Exploratory Study of Associations and Agreement between Prognostic Patient-Registered Factors, Physiotherapists’ Intuitive Synthesis, and Patient-Reported Factors in Whiplash-Associated Disorders
Background: A large proportion of people who sustain a whiplash injury will have persistent pain, disability, and participation problems. Several prognostic factors for functional recovery have been reported in the literature but these factors are often evaluated based on differing implementations i...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/6/2330 |
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| author | Rob A. B. Oostendorp Gwendolyne G. M. Scholten-Peeters Jan Mulder Emiel Van Trijffel Geert M. Rutten Margot De Kooning Marjan Laekeman Nathalie Roussel Jo Nijs J. W. Hans Elvers |
| author_facet | Rob A. B. Oostendorp Gwendolyne G. M. Scholten-Peeters Jan Mulder Emiel Van Trijffel Geert M. Rutten Margot De Kooning Marjan Laekeman Nathalie Roussel Jo Nijs J. W. Hans Elvers |
| author_sort | Rob A. B. Oostendorp |
| collection | DOAJ |
| description | Background: A large proportion of people who sustain a whiplash injury will have persistent pain, disability, and participation problems. Several prognostic factors for functional recovery have been reported in the literature but these factors are often evaluated based on differing implementations in clinical practice. Additionally, physiotherapists also rely on their clinical intuition to estimate the functional prognosis of their patients, but this is seldom measured in experimental research. Furthermore, no study to date has explored the associations between clinical intuition, clinically estimated factors, and objectively measured factors for functional recovery of patients with Whiplash-Associated Disorders (WAD). Aim: The aim of this exploratory study is to evaluate associations between prognostic factors for functional recovery, based on routinely collected data in a specialized primary care physiotherapy practice in a consecutive sample of patients (n = 523) with WAD. Methods: Three sources of prognostic factors were selected: (1) physiotherapists’ synthesis of clinical intuition in terms of high-risk, inconclusive risk, or low-risk for functional recovery, (2) patient-registered factors from history taking, and (3) patient-reported prognostic factors derived from questionnaires. Prognostic factors were selected based on the literature, recommendations in Dutch clinical practice guidelines, and consensus between experts. Spearman’s rank correlation coefficients were calculated to explore the associations between sources of prognostic factors, using a cutoff ≥0.25 for acceptable association. Results: Associations between physiotherapists’ intuitive synthesis and patient-registered variables were substantial (<i>r<sub>s</sub></i> = 0.86), between patient-registered variables and patient-reported variables fair (ranging from 0.30 to 0.41) to substantial (ranging from 0.69 to 0.73), and between physiotherapists intuitive synthesis and patient-reported variables fair (ranging from 0.30 to 0.37). Conclusion: When estimating prognosis for functional recovery using clinical reasoning, physiotherapists should integrate patients’ registered experience of their course of recovery, as well as the timeline after an accident, with their own synthesis of clinical intuition regarding prognostic factors in patients with WAD. |
| first_indexed | 2024-03-11T06:21:54Z |
| format | Article |
| id | doaj.art-346de43b5a73436786a077e50613602b |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T06:21:54Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-346de43b5a73436786a077e50613602b2023-11-17T11:51:22ZengMDPI AGJournal of Clinical Medicine2077-03832023-03-01126233010.3390/jcm12062330Exploratory Study of Associations and Agreement between Prognostic Patient-Registered Factors, Physiotherapists’ Intuitive Synthesis, and Patient-Reported Factors in Whiplash-Associated DisordersRob A. B. Oostendorp0Gwendolyne G. M. Scholten-Peeters1Jan Mulder2Emiel Van Trijffel3Geert M. Rutten4Margot De Kooning5Marjan Laekeman6Nathalie Roussel7Jo Nijs8J. W. Hans Elvers9Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, 6525 Nijmegen, The NetherlandsAmsterdam Movement Sciences Program Musculoskeletal Health, Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, 1081 Amsterdam, The NetherlandsScientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, 6525 Nijmegen, The NetherlandsZiekenhuisgroep Twente, ZGT Academy, 7609 Almelo, The NetherlandsResearch Program of Organization of Healthcare and Social Services, School of Health Studies, HAN University of Applied Science, 6826 Nijmegen, The NetherlandsPain in Motion International Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, BelgiumDepartment of Physiological Psychology, Otto-Friedrich University of Bamberg, 96047 Bamberg, GermanyDepartment