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Pain and Disability Measures for Whiplash

In this study researchers compare tests used to measure change in pain and disability before and after treatment for chronic whiplash. Most patients do improve over time. Measuring how soon and how much they improve helps guide treatment. Finding the tool that measures these changes most accurately would be helpful.

Four tests commonly used to measure disability were included. These were the Neck Disability Index, the Functional Rating Scale, the Copenhagen Scale, and the Patient-Specific Functional Scale.

Tests used to measure change in pain included the Visual Analog Scale, Bothersome Numerical Rating Scale, and Pain Numerical Rating Scale. The well-known test SF-36 was used as an overall measure of health status.

All of these tools are known to be reliable. This study looks at how responsive they are to changes over a specific period of time. All four tests were used on the same group of whiplash patients. The patients were tested before treatment began and again after six weeks of treatment.

The authors report that the Patient-Specific Functional Scale (PSFS) was the most responsive test measure for disability. The other three tests were equally responsive compared to each other. This means that any of those tests could be used and get the same results but the PSFS gave the best results.

The PSFS is quick and easy to give. It is recommended as the best measure of changes in disability for patients with chronic whiplash. The numerical pain rating scale of pain bothersome was the most responsive measure of pain.

References: Mark Stewart, MPH(Hons), et al. Responsiveness of Pain and Disability Measures for Chronic Whiplash. In Spine. March 1, 2007. Vol. 32. No. 5. Pp. 580-585.

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