Objective: Chiropractic care is widely used to manage whiplash-associated disorders (WAD) and the related vertebral subluxations that arise from such injuries. Postulated mechanisms include improvement in cervical range of motion (cROM) and lordotic alignment. Some patients do not adhere to care plans and frequently self-determine care conclusions before meeting maximum medical
improvement (MMI), which may affect final outcomes. This study evaluated the efficacy of chiropractic in managing patients with WAD, as well as the possible relationship between adherence to care plans and clinical outcomes.
Methods: This study utilized a retrospective analysis of clinical data from an active chiropractic clinic. Cases were evaluated for criteria of interest, including completion of care by reaching MMI, number of visits, pre/post neck disability index (NDI), and improvement percentage. MMI was based on clinical decisionmaking rendered by the managing chiropractor, as informed by history and exam findings.
Results: Initially, 23 participants met the study inclusion criteria. Several were eliminated due to incomplete NDI data, resulting in a total of 14 qualified participants who suffered WAD after motor vehicle collision (MVC)-related cervical acceleration-deceleration (CAD) injury. The average improvement in the MMI group was 82.1%, whereas the non-MMI group showed an average
improvement of 37.3%. There was a statistically significant difference between the mean improvement in each group
Conclusion: The outcomes were superior in the MMI group. Chiropractic care was associated with improved NDI outcomes when care plans were followed, and MMI was reached. This was true independent of total visit quantity.
Key words: chiropractic, whiplash associated disorders, cervical accelerationdeceleration injury, vertebral subluxation, neck disability index, maximum medical improvement, spinal manipulation, spinal adjustment
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