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BMJ. 1989 Oct 21;299(6706):1006-8.

Early mobilisation and outcome in acute sprains of the neck.

Author information

  • Accident and Emergency Department, Royal Victoria Hospital, Belfast, Northern Ireland.

Abstract

OBJECTIVE:

To assess the long term effect of early mobilisation exercises in patients with acute sprains of the neck after road accidents.

DESIGN:

Single blind randomised prospective study of patients receiving physiotherapy, advice on mobilisation, or on an initial period of rest followed up after two years by postal questionnaire.

SETTING:

Accident and emergency department in urban hospital.

PATIENTS:

247 Consecutive patients (mean age at injury 30.6 years) presenting within 48 hours after injury with no pre-existing disease of the neck or serious skeletal injury. Of these, 167 patients responded to the questionnaire; 77 who responded but had not completed their treatment or review course were included in the analysis as a fourth group (non-attenders).

MAIN OUTCOME MEASURE:

Presence of symptoms after two years.

RESULTS:

Of the 167 patients (68%) responding, the percentage of patients still with symptoms was not significantly different in those receiving rest or physiotherapy (46%, 12/26 v 44%, 24/54), but that in those receiving advice on early mobilisation was significantly lower (23%, 11/48, p = 0.02). Of the 104 patients without symptoms, 94 (90%) recovered within six months and 62 (60%) within three months. Patients without symptoms who received advice or physiotherapy wore a collar for a significantly shorter time than those with persistent symptoms (mean duration 1.4 (SD 0.7) months v 2.8 (1.6) months, p = 0.005 and 1.6 (1.1) months v 1.8 (1.3) months, p = 0.006 respectively).

CONCLUSIONS:

Advice to mobilise in the early phase after neck injury reduces the number of patients with symptoms at two years and is superior to manipulative physiotherapy. Prolonged wearing of a collar is associated with persistence of symptoms.

PMID:
2511939
[PubMed - indexed for MEDLINE]
PMCID:
PMC1837927
Free PMC Article
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