Survey of general practitioner, family physician, and chiropractor's beliefs regarding the management of acute whiplash patients.

摘要

STUDY DESIGN: Questionnaire Survey. OBJECTIVE: The purpose of this study was to survey the whiplash management beliefs for practicing general practitioners, family physicians, and chiropractors. SUMMARY OF BACKGROUND DATA: Many treatments are prescribed by general practitioners, family physicians, and chiropractors for acute whiplash, but to date no survey of management beliefs for acute whiplash has been reported. METHODS: A total of 483 physicians and 123 chiropractors in the urban setting of Edmonton, Alberta, Canada were asked to participate by completing a questionnaire with 24 items designed to assess management beliefs regarding acute whiplash. RESULTS: A total of 362 physicians (75%) and 88 chiropractors (72%) completed the survey. Only 1% of physicians and none of the chiropractors believed that whiplash patients should be prescribed bed rest until almost all their pain goes away. As well, only 1% of physicians and none of the chiropractors believed that patients with acute whiplash should notreturn to work until almost all their pain goes away. More than 89% of physicians and 76% of chiropractors believed that encouragement of maintaining normal activities, even if they hurt, is important in the recovery from whiplash. Also, 91% of physicians and 84% of chiropractors agreed that exercise therapy was effective in acute whiplash patients. Physicians are more likely to have negative feelings about treating patients who have whiplash, were more likely to believe there was nothing physically wrong with many patients with chronic whiplash, and agree that nonsteroidal anti-inflammatory drugs and muscle relaxants are effective in acute whiplash. Chiropractors are more likely to agree that traction, transcutaneous electrical nerve stimulation, manipulation, massage, and acupuncture are effective in acute whiplash. CONCLUSIONS: Physicians and chiropractors generally hold beliefs that are consistent with the current evidence regarding the most helpful approaches to acute whiplash, although chiropractors were more likely to be supportive of passive therapy methods.