Optimism after whiplash injury vital to recovery

By Joene Hendry, Reuters

NEW YORK — After a whiplash-type injury, a person’s expectation of getting better plays an important role in the likelihood of his or her recovery, even after the severity of their physical and psychological symptoms are taken into account, research shows. “There is a dose-response relation between recovery expectations and the degree of subsequent disability,” Dr. Lena Holm, of the Institute of Environmental Medicine in Stockholm, Sweden, told Reuters Health. Holm and colleagues compared the expectations for recovery among 1,032 adults who had made an insurance claim for a whiplash-type injury over 12 months. They compared participants’ reports of neck pain and reduced neck movement, and their expectations for recovery in questionnaires completed about 23 days after their accident. Six months later, they reassessed the participants’ disability levels and compared these with the original disability levels and expectations for recovery. As anticipated, individuals with less initial disability had higher expectations for recovery, the researchers report in the Public Library of Science (PLoS) Medicine journal.

But when Holm’s group adjusted for participants’ original degree and extent of pain and injury, and original expectations for recovery, they found a correlation between original expectations for recovery and the patients’ outcomes. That is, compared with individuals reporting the highest expectations of recovery, those with the lowest expectations for recovery were four times more likely to have higher disability and two times more likely to have moderate disability 6 months later.

Likewise, “Those who scored their expectations in the medium range … were two times more likely to report high disability and 50 percent more likely to end up in moderate disability,” Holm told Reuters Health. Early identification of people with low expectations for recovery after whiplash injury may better predict a patient’s future prognosis, the investigators suggest.

Moreover, these findings indicate the need for follow up studies to assess whether interventions may modify an injured persons expectation for recovery and subsequent recuperation.