European Spine Journal

, Volume 17, Issue 7, pp 930–935 | Cite as

Neither the WAD-classification nor the Quebec Task Force follow-up regimen seems to be important for the outcome after a whiplash injury. A prospective study on 186 consecutive patients

  • Jouko Kivioja
  • Irene Jensen
  • Urban Lindgren
Original Article


A classification of injury and a follow-up schedule were proposed by the Quebec Task Force (QTF) in 1995. No general agreement about the clinical usefulness of the WAD-classification or of the suggested follow-up regimen exists. A series of 186 consecutive cases seen in the emergency room during the acute phase after a whiplash injury was prospectively studied for 1 year. All findings including history and physical findings were recorded using standardized QTF protocols. In one group follow-up visits were done according to the QTF regimen: at 1, 3, 6, 12 weeks and 1 year after the accident; in a control group no visit was scheduled. The outcome variable was neck pain at 1 year after the accident. After 1 year, 18% of the total number of patients had significant neck pain. Risk factors for chronic neck pain at 1 year after whiplash injury were: neck pain before the accident and a high degree of emotional distress at the time of the accident; both factors independently associated with a tenfold increased risk of developing chronic neck pain. Neither the WAD classification nor the QTF follow-up regimen could be linked to a better outcome. In this study the outcome was associated with patient-specific characteristics and not with physical signs of injury, the depth of the initial evaluation or the follow-up regimen.


QTF classification Follow-up plan Multivariate analysis Neck sprain Outcome Predictors WAD Whiplash injury 



We are obliged to Per Näsman, the Royal Institute of Technology, for statistical advice

Conflict of interest statement

There is no conflict of interest for any of the authors.


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  1. 1.Division of Orthopaedics, Department of Clinical Intervention and Technology (Huddinge)Karolinska InstituteStockholmSweden
  2. 2.Section of Personal Injury Prevention, Department of Clinical NeuroscienceKarolinska InstituteStockholmSweden

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