Management of neck pain and associated disorders: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration

被引:185
作者
Cote, Pierre [1 ,2 ,3 ]
Wong, Jessica J. [2 ,3 ,4 ,5 ]
Sutton, Deborah [2 ,3 ,4 ,5 ]
Shearer, Heather M. [2 ,3 ,4 ,5 ]
Mior, Silvano [5 ,6 ]
Randhawa, Kristi [2 ,3 ,4 ,5 ,7 ]
Ameis, Arthur [8 ]
Carroll, Linda J. [9 ,10 ]
Nordin, Margareta [11 ,12 ]
Yu, Hainan [2 ,3 ,4 ,5 ]
Lindsay, Gail M. [6 ]
Southerst, Danielle [13 ]
Varatharajan, Sharanya [2 ,3 ,4 ,5 ,7 ]
Jacobs, Craig [2 ,3 ,14 ]
Stupar, Maja [2 ,3 ]
Taylor-Vaisey, Anne [2 ,3 ]
van der Velde, Gabrielle [15 ,16 ,17 ]
Gross, Douglas P. [18 ,19 ]
Brison, Robert J. [20 ,21 ]
Paulden, Mike [22 ]
Ammendolia, Carlo [17 ,23 ]
Cassidy, J. David [24 ,25 ]
Loisel, Patrick [4 ,5 ,26 ]
Marshall, Shawn
Bohay, Richard N. [27 ]
Stapleton, John [28 ]
Lacerte, Michel [29 ,30 ]
Krahn, Murray [23 ]
Salhany, Roger
机构
[1] Univ Ontario, Inst Technol, Canada Res Chair Disabil Prevent & Rehabil, 2000 Simcoe St North, Oshawa, ON L1H 7L7, Canada
[2] Univ Ontario, Inst Technol, UOIT CMCC Ctr Study Disabil Prevent & Rehabil, 6100 Leslie St, Toronto, ON M2H 3J1, Canada
[3] CMCC, 6100 Leslie St, Toronto, ON M2H 3J1, Canada
[4] CMCC, Grad Educ Program, 6100 Leslie St, Toronto, ON M2H 3J1, Canada
[5] CMCC, Grad Res Program, 6100 Leslie St, Toronto, ON M2H 3J1, Canada
[6] Univ Ontario, Fac Hlth Sci, Inst Technol, 2000 Simcoe St North, Oshawa, ON L1H 7L7, Canada
[7] Canadian Mem Chiropract Coll, Undergrad Educ, 6100 Leslie St, Toronto, ON M2H 3J1, Canada
[8] Univ Montreal, Certificat Program Insurance Med & Medicolegal Ex, Fac Med, N-414,Roger Gaudry Bldg 2900, Montreal, PQ H3T 1J4, Canada
[9] Univ Alberta, Injury Prevent Ctr, 3-300 Edmonton Clin Hlth Acad,11405-87 Ave, Edmonton, AB T6G IC9, Canada
[10] Univ Alberta, Sch Publ Hlth, 3-300 Edmonton Clin Hlth Acad,11405-87 Ave, Edmonton, AB T6G IC9, Canada
[11] NYU, Sch Med, Dept Orthoped Surg, Occupat & Ind Orthoped Ctr, 550 Ist Ave, New York, NY 10016 USA
[12] NYU, Sch Med, Dept Environm Med, Occupat & Ind Orthoped Ctr, 550 Ist Ave, New York, NY 10016 USA
[13] Mt Sinai Hosp, Rebecca MacDonald Ctr Arthrit & Autoimmune Dis, Joseph & Wolf Lebovic Hlth Complex,60 Murray St, Toronto, ON M5T 3L9, Canada
[14] CMCC, Div Clin Educ, 6100 Leslie St, Toronto, ON M2H 3J1, Canada
[15] Toronto Hlth Econ & Technol Assessment THETA Coll, 144 Coll St, Toronto, ON M5S 3M2, Canada
[16] Univ Toronto, Leslie Dan Fac Pharm, 144 Coll St, Toronto, ON M5S 3M2, Canada
[17] Inst Work & Hlth, 481 Univ Ave, Toronto, ON M5G 2E9, Canada
[18] Univ Alberta, Dept Phys Therapy, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada
[19] Univ Alberta, Rehabil Res Ctr, 3-62 Corbett Hall, Edmonton, AB T6G 2G4, Canada
[20] Kingston Gen Hosp, Clin Res, 76 Stuart St, Kingston, ON K7L 2V7, Canada
[21] Queens Univ, Sch Med, Dept Emergency Med, 15 Arch St, Kingston, ON K7L 3N6, Canada
[22] Univ Alberta, Fac Med & Dent, 116 St & 85 Ave, Edmonton, AB T6G 2R3, Canada
[23] Univ Toronto, Inst Hlth Policy Management & Evaluat, 155 Coll St, Toronto, ON M5T 3M7, Canada
[24] Univ Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark
[25] Univ Toronto, Dalla Lana Sch Publ Hlth, 155 Coll St, Toronto, ON M5T 3M7, Canada
[26] Univ Toronto, Dalla Lana Sch Publ Hlth, Div Occupat & Environm Hlth, 155 Coll St, Toronto, ON M5T 3M7, Canada
[27] Western Univ, Schulich Sch Med & Dent, Dent Sci Bldg, London, ON N6A 5C1, Canada
[28] Open Policy Ontario, Toronto, ON, Canada
[29] Univ Montreal, 2375 Cote Ste Catherine, Montreal, PQ H3T 1A8, Canada
[30] Western Univ, Schulich Sch Med & Dent, Dept Phys Med & Rehabil, London, ON N6A 5C1, Canada
