PMID- 33061316 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220417 IS - 1177-889X (Print) IS - 1177-889X (Electronic) IS - 1177-889X (Linking) VI - 14 DP - 2020 TI - Clinical Characteristics and Patient-Reported Outcomes of Primary Care Physiotherapy in Patients with Whiplash-Associated Disorders: A Longitudinal Observational Study. PG - 1733-1750 LID - 10.2147/PPA.S262578 [doi] AB - BACKGROUND: Whiplash-associated disorders (WADs) constitute a state of health characterized by a wide diversity of symptoms as a result of impairments of functions, activity limitations, and participation restrictions. Patient-reported outcome measurements (PROMs) and patient-reported outcomes (PROs) seem appropriate when describing and evaluating the health status of patients with WAD. AIM: To measure the use of PROMs and PROs as quality indicators in clinical reasoning, and to analyze and evaluate pre- and post-treatment 'pain intensity' and 'functioning', and for 'perceived improvement' in patients with WAD in primary care physiotherapy practice by year of referral, with the phase after accident and prognostic health profile embedded in the clinical reasoning process. MATERIALS AND METHODS: Data were collected over a period of 10 years. Pain intensity, functioning, and perceived improvement were measured using the Visual Analogue Scale for Pain (VAS-P), the Neck Disability Index (NDI) and the Global Perceived Effect scale (GPE). Pre- and post-treatment mean differences were tested for statistical significance and compared to minimal clinically important differences (MCID). Effect sizes were expressed as Cohen's d. Multivariable regression analysis was performed to explore independent associations of year of referral, phase after the accident, and the patient's prognostic health profile with post-treatment pain intensity and functioning. RESULTS: A consecutive sample of 523 patients was included. Pre- and post-treatment mean differences on VAS-P and NDI were statistically significant (P<0.000) and clinically relevant, with 'large' effect sizes for pain intensity and functioning. MCIDs were achieved by 80% for VAS-P and for 60% for NDI. Year of referral and phase after the accident were independently associated with worse post-treatment functioning. About half of the patients (n=241 [46.1%]) perceived themselves as improved. CONCLUSION: The PROMs and PROs pain intensity, functioning and perceived improvement were integrated as quality indicators in the physiotherapy clinical reasoning process for patients with WAD. Significant differences in pain intensity and functioning were found but were unrelated to year of referral, phase after whiplash-related injury or prognostic health profile. The MCID VAS-P scores did not differ depending on experienced pain. CI - (c) 2020 Oostendorp et al. FAU - Oostendorp, Rob A B AU - Oostendorp RAB AUID- ORCID: 0000-0001-6697-0817 AD - Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. AD - Department of Manual Therapy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium. AD - Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium. AD - Practice Physiotherapy and Manual Therapy, Heeswijk-Dinther, the Netherlands. FAU - Elvers, J W Hans AU - Elvers JWH AUID- ORCID: 0000-0003-0423-1829 AD - Department of Public Health and Research, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. AD - Department of Allied Health Care, Methodological Health-Skilled Institute, Beuningen, the Netherlands. FAU - van Trijffel, Emiel AU - van Trijffel E AD - Department of Master Education, SOMT University of Physiotherapy, Amersfoort, the Netherlands. AD - Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium. FAU - Rutten, Geert M AU - Rutten GM AD - Institute of Health Studies, Faculty of Health and Social Studies, HAN University of Applied Science, Nijmegen, the Netherlands. AD - Campus Venlo, Faculty of Science and Engineering, Maastricht University, Maastricht, the Netherlands. FAU - Scholten-Peeters, Gwendolyne G M AU - Scholten-Peeters GGM AUID- ORCID: 0000-0002-4409-9554 AD - Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands. FAU - Heijmans, Marcel AU - Heijmans M AD - Practice Physiotherapy and Manual Therapy, Heeswijk-Dinther, the Netherlands. FAU - Hendriks, Erik AU - Hendriks E AD - Department of Epidemiology, Center of Evidence Based Physiotherapy, Maastricht University, Maastricht, the Netherlands. AD - Practice Physiotherapy 'Maasstaete, Druten, the Netherlands. FAU - Mikolajewska, Emilia AU - Mikolajewska E AUID- ORCID: 0000-0002-2769-3068 AD - Department of Physiotherapy, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland. AD - Neurocognitive Laboratory, Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Torun, Poland. FAU - De Kooning, Margot AU - De Kooning M AUID- ORCID: 0000-0002-5194-7400 AD - Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium. AD - Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium. FAU - Laekeman, Marjan AU - Laekeman M AUID- ORCID: 0000-0002-8466-3404 AD - Department of Nursing Sciences, Ph.D.-Kolleg, Faculty of Health, University Witten/Herdecke, Witten, Germany. AD - Department of Physiological Psychology, University of Bamberg, Bamberg, Germany. FAU - Nijs, Jo AU - Nijs J AUID- ORCID: 0000-0002-4976-6563 AD - Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium. AD - Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium. AD - Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden. FAU - Roussel, Nathalie AU - Roussel N AUID- ORCID: 0000-0002-7409-878X AD - Department of Physiotherapy and Rehabilitation Sciences (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. FAU - Samwel, Han AU - Samwel H AD - Revalis Pain Rehabilitation Centre, S Hertogenbosch, the Netherlands. LA - eng PT - Journal Article DEP - 20200928 PL - New Zealand TA - Patient Prefer Adherence JT - Patient preference and adherence JID - 101475748 PMC - PMC7532902 OTO - NOTNLM OT - neck pain OT - patient-reported outcomes measures OT - physiotherapy OT - routinely collected data OT - whiplash-Associated Disorders COIS- The authors report no conflicts of interest in this work. EDAT- 2020/10/17 06:00 MHDA- 2020/10/17 06:01 PMCR- 2020/09/28 CRDT- 2020/10/16 05:50 PHST- 2020/05/13 00:00 [received] PHST- 2020/08/22 00:00 [accepted] PHST- 2020/10/16 05:50 [entrez] PHST- 2020/10/17 06:00 [pubmed] PHST- 2020/10/17 06:01 [medline] PHST- 2020/09/28 00:00 [pmc-release] AID - 262578 [pii] AID - 10.2147/PPA.S262578 [doi] PST - epublish SO - Patient Prefer Adherence. 2020 Sep 28;14:1733-1750. doi: 10.2147/PPA.S262578. eCollection 2020.