Prognostic Factors of Perceived Disability and Perceived Recovery After Whiplash

Abstract

Objectives. The understanding of the role that cognitive and emotional factors play in how an individual recovers from a whiplash injury, is important. Hence, we sought to evaluate if pain-related cognitions (self-efficacy beliefs, expectation of recovery, pain catastrophizing, optimism, and pessimism) and emotions (kinesiophobia) are longitudinally associated with the transition to chronic whiplash associated disorders (WAD) in terms of perceived disability, and perceived recovery at 6 and 12-months. Methods: One-hundred and sixty-one participants with acute or subacute WAD were included. The predictors were: self-efficacy beliefs, expectation of recovery, pain catastrophizing, optimism, and pessimism, pain intensity, and kinesiophobia. The two outcomes were the dichotomized scores of perceived disability and recovery expectations at six and twelve months. Stepwise regression with bootstrap resampling was performed to identify the predictors most strongly associated with the outcomes, and the stability of such selection. Results. Baseline perceived disability, pain catastrophizing, and expectation of recovery were the most likely to be statistically significant, with an overage frequency of 87.2%, 84.0%, and 84.0%, respectively. Discussion: Individuals with higher expectation of recovery and lower levels of pain catastrophizing and perceived disability at baseline, have higher perceived recovery and perceived disability at 6 and 12-months. These results have important clinical implications as both factors are modifiable via health education approaches.