关键词
Clinical practice guideline; Neck pain; Treatment; Management; Practice guideline; Therapies; Therapy; Disease management; Whiplash; WHIPLASH-ASSOCIATED DISORDERS; RANDOMIZED CONTROLLED-TRIAL; 2000-2010; TASK-FORCE; LOW-BACK-PAIN; LEVEL LASER THERAPY; NAPRAPATHIC MANUAL THERAPY; CERVICAL MYOFASCIAL PAIN; QUALITY-OF-LIFE; DOUBLE-BLIND; PHYSICAL-THERAPY;
D O I
10.1007/s00586-016-4467-7
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
To develop an evidence-based guideline for the management of grades I-III neck pain and associated disorders (NAD). This guideline is based on recent systematic reviews of high-quality studies. A multidisciplinary expert panel considered the evidence of effectiveness, safety, cost-effectiveness, societal and ethical values, and patient experiences (obtained from qualitative research) when formulating recommendations. Target audience includes clinicians; target population is adults with grades I-III NAD < 6 months duration. Clinicians should rule out major structural or other pathologies as the cause of NAD. Once major pathology has been ruled out, clinicians should classify NAD as grade I, II, or III. Clinicians should assess prognostic factors for delayed recovery from NAD. Clinicians should educate and reassure patients about the benign and self-limited nature of the typical course of NAD grades I-III and the importance of maintaining activity and movement. Patients with worsening symptoms and those who develop new physical or psychological symptoms should be referred to a physician for further evaluation at any time during their care. For NAD grades I-II a parts per thousand currency sign3 months duration, clinicians may consider structured patient education in combination with: range of motion exercise, multimodal care (range of motion exercise with manipulation or mobilization), or muscle relaxants. In view of evidence of no effectiveness, clinicians should not offer structured patient education alone, strain-counterstrain therapy, relaxation massage, cervical collar, electroacupuncture, electrotherapy, or clinic-based heat. For NAD grades I-II > 3 months duration, clinicians may consider structured patient education in combination with: range of motion and strengthening exercises, qigong, yoga, multimodal care (exercise with manipulation or mobilization), clinical massage, low-level laser therapy, or non-steroidal anti-inflammatory drugs. In view of evidence of no effectiveness, clinicians should not offer strengthening exercises alone, strain-counterstrain therapy, relaxation massage, relaxation therapy for pain or disability, electrotherapy, shortwave diathermy, clinic-based heat, electroacupuncture, or botulinum toxin injections. For NAD grade III a parts per thousand currency sign3 months duration, clinicians may consider supervised strengthening exercises in addition to structured patient education. In view of evidence of no effectiveness, clinicians should not offer structured patient education alone, cervical collar, low-level laser therapy, or traction. For NAD grade III > 3 months duration, clinicians should not offer a cervical collar. Patients who continue to experience neurological signs and disability more than 3 months after injury should be referred to a physician for investigation and management. Clinicians should reassess the patient at every visit to determine if additional care is necessary, the condition is worsening, or the patient has recovered. Patients reporting significant recovery should be discharged.
引用
收藏
页码:2000 / 2022
页数:23
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