Effect of global osteopathic treatment on individuals with chronic neck pain and a history of whiplash
Item
- Title
- Effect of global osteopathic treatment on individuals with chronic neck pain and a history of whiplash
- Author(s)
- Stocker Kevin
- Abstract
-
The objective of this proposed quantitative study was to determine the short and long-term efficacy of global osteopathic treatment for the treatment of chronic neck pain following a motor vehicle accident (MVA) whiplash injury.
Chronic neck pain is the most common problem after a motor vehicle accident whiplash injury. A sizable group of individuals suffer from this condition. The pain can be mild to severe, intermittent to constant, and interfere with both personal and professional endeavors. Associated financial costs are significant. There is currently no treatment option considered scientifically proven for this condition. Global osteopathic treatment has been advocated in the osteopathic literature, but the efficacy or relative value of this approach has not been scientifically established.
An intra-subject (within-subject) study design was employed, allowing the 1 subject group to act as its own control group. Eleven subjects were selected and included via consecutive referral. Subjects were included if they had chronic neck pain 6 months to 5 years following a motor vehicle accident whiplash injury. The permitted age range was 18-40 years. Further inclusion and exclusion criteria were designed to increase the probability of a causative link between the whiplash accident injury and the chronic neck pain. The independent variable was 4 weekly global osteopathic treatments applied according to the Canadian College of Osteopathy (CCO) methodology. Treatment was individualized according to assessment findings. The three dependent variables were a composite Numerical Rating Scale 101 (NRS-101), the Neck Disability Index (NDI) and the Medication Change Questionnaire (MCQ) that was interpreted by the Medication Quantification Scale (MQS). Subjects were not required to be taking medications for their condition. Therefore, the MCQ was only utilized when a subject was taking medications. The dependent variables were measured 3 times weekly in order to establish a 3-week baseline period prior to commencing treatment. They were also measured at 2 weeks and 2 months after the last treatment. Statistical comparisons were made between these 2 follow up periods and the baseline to determine short and long term treatment efficacy, respectively.
Statistically significant results were observed in both the short-term and long-term versus the baseline according to the NRS-101 and NDI dependent variables. According to the NRS-101, both the short-term (p = 0.015) and long-term (p < 0.001) follow up were statistically significant. The percentage improvement versus the baseline was 38.5 – 41.0% in the short-term and 35.2 – 39.2% in the long-term. According to the NDI, both the short-term and long-term follow up were statistically significant (p < 0.001). The percentage improvement versus the baseline was 35.4 – 41.2% in the short-term and 45.1 – 50% in the long-term. Only 1 subject was taking medications, thereby precluding meaningful statistical analysis in relation to this dependent variable. The percentage improvement noted in this one subject versus the baseline was 27% in the short-term and 56% in the long term. These medication usage results suggest that further investigation may be warranted in this area.
These study results demonstrate that 4 individualized weekly global osteopathic treatments applied according to the CCO methodology significantly reduced chronic neck pain and associated functional disability for individuals suffering from chronic neck pain following a whiplash injury in both the short and long term. The selected study design supports the internal validity of these findings. The external validity of these findings remains in question. An important step has been taken to establish a proven conservative treatment option for this condition. Establishing a proven treatment option will be instrumental in alleviating a high degree of suffering and lowering associated health care, insurance and legal costs. Future research is recommended in order to establish external validity, the benefit of additional treatment, the duration of treatment effects, the effect of treatment upon medication usage, the benefit of treatment for other chronic whiplash symptoms, and the effect of treatment applied during the acute and sub-acute stages of healing. - presented at
- Canadian College of Osteopathy
- Date Accepted
- 2009
- Date Submitted
- 23.9.2010 00:00:00
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 14893
- Inst-Identifier
- 1130
- Keywords
- Whiplash,Neck Pain,Osteopathic Treatment,Osteopathic Research,Pain
- Recommended
- 0
- Item sets
- Thesis
Stocker Kevin, “Effect of global osteopathic treatment on individuals with chronic neck pain and a history of whiplash”, Osteopathic Research Web, accessed November 1, 2024, https://www.osteopathicresearch.org/s/orw/item/876