In 2000, Rosenfeld, et. al., conducted study about Whiplash-associated disorders (WAD) which resulting from motor vehicle collisions pose a significant challenge in terms of management, with limited compelling evidence available. Previous studies have suggested that active treatment during the acute stage may be more beneficial than rest and the use of a soft collar. This study aimed to compare the effectiveness of early active mobilization versus a standard treatment protocol and assess the impact of the timing of treatment initiation.

A prospective randomized trial involving 97 patients with whiplash injuries caused by motor vehicle collisions was conducted. Patients were randomly assigned to four groups, comparing active versus standard treatment and early (within 96 hours) versus delayed (after 2 weeks) initiation of treatment. Measures of range of motion and pain were recorded at the outset and at the 6-month follow-up.

Of the 97 patients, 88 (91%) were successfully followed up at the 6-month mark. The study found that active treatment significantly reduced pain compared to standard treatment (P < 0.001). Further analysis revealed a combined effect when considering the type and onset of treatment. Active treatment showed superior outcomes when initiated early, whereas standard treatment demonstrated better results when administered later. This was particularly evident in pain reduction (P = 0.04) and increased cervical flexion (P = 0.01).

For patients experiencing WAD due to motor vehicle collisions, a treatment approach involving frequently repeated active submaximal movements, coupled with mechanical diagnosis and therapy, proves more effective in reducing pain compared to a standard program advocating initial rest, soft collar usage, and gradual self-mobilization. Notably, this therapeutic strategy could be implemented through home exercises initiated and guided by a qualified physiotherapist. These findings underscore the importance of considering both the type and timing of treatment in optimizing outcomes for individuals with acute whiplash-associated disorders.

Reference: Rosenfeld, M., Gunnarsson, R., & Borenstein, P. (2000). Early intervention in whiplash-associated disorders: a comparison of two treatment protocols. Spine, 25(14), 1782-1787.