of Physiotherapy and Rehabilitation Sciences (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, BelgiumPain in Motion International Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, BelgiumDepartment of Public Health and Research, Radboud University Nijmegen Medical Centre, 6525 Nijmegen, The NetherlandsBackground: A large proportion of people who sustain a whiplash injury will have persistent pain, disability, and participation problems. Several prognostic factors for functional recovery have been reported in the literature but these factors are often evaluated based on differing implementations in clinical practice. Additionally, physiotherapists also rely on their clinical intuition to estimate the functional prognosis of their patients, but this is seldom measured in experimental research. Furthermore, no study to date has explored the associations between clinical intuition, clinically estimated factors, and objectively measured factors for functional recovery of patients with Whiplash-Associated Disorders (WAD). Aim: The aim of this exploratory study is to evaluate associations between prognostic factors for functional recovery, based on routinely collected data in a specialized primary care physiotherapy practice in a consecutive sample of patients (n = 523) with WAD. Methods: Three sources of prognostic factors were selected: (1) physiotherapists’ synthesis of clinical intuition in terms of high-risk, inconclusive risk, or low-risk for functional recovery, (2) patient-registered factors from history taking, and (3) patient-reported prognostic factors derived from questionnaires. Prognostic factors were selected based on the literature, recommendations in Dutch clinical practice guidelines, and consensus between experts. Spearman’s rank correlation coefficients were calculated to explore the associations between sources of prognostic factors, using a cutoff ≥0.25 for acceptable association. Results: Associations between physiotherapists’ intuitive synthesis and patient-registered variables were substantial (<i>r<sub>s</sub></i> = 0.86), between patient-registered variables and patient-reported variables fair (ranging from 0.30 to 0.41) to substantial (ranging from 0.69 to 0.73), and between physiotherapists intuitive synthesis and patient-reported variables fair (ranging from 0.30 to 0.37). Conclusion: When estimating prognosis for functional recovery using clinical reasoning, physiotherapists should integrate patients’ registered experience of their course of recovery, as well as the timeline after an accident, with their own synthesis of clinical intuition regarding prognostic factors in patients with WAD.https://www.mdpi.com/2077-0383/12/6/2330whiplash associated disordersprognostic factorsprognosisfunctional recoveryroutinely collected dataclinical reasoning |
| spellingShingle | Rob A. B. Oostendorp Gwendolyne G. M. Scholten-Peeters Jan Mulder Emiel Van Trijffel Geert M. Rutten Margot De Kooning Marjan Laekeman Nathalie Roussel Jo Nijs J. W. Hans Elvers Exploratory Study of Associations and Agreement between Prognostic Patient-Registered Factors, Physiotherapists’ Intuitive Synthesis, and Patient-Reported Factors in Whiplash-Associated Disorders Journal of Clinical Medicine whiplash associated disorders prognostic factors prognosis functional recovery routinely collected data clinical reasoning |
| title | Exploratory Study of Associations and Agreement between Prognostic Patient-Registered Factors, Physiotherapists’ Intuitive Synthesis, and Patient-Reported Factors in Whiplash-Associated Disorders |
| title_full | Exploratory Study of Associations and Agreement between Prognostic Patient-Registered Factors, Physiotherapists’ Intuitive Synthesis, and Patient-Reported Factors in Whiplash-Associated Disorders |
| title_fullStr | Exploratory Study of Associations and Agreement between Prognostic Patient-Registered Factors, Physiotherapists’ Intuitive Synthesis, and Patient-Reported Factors in Whiplash-Associated Disorders |
| title_full_unstemmed | Exploratory Study of Associations and Agreement between Prognostic Patient-Registered Factors, Physiotherapists’ Intuitive Synthesis, and Patient-Reported Factors in Whiplash-Associated Disorders |
| title_short | Exploratory Study of Associations and Agreement between Prognostic Patient-Registered Factors, Physiotherapists’ Intuitive Synthesis, and Patient-Reported Factors in Whiplash-Associated Disorders |
| title_sort | exploratory study of associations and agreement between prognostic patient registered factors physiotherapists intuitive synthesis and patient reported factors in whiplash associated disorders |
| topic | whiplash associated disorders prognostic factors prognosis functional recovery routinely collected data clinical reasoning |
| url | https://www.mdpi.com/2077-0383/12/6/2330 |
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