11:27pm Monday 11 December 2017

Soft collar no good for whiplash

Dr Saravana KumarDr Saravana Kumar from UniSA’s School of Health Sciences says the commonly prescribed treatment is actually harmful for patients and one of many popular health care practices not based on research evidence.
 
“Whiplash associated disorders (WAD) are a significant problem in Australia and account for 42 per cent of all compulsory third party claims,” Dr Kumar says.
 
“People suffering WAD are currently offered a range of costly treatment and rehabilitation options but despite this many patients remain in constant pain and develop long-term complaints.
 
“Evidence shows that wearing soft collars is actually harmful and it is staying active which promotes recovery in whiplash, yet clinicians’ behaviour does not match this evidence.
 
“The use of soft collars for treatment of whiplash was originally developed when it was believed that whiplash could be managed like a broken bone that is immobilising the spine. However, new research evidence has disproved this theory but the use of soft collar in clinical practice continues to persist,” he says.
 
Dr Kumar, who is also the deputy director of the International Centre for Allied Health Evidence, worked with 34 physiotherapists and 16 chiropractors across Adelaide as part of a two year study of WAD treatment, funded by National Health and Medical Research Council (NHMRC) – National Institute of Clinical Studies (NICS) – Motor Accident Commission (MAC) Fellowship.
 
He says a number of factors contribute to the uptake of emerging research evidence into clinical practice.
 
“For example, the sheer volume of new research that is published poses numerous challenges for clinicians. Many clinicians simply do not have access to research articles, and even if they do, it is often limited. Clinicians also need to be discerning consumers of research as not all research is good quality research” Dr Kumar says.
 
“Many clinicians also work in a hierarchical environment where it’s difficult to question the status quo, making it hard to break away from behaviour entrenched in historical practices.
 
“Patients expectations also come into play. For example, someone who has been treated for a similar injury twenty years ago will often see a clinician and ask for the same medication or therapy, unaware that more effective treatments have been developed since.”
 
“We found clinicians were continually challenged in the implementation of research evidence into practice than originally assumed,” says Dr Kumar.
 
Changing clinicians’ behaviour to reflect current research evidence is Dr Kumar’s next challenge. He’ll be working with local and international researchers, from countries such as Canada and the United Kingdom, in a bid to better understand how practices can be changed.
 
He’ll also continue to collaborate with Queensland researchers on developing websites offering evidence based information to the general public and clinicians about commonly encountered health problems such as whiplash and lower back pain.
 
“These websites rates health care treatments according to research evidence, so consumers can clearly see which treatments are effective and those which are outdated, harmful or based on myth.
 
“Apart from the soft collar treatment for whiplash, having an x-ray for lower back pain and getting an antibiotic prescription for the common flu are other frequently requested treatments that should not be used,” Dr Kumar says. 
 
To learn more visit www.implementationcentral.com


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