Five years post whiplash injury: Symptoms and psychological factors in recovered versus non-recovered

<p>Abstract</p> <p>Background</p> <p>Few studies have focused on the differences between persons who are recovered after whiplash injury and those who suffer from persistent disability. The primary aim of this study was therefore to examine differences in symptoms, psychological factors and life satisfaction between subjects classified as recovered and those with persistent disability five years after whiplash injury based on the Neck Disability Index (NDI).</p> <p>Methods</p> <p>A set of questionnaires was answered by 158 persons (75 men, 83 women) to assess disability (NDI), pain intensity (VAS), whiplash-related symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ), post-traumatic stress (Impact of Event Scale, IES), depression (Beck's depression inventory, BDI) and life satisfaction (LiSat-11).</p> <p>The participants were divided into three groups based on the results of the NDI: recovered (34.8%), mild disability (37.3%) and moderate/severe disability (27.3%).</p> <p>Results</p> <p>The moderate/severe group reported significantly higher VAS, BDI and IES scores and lower level of physical health and psychological health compared to the mild and the recovered groups. Less significant differences were reported between the mild and the recovered groups.</p> <p>Conclusions</p> <p>The group with the highest disability score reported most health problems with pain, symptoms, depression, post-traumatic stress and decreased life satisfaction. These findings indicate that classifying these subjects into subgroups based on disability levels makes it possible to optimize the management and treatment after whiplash injury.</p

Equações obtidas a partir das leis de conservação para dimensionamento de drenos subterrâneos

Neste trabalho se obteve uma expressão algébrica para o modelo de Dumm através do qual se descrevem suas soluções por meio de algoritmo geométrico. Utilizaram-se as técnicas de identificação de padrões potenciais, hiperbólicos, lineares e exponenciais, por intermédio de representações em gráficos monolog e dilog visando definir estratégias de ajuste pela técnica dos mínimos quadrados, sentido em que foram analisados diversos modelos e se identificou que os modelos do tipo linear e potencial ajustam muito bem a razão entre os níveis do lençol freático inicial e após t dias decorridos; além disto, a identificação de que modelos potenciais podem ajustar bem o processo, possibilitou gerar, com o uso do Solver, Office Excel da Microsoft. Inc., modelos simplificados para o problema, razão pela qual se propõe, neste estudo, o ajuste com equações empíricas do tipo potencial para representá-lo com o uso das variáveis: condutividade hidráulica, profundidade e tempo para determinar a distância entre drenos permitindo, inclusive, a descrição dessa distância sob os mesmos parâmetros que o modelo de Glover-Dumm. As soluções encontradas têm pequenas diferenças porém não significativas quanto aos modelos de Glover, Dumm e Glover-Dumm

Symptoms, disabilities, and life satisfaction five years after whiplash injuries

Background: Chronic whiplash-associated disorders (WADs) are often associated with social functioning problems and decreased ability to perform previous activities. This may lead to decreased life satisfaction, which is insufficiently studied in the context of whiplash injuries. Symptoms included in chronic WAD are similar to symptoms frequently reported by persons who have sustained mild traumatic brain injury (MTBI)/concussion. In cases of MTBI, the severity and number of symptoms have been suggested to have a diagnostic value. The corresponding importance of symptoms in chronic WAD has not been documented. Most studies of whiplash injuries have focused on neck pain because this is the dominant complaint, while other symptoms are less studied. The frequency of long-term symptoms after whiplash injuries seems to vary. It is difficult to compare the long-term outcome since the follow-up after whiplash injury in most studies has been rather short. Therefore, the primary aim of this investigation was to study neck pain and other symptoms, disability, and life satisfaction five years after whiplash injury in a defined population and geographical area. Methods: The study was carried out at a public hospital in northern Sweden and was a cross-sectional survey of patients five years after the injury event in a cohort of whiplash-injured patients. Five years after the emergency department visit, 186 persons aged 18-64 answered questionnaires on symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ), disabilities (Rivermead Head Injury Follow Up Questionnaire, RHFUQ), and life satisfaction (LiSat-11). The answers were compared to those of a comparison cohort. Results: The most common symptoms five years after whiplash injury were fatigue (41%), poor memory (39%), and headache (37%). Inability to sustain previous workload (44%) and fatigue at work (43%) were frequently reported disabilities. Only 39% were satisfied with their somatic health and 60% with their psychological health. Compared with healthy controls, the whiplash injured exhibited more symptoms and had lower life satisfaction. Women reported significantly higher pain intensity than men. Few significant differences between women and men regarding the other parameters were found. Conclusions: This study shows that five years after a whiplash injury, patients reported symptoms that are typical of mild traumatic brain injury. Further, this study emphasizes the possibility of screening patients with chronic WAD for these symptoms as a complement to the assessment. Implications: Untreated symptoms may negatively affect the outcome of pain rehabilitation. This implies that it might be clinically meaningful to quantify symptoms earlier in the rehabilitation process.</p

Serum concentrations of two biochemical markers of brain tissue damage S‐100B and neurone specific enolase are increased in elite female soccer players after a competitive game

BACKGROUND: It is a matter of debate whether or not ordinary heading of the ball in soccer causes injury to brain tissue.OBJECTIVE: To analyse concentrations of the biochemical markers of brain tissue damage S-100B and neurone specific enolase (NSE) in serum of female elite soccer players in association with a competitive game.METHODS: Venous blood samples were obtained from 44 female soccer players before and after a competitive game for analysis. The number of headers and trauma events (falls, collisions, etc) was assessed from videotape recordings for each player.RESULTS: Concentrations of both brain damage markers were increased after the game (S-100B, 0.18 (0.11) v 0.11 (0.05) microg/l (p = 0.000); NSE, 10.14 (1.74) v 9.05 (1.59) microg/l (p = 0.001)). There was a significant correlation between changes in S-100B concentrations and both the number of headers (r = 0.430, p = 0.004) and the number of other trauma events (r = 0.517, p &lt; 0.001).CONCLUSION: The concentrations of both S-100B and NSE were increased by game associated activities and events. The increases in S-100B concentration were significantly related to the number of headers and other trauma events, which indicates that both these factors may have contributed to these increases.</p