TY - JOUR
T1 - The effects of soft cervical collars on persistent neck pain in patients with whiplash injury
AU - Gennis, P.
AU - Miller, L.
AU - Gallagher, E. J.
AU - Giglio, J.
AU - Carter, W.
AU - Nathanson, N.
PY - 1996
Y1 - 1996
N2 - Objective: To assess the efficacy of soft cervical collars in the early management of whiplash-injury-related pain. Methods. A controlled, clinical trial was conducted in an urban ED. Adults with neck pain following auto mobile crashes indicated their initial degrees of pain on a visual analog scale. Patients with cervical spine fractures or subluxation, focal neurologic deficits, or other major distracting injuries were excluded. Patients were assigned to receive a soft cervical collar or no collar based on their medical record numbers. Pain at ≥6 weeks postinjury was coded as none, better, same, or worse, and analyzed as 3 dichotomous outcomes: recovered (pain = none); improved (pain = none or better); and deteriorated (pain = worse). Results: Of 250 patients enrolled, 196 (78%) were available for follow-up. Of these patients, 104 (53%) were assigned to the soft cervical collar group, and 2 (47%) to the control group. These groups were similar in age, gender, seat position in the car, seat belt use, and initial pain score. Pain persisted at ≥6 weeks in 122 (62%) patients. The groups showed no difference in follow-up pain category (p = 0.59). There was no significant difference between the 2 groups in complete recovery (p = 0.34), improvement (p = 0.34%) or deterioration (p = 0.60). The study had a power of 80% to detect an absolute difference of at least 20% in recovery, 17% in improvement, and 7% in deterioration (2-tailed, α = 0.05). Conclusions: Most patients with whiplash injuries have persistent pain for at least 6 weeks. Soft cervical collars do not influence the duration or degree of persistent pain.
AB - Objective: To assess the efficacy of soft cervical collars in the early management of whiplash-injury-related pain. Methods. A controlled, clinical trial was conducted in an urban ED. Adults with neck pain following auto mobile crashes indicated their initial degrees of pain on a visual analog scale. Patients with cervical spine fractures or subluxation, focal neurologic deficits, or other major distracting injuries were excluded. Patients were assigned to receive a soft cervical collar or no collar based on their medical record numbers. Pain at ≥6 weeks postinjury was coded as none, better, same, or worse, and analyzed as 3 dichotomous outcomes: recovered (pain = none); improved (pain = none or better); and deteriorated (pain = worse). Results: Of 250 patients enrolled, 196 (78%) were available for follow-up. Of these patients, 104 (53%) were assigned to the soft cervical collar group, and 2 (47%) to the control group. These groups were similar in age, gender, seat position in the car, seat belt use, and initial pain score. Pain persisted at ≥6 weeks in 122 (62%) patients. The groups showed no difference in follow-up pain category (p = 0.59). There was no significant difference between the 2 groups in complete recovery (p = 0.34), improvement (p = 0.34%) or deterioration (p = 0.60). The study had a power of 80% to detect an absolute difference of at least 20% in recovery, 17% in improvement, and 7% in deterioration (2-tailed, α = 0.05). Conclusions: Most patients with whiplash injuries have persistent pain for at least 6 weeks. Soft cervical collars do not influence the duration or degree of persistent pain.
KW - cervical collar
KW - cervical spine
KW - controlled clinical trial
KW - injury
KW - neck
KW - pain
KW - whiplash injury
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U2 - 10.1111/j.1553-2712.1996.tb03466.x
DO - 10.1111/j.1553-2712.1996.tb03466.x
M3 - Article
C2 - 8727627
AN - SCOPUS:0029666067
SN - 1069-6563
VL - 3
SP - 568
EP - 573
JO - Academic Emergency Medicine
JF - Academic Emergency Medicine
IS - 6
ER -