The symptom profile of people with whiplash-associated disorder - A mixed-method systematic review

Background: Several studies have shown that people with whiplash-associated disorder (WAD) may experience diverse symptoms, and social, activity and participation limitations. However, the symptom profile of WAD is still unclear. Therefore, this systematic review aimed to identify the symptoms, impairments, activity limitations, and participation restrictions of people with WAD to construct a symptom profile. Methods: The data search was performed using PubMed, Embase, PsycINFO, CINAHL, and Scopus databases. Fulltext quantitative and qualitative studies reporting symptoms, impairments, activity and participation limitations, or environmental factors affecting them in people with WAD were included. The extracted data was synthesised using Joanna Briggs Institute's convergent integrated approach. The Critical Appraisal Skills Programme checklist was chosen to evaluate the quality of the studies. Results: Fifty-three studies involving 102 943 people with WAD met the inclusion criteria. Three key themes were identified to describe the symptom profile: 1) the prevalence of symptoms, impairments or limitations; 2) the severity of symptoms and the effect of symptoms on functioning, activity and participation; and 3) the effects of environmental factors on the symptom profile. Two-thirds of the symptoms, impairments and limitations identified from the studies related to problems in body functions, and one-third to difficulties executing activities or participating in life situations. Discussion: The literature describes a wide variety of symptoms in people with WAD. However, it does not adequately describe how these symptoms affect a patient's function, activity, or levels of participation. Considering the symptom profile after whiplash injury to be primarily neck-related may be misdirected.