Comparison of the Relative Benefits of 2 Versus 10 Days of Soft Collar Cervical Immobilization After Acute Whiplash Injury

Abstract 

Dehner C, Hartwig E, Strobel P, Scheich M, Schneider F, Elbel M, Kinzl L, Kramer M. Comparison of the relative benefits of 2 versus 10 days of soft collar cervical immobilization after acute whiplash injury.

Objective

To investigate the effects of 2-day and 10-day immobilization of the cervical spine on pain, range of motion (ROM), and disability of patients with Quebec Task Force (QTF) grade II whiplash injuries.

Design

Randomized controlled trial.

Setting

University hospital emergency department.

Participants

Seventy patients with acute QTF grade II whiplash injuries.

Interventions

At the intake examination within 24 hours after the whiplash trauma, the patients were randomized to 2 therapy groups (2-d or 10-d immobilization with a soft cervical collar). All patients received pain drugs (nonsteroidal anti-inflammatory drugs) and after 7 days, all patients started a standardized physiotherapy program 2 to 3 times a week.

Main Outcome Measures

Patients’ pain and disability scores were assessed using visual analog scales and ROM was assessed using a goniometer. All parameters were measured within 24 hours after injury and after 2 and 6 months.

Results

After 2 months, the different periods of immobilization (2d or 10d) were associated with comparable improvements in pain symptoms (median, 4.60 vs 4.65), ROM (median, 100.0° vs 117.5°), and disability score (median, 4.90 vs 5.15). No statistically significant differences could be identified between the 2 treatment groups. After 6 months, persistent pain was reported by 4 patients in each group (12.5%).

Conclusions

In patients with QTF grade II whiplash injuries, there is no short- or long-term difference between 2-day and 10-day immobilization with a cervical collar in terms of pain, ROM, or disability.

Key Words: Cervical pain, Immobilization, Rehabilitation, Whiplash injuries