Summary of Recommendations for neck intervention (Continued):
NECK PAIN WITH MOVEMENT COORDINATION IMPAIRMENTS (including whiplash-associated disorder [WAD]):
- Clinicians should provide the following:
• Education of the patient to Return to normal, non-provocative pre-accident activities as soon as possible.
- Minimize use of a cervical collar.
- Perform postural and mobility exercises to decrease pain and increase ROM.
- Reassurance to the patient that recovery is expected to occur within the first 2 to 3 months.
- Clinicians should provide a multimodal intervention approach
including manual mobilization techniques plus exercise
(eg, strengthening, endurance, flexibility, postural, coordination,
aerobic, and functional exercises) for those patients expected to experience a moderate to slow recovery with persistent impairments.
- Clinicians may provide the following for patients whose
condition is perceived to be at low risk of progressing toward chronicity:
• A single session consisting of early advice, exercise instruction,
• A comprehensive exercise program (including strength and/or
endurance with/without coordination exercises)
• Transcutaneous electrical nerve stimulation (TENS)
- Clinicians should monitor recovery status in an attempt to
identify those patients experiencing delayed recovery who
may need more intensive rehabilitation and an early pain education program.
- Clinicians may provide the following:
• Patient education and advice focusing on assurance, encouragement, prognosis, and pain management.
• Mobilization combined with an individualized, progressive submaximal exercise program including cervicothoracic strengthening, endurance, flexibility, and coordination, using principles of cognitive behavioral therapy.
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