Demographic Characteristics of 38 Patients Injured in Motor Vehicle Accidents Referred by Chiropractors to Physiatrists

Department of Rehabilitation Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107, USA.
Journal of manipulative and physiological therapeutics (Impact Factor: 1.48). 11/2009; 32(9):772-5. DOI: 10.1016/j.jmpt.2009.10.004
Source: PubMed


The purpose of this study is to describe the demographic profile of patients in the New Jersey area who are involved in motor vehicle personal injury lawsuits and who are referred from chiropractors to physiatrists.
The study design was a prospective chart review of patients (N = 38) referred to a private physiatric practice from 5 chiropractic practices. Patient data collected at initial consultation included age, employment status, emergency department consultation, time since accident, visual analog score, neck pain and back pain, review of systems, and functional limitations.
The average patient was 37.1 years old, with male-to-female ratio nearly 1:1, and presenting 4.5 months after the accident; 81.6% were employed before the accident, 25.8% of which stopped working. The average pain score was 6.6 on a visual analog scale. Neck and back pain were common at 84.2% and 89.5%, respectively. Other complaints included headaches, sleeping difficulties, dizziness, depression, and anxiety. Limitations in function was reported in most patients.
In this study, patients referred to a physiatrist from doctors of chiropractic had neck and low back pain not requiring hospital admission. Patients referred tended to have complicated cases with a variety of medical, legal, and psychological factors that are associated with delayed recovery. Physiatrists may be uniquely suited to assist chiropractors in management of complicated patients who have been involved in motor vehicle personal injury lawsuits and who have multidisciplinary needs.

2 Reads

  • No preview · Article · Dec 2010 · Free Radical Biology and Medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to investigate whether a computer interviewing system (CIS) could be used as part of the periodic patient reassessment process, if patients and practitioners perceived that the CIS enhanced communication, and if the CIS could be used to identify patients with possible anxiety and/or depression. An observational method was used, whereby the CIS was used to augment the usual patient reassessment routine in a chiropractic clinic. One clinic in the Dundee region, with 3 chiropractors, collected information from 60 patients using a CIS directly before the patient treatment session. The patients were then asked to rate whether they had disclosed new information relative to their care, if they felt better prepared, or if it had helped them to formulate questions. The chiropractors reported whether the interview transcript was useful, if it helped to identify communication issues, and if it had altered the treatment session. The doctors of chiropractic rated the interview transcript as useful for 83% of patients, they altered the treatment session for 20% of patients, and the CIS helped to identify communication difficulties for 13% of patients. The chiropractors were surprised by the Hospital Anxiety and Depression Scale results for 23% of patients. The patients were positive about the inclusion of the CIS, with 42% saying that they disclosed new information and 33% saying that they felt better prepared for the session with the chiropractor after having used the CIS. The CIS was acceptable to 90% of patients. The inclusion of the CIS at this one clinic appeared to be a useful addition to the periodic patient reassessment process and was perceived to be an efficient media to evaluate Hospital Anxiety and Depression Scale scores.
    No preview · Article · Sep 2011 · Journal of manipulative and physiological therapeutics
  • [Show abstract] [Hide abstract]
    ABSTRACT: Synthesis and application of research. To provide a framework to consider the role of signs and symptoms of postural control disturbance in the transition to chronicity after a whiplash trauma. Dizziness is one of the most frequent complaints in those with persistent pain after a whiplash trauma and is often associated with postural control disturbances. Focus paper to review the causes, management, onset, and relationships of such signs and symptoms after a whiplash trauma to explore the role they may have in the transition to chronicity. Contemporary literature suggests these signs and symptoms are often, but not always, aligned with those with significant neck pain and disability and have been related to a poorer prognosis. There are obvious links between the cervical proprioceptors and the musculoskeletal system, but links to the autonomic nervous, vestibular, and visual systems and influence on pain modulation are important. Postural control may have potential to alter other systems and affect pain and should be considered as one of the processes that might influence the transition to chronicity after a whiplash trauma. Future research should monitor the effect that addressing abnormal cervical afferent input has on not just dizziness and postural control but other symptoms such as altered pain processing and psychological distress. The causes of transition into chronicity after a whiplash trauma are present early and appear to be multifactorial. Pain sensitivity and psychosocial distress have recently been considered but postural deficits and the symptom of dizziness also appear to have a role.It is recommended that future research address these issues to further the understanding of the transition to chronicity after a whiplash trauma.
    No preview · Article · Dec 2011 · Spine
Show more