and the use of a soft collar should be avoided in WAD grades I to III. An appropriate and effective physiotherapy in the early WAD management should comprise pain relief, home exercises to maintain cervical movement, posture and coping strategies to handle disability due to neck pain and outcome follow-up.

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A brief summary and a critical assessment of this review may be available at DARE