Background & Aims
Traffic accidents often result in post-traumatic neck pain (1), affecting both society and individuals (2,3). 15-25% of those injured continue to experience symptoms and functional impairment 1 year after the accident (4,5). Both physical (6) and psychosocial (7) factors contribute to the development of chronic pain. Hyper arousal can be associated with increased pain sensitization (8,9). A biomarker of hyper arousal (i.e., stress response) and the onset of posttraumatic stress is low heart rate variability (HRV) (10).
Aims of this cohort study are to:
-Test post-traumatic neck pain prediction tools in a Danish emergency department context and improvement by exploring whether stress biomarkers enhance accuracy
-Evaluate health economic costs after 1 year for the group of individuals who do not improve compared to those who do
-Investigate whether posttraumatic stress symptoms at three months mediates the link between low baseline HRV and later indicators of pain sensitization
Methods
The study is a multicentre prospective cohort study (n=155 participants) in two Danish emergency departments.
Participants 18-70 years of age and proficient in Danish that has acquired posttraumatic neck pain within the last 72 hours in a traffic accident will be included. Participants reporting ongoing chronic pain conditions of any origin or fractures acquired in the accident will be excluded.
Data collected at inclusion and follow up visit at 1 week will serve as baseline data. Follow-up data will be collected at 3, 6, and 12 months.
Data is a combination of self-reported variables (e.g., pain and disability), clinical examinations (e.g., neck mobility and HRV), and health economic cost at 12 months based on registry data (e.g, labour market attachment and use of health service).
The prediction tools will be assessed using a receiver operator characteristics (ROC) analysis. Sensitivity and specificity will be calculated for different cutoff points.
Results
Preliminary results will be presented.
Conclusions
Preliminary conclusion will be presented.
References
1.Al-Khazali HM, Ashina H, Iljazi A, Lipton RB, Ashina M, Ashina S, m.fl. Neck pain and headache after whiplash injury: a systematic review and meta-analysis. Pain. maj 2020;161(5):880–8.
2.Schmidt D. yumpu.com. [henvist 21. februar 2023]. Whiplash koster kassen fra Livtag #1 – PTU. Tilgængelig hos: https://www.yumpu.com/da/document/read/18261277/whiplash-koster-kassen-fra-livtag-1-ptu
3.Carroll LJ, Holm LW, Hogg-Johnson S, Côtè P, Cassidy JD, Haldeman S, m.fl. Course and Prognostic Factors for Neck Pain in Whiplash-Associated Disorders (WAD): Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. J Manipulative Physiol Ther. 1. februar 2009;32(2, Supplement):S97–107.
4.Andersen T e., Karstoft KI, Brink O, Elklit A. Pain-catastrophizing and fear-avoidance beliefs as mediators between post-traumatic stress symptoms and pain following whiplash injury – A prospective cohort study. Eur J Pain. 2016;20(8):1241–52.
5.Sterling M. Whiplash-associated disorder: musculoskeletal pain and related clinical findings. J Man Manip Ther. november 2011;19(4):194–200.
6.Andersen TE, Ravn SL, Carstensen T, Ørnbøl E, Frostholm L, Kasch H. Posttraumatic Stress Symptoms and Pain Sensitization After Whiplash Injury: A Longitudinal Cohort Study With Quantitative Sensory Testing. Front Pain Res [Internet]. 2022 [henvist 31. januar 2024];3. Tilgængelig hos: https://www.frontiersin.org/articles/10.3389/fpain.2022.908048
7.Sterling M, Hendrikz J, Kenardy J. Similar factors predict disability and posttraumatic stress disorder trajectories after whiplash injury. PAIN. 1. juni 2011;152(6):1272–8.
8.Gil-Jardiné C, Evrard G, Al Joboory S, Tortes Saint Jammes J, Masson F, Ribéreau-Gayon R, m.fl. Emergency room intervention to prevent post concussion-like symptoms and post-traumatic stress disorder. A pilot randomized controlled study of a brief eye movement desensitization and reprocessing intervention versus reassurance or usual care. J Psychiatr Res. 1. august 2018;103:229–36.
9.Liedl A, Knaevelsrud C. PTBS und chronische Schmerzen: Entstehung, Aufrechterhaltung und Zusammenhang – ein Überblick. Schmerz. 1. december 2008;22(6):644–51.
10.Rabellino D, D’Andrea W, Siegle G, Frewen PA, Minshew R, Densmore M, m.fl. Neural correlates of heart rate variability in PTSD during sub- and supraliminal processing of trauma-related cues. Hum Brain Mapp. 2017;38(10):4898–907.
Presenting Author
Christian Lynæs
Poster Authors
Christian Lynæs
MSc
Department of Psychology, University of Southern Denmark, Odense, Denmark
Lead Author
Sophie Lykkegaard Ravn and PhD
Department of Psychology, University of Southern Denmark, DK
Lead Author
Søren T Skou
Ph.D.
The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy,
Lead Author
Steffan Wittrup McPhee Christensen PhD
Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark
Lead Author
Tonny Andersen
University of Southern Denmark
Lead Author
Topics
- Assessment and Diagnosis