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4. Review and take recommended action

Use outcome measures to help to monitor progress and identify people at risk of poor recovery.

This is only a guide and there will always be individual differences.

Green light - recommended

Recommended

Below provides a summary of how to review patient progress, and what action to take based on the indicators of recovery or poor recovery during the first 12 weeks.

Use these assessments as part of the treatment program to monitor progress. If your initial assessment is more than seven days post-injury, use these intervals as a guide.

Initial assessment

Do these assessments:

Indicates recovery Recommended action
  • NDI less than 15/50
  • VAS less than 5/10
  • Good expectation of
    recovery
Indicates risk of poor recovery Recommended action
  • NDI greater than 15/50
  • VAS greater than 5/10
  • Poor expectation of recovery
  • Refer for physical therapy
  • Consider further psychological assessment

7 days post injury

Do these assessments:

Indicates recovery Recommended action
  • Improvement of 10% on NDI and VAS
  • Continue recommended treatments
Indicates risk of poor recovery Recommended action
  • VAS and NDI scores are high or unchanged
  • Review treatment types and intensity and consider other recommended treatments

3 weeks post injury

Do these assessments:

Where the patient has unchanged VAS and NDI, do this assessment:

Indicates recoveryRecommended action
  • Improvement of 10% on NDI and VAS
  • Continue recommended treatments
Indicates risk of poor recoveryRecommended action
  • VAS and NDI scores are high or unchanged
  • IES higher than 25
  • Conduct a more comprehensive
    physical and psychological
    examination
  • Consider referral to a clinician
    with expertise in whiplash
    management
  • Refer to psychologist for:
    • adjustment difficulties
    • management of pain, and/or
    • posttraumatic stress
      management

6 weeks post injury

Do these assessments:

Where the patient has unchanged VAS and NDI scores, do this assessment:

Indicates recoveryRecommended action
  • Improvement of 10% on NDI and VAS
  • Gradually withdraw treatment
Indicates risk of poor recoveryRecommended action
  • VAS and NDI scores are
    high or unchanged
  • IES higher than 25
  • Consider referral to a clinician
    with expertise in whiplash
    management
  • Refer to psychologist for:
    • adjustment difficulties
    • management of pain, and/or
    • posttraumatic stress
      management

12 weeks post injury

Do these assessments:

Indicates recoveryRecommended action
  • Improvement of 10% on NDI and VAS
  • Gradually withdraw treatment and focus interventions which require active participation and independence
Indicates risk of poor recoveryRecommended action
  • VAS and NDI scores are high or unchanged
  • IES higher than 25