Sherlock Holmes and the case of the whipping neck with Nick Kendrick

Whiplash patients -they can be a tricky mob to treat. Why is that? Some do amazingly, and recover really quickly, and others have lingering pain that is really hard to budge. There seems to be a lot of factors involved in whiplash, from the physical effects of a motor vehicle accidents, to the psychological effects that can be almost post-traumatic. What is the best way to treat whiplash patients? Who is going to get better regardless of what you do, and who needs more intensive therapy? What other health professionals can you involve when progress is slow?

The latest evidence reveals mixed (or often poor) results with conservative management of whiplash. We also have specific prognostic factors that you identify patients likely to have poorer outcomes. Where does that leave us when it comes time to treat our patients? How can you use these prognostic factors to help guide your treatment selection? How can you apply the latest evidence in your treatment of whiplash?

Today we have a fantastic analysis of the latest evidence on whiplash/whiplash associated disorder (WAD), and a demonstration of applying the evidence in a case study, to help improve your assessment and management of whiplash associated disorder. In this 6 part presentation, Sherlock Holmes a.k.a. APA Titled Musculoskeletal and Sports Physiotherapist Nick Kendrick will take you through whiplash, the current grading of whiplash, how to grade your patients whiplash, and provides you with evidence-based treatment ideas that you can use with your patients. You will discover:

Part 1

• Grading whiplash and the issues associated with grading
• The burden of whiplash
• Indentifying complex whiplash patients
• Treating whiplash – the latest evidence
• Applying prognostic factors into whiplash assessment and management

Part 2

• Clinical Prediction Rules (CPR) - how they can help you identify patients at risk of poor outcomes, and what to do with the information this provides
• Identifying complex patients
• Sensitivity and specificity of the CPR
• How you can identify patients at risk of poor outcomes and why this is important

Part 3

• Outcome measures you can use to identify patients at risk of poor outcomes, that require specific interventions
• Whiplash factors that you thought may be involved in your patient's outcome, that have been demonstrated to be unrelated
• Our case study
  • Subjective findings

Part 4

• Canadian C-spine rule, to know when to order imaging
• Outcome measures you can use
• Identifying patients that will benefit from referral to other health professionals eg psychologists
• Imaging findings and relevance to the presenting pain
• Case study objective findings, and how this guides your treatment, and diagnosis

Part 5

• Current evidence regarding treatment of whiplash, including the PROMISE trial (Michaleff et al., 2015), and Management of acute whiplash with stratified care (Jull et al., 2013)
• Analysis of the latest evidence, including how this applies to your treatment
• Case study
  • How the current evidence was incorporated to create an evidence informed treatment incorporating manual therapy, motor control training and strength training

Part 6

• Case study
  • Co-interventions and cross-referral
  • Treatment outcomes for this patient
    • Take home messages