Theroleofphysiotherapy inthe managementofacutenecksprains following road-traffic accidents

SUMMARY Inacutewhiplash injuries, early physiotherapy hasbeenshowntoreduce painand increase cervical movement, butthecost-effectiveness ofthistreatment hasbeen questioned. Itisunclear whether thebenefits result frommanipulative physiotherapy orfromthepatient's ability toperform theaccompanying homeexercise programme wheninstructed aboutitsimportance. Inasingle blind prospective randomized trial 71 patients who received out-patient physiotherapy wereshowntohavesignificant improvement inseverity ofneckpain(P<0-01) andcervical movement(P<0-01) at1 and2monthspost-injury whencompared with33patients whoreceived analgesia anda cervical collar. Sixty-six patients whowereoffered comprehensive advice forhome mobilization byaphysiotherapist showedasimilar improvement. Thereappears tobe nodifference ineffectiveness between outpatient physiotherapy andhomemobilization.