Additional Emergency Department Staff Training and Physical Therapy Provide No Long-Term Benefit for Whiplash

Clinical guidelines recommending physical therapy for whiplash are not evidence-based. To assess the benefit of additional staff training and early physical therapy, researchers performed a two-step pragmatic study of 3851 patients presenting to 15 emergency departments (EDs) in the U.K. with acute whiplash injuries, primarily after motor vehicle collisions. The active management training group (>500 clinicians) provided patients with reassurance, encouragement to return to regular activities, advice on consistent use of analgesia, and direction that a neck collar should be avoided.

In step one, the EDs were randomized to provide usual care (1598 patients) or active management (2253 patients). Among the 70% of patients who participated in 12…