Neck sprains are a common consequence of road accidents, often leading to persistent symptoms and discomfort for affected individuals. In an effort to improve patient outcomes, a pioneering study conducted by L.A. McKinney(1989) sought to explore the long-term effects of early mobilization exercises compared to rest or physiotherapy in patients with acute neck sprains.

The study employed a single-blind, randomized, prospective design, enrolling 247 consecutive patients (average age of 30.6 years) who presented within 48 hours of injury, without pre-existing neck conditions or significant skeletal damage. These patients were assigned to one of three groups: those receiving physiotherapy, advice on mobilization, or an initial period of rest. An additional fourth group consisted of non-attenders who responded to the questionnaire.

Two years after the initial injury, a postal questionnaire was used to assess the presence of symptoms among the respondents. Out of the 167 patients who completed the questionnaire (68% response rate), the results revealed some intriguing findings.

The percentage of patients still experiencing symptoms was comparable between those receiving rest and physiotherapy (46% vs. 44%, respectively). However, patients who were advised to pursue early mobilization exhibited significantly fewer lingering symptoms (23%, p = 0.02). These results indicate that encouraging early mobilization might be a crucial factor in reducing the burden of persistent symptoms following neck sprains.

Among the 104 patients who had recovered and were symptom-free, an impressive 90% achieved full recovery within six months, with 60% recovering even earlier, within three months. Moreover, patients who received advice or physiotherapy and were symptom-free utilized neck collars for a significantly shorter duration compared to those experiencing lingering symptoms (mean duration of 1.4 months vs. 2.8 months, p = 0.005, and 1.6 months vs. 1.8 months, p = 0.006, respectively).

These groundbreaking results highlight the importance of early mobilization in the management of acute neck sprains after road accidents. The study clearly demonstrates that advising patients to engage in early mobilization exercises is superior to manipulative physiotherapy and rest, leading to a reduction in the number of patients experiencing symptoms even after two years. Additionally, the prolonged use of neck collars appears to be associated with ongoing symptoms, underscoring the significance of implementing mobilization interventions promptly.

This study sheds light on a simple yet effective approach that could significantly improve the lives of individuals affected by neck sprains. By advocating for early mobilization in the critical phase following injury, healthcare professionals can empower patients on their journey towards a faster and more complete recovery, ultimately minimizing the long-term impact of neck sprains on patients’ quality of life.

Reference: McKinney, L. A. (1989). Early mobilisation and outcome in acute sprains of the neck. British Medical Journal, 299(6706), 1006-1008.