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Prospective one-year follow-up with SF36 for trigger point resection in chronic whiplash syndrome: 55 consecutive patients

Robert J. Meuret, MPT, School of Medicine, University of Nebraska Medical Center, 986585 Nebraska Medical Center, POB WH 1257, Omaha, NE 68198, N. Ake Nystrom, MD, PhD, Orthopaedic Surgery / Plastic Surgery, University of Nebraska Medical Center, 983335, Omaha, NE 68198-3335, and Connie Feschuk, RN, BA, Clinical Research Coordinator, Orthopaedic Surgery, University of Nebraska Medical Center, 981080 Nebraska Medical Center, Omaha, NE 68198-1080.

Whiplash Associated Disorders (WAD) is a common cause of disability, encompassing a constellation of signs and symptoms that present in a variety of patterns. The many variables in the chronic whiplash syndrome, as well as the common failure of current imaging and other diagnostic studies to provide evidence of injury, complicates treatment management and outcome assessments. The 36-item short-form (SF-36), used in numerous past investigations to evaluate disease burden and treatment benefits through norm-based estimates, has previously not been applied to the clinical entity of WAD and related treatment. The present investigation was undertaken to explore the usefulness of SF-36 as an outcome measurement tool in WAD. 55 patients underwent trigger point excision for chronic neck pain after whiplash. Preoperatively the SF-36 questionnaire was used to provide a baseline value, and again postoperatively at 1-2 weeks, 3 months and one year to assess the outcome of the surgical intervention. The outcome data are presented as norm-based for direct comparison with the adult normal US population. The preoperative means for mental health and physical health components were 1.3 and 1.8 SD below the general population, respectively. At one year follow-up, there was a statistically significant improvement with the means for mental health at 0.5 SD and physical health 0.8 SD below the general population means. This study confirms that chronic whiplash syndrome may seriously impair the mental and physical health function. The SF-36 is an effective tool for evaluation of treatment interventions in WAD.