# Predictors of Delayed Recovery in Japanese Patients With Whiplash-Associated Disorders: The Role of Initial Catastrophizing and Disability Levels

## TL;DR

The study identifies initial levels of pain-related fear and disability as predictors of longer recovery times in Japanese patients with whiplash injuries.

## Contribution

The study introduces specific cut-off values for the Neck Disability Index and Pain Catastrophizing Scale to predict delayed recovery in whiplash patients.

## Key findings

- An initial Neck Disability Index score of ≥35% increases the odds of delayed recovery by 3.19 times.
- A Pain Catastrophizing Scale score of ≥12 increases the odds of delayed recovery by 4.46 times.

## Abstract

Background

Whiplash-associated disorders are sequelae of traffic accidents that frequently result in sustained pain and disability due to a broader spectrum of symptoms than typical neck pain. Several studies have used the length of time from injury to the completion of insurance claims as a measure of recovery time for patients with whiplash-associated disorders. However, studies on the initial factors in patients whose treatment exceeds 90 days are lacking. Therefore, this study aimed to identify key factors predicting prolonged treatment duration in Japanese patients with whiplash-associated disorders.

Methodology

We included 103 outpatients who presented with neck pain after a motor vehicle accident. During their initial visits, various factors were comprehensively assessed, including pain intensity, Neck Disability Index (NDI), six items of the Pain Catastrophizing Scale (PCS-6), a short version of the Tampa Scale of Kinesiophobia, the Injustice Experience Questionnaire, cervical range of motion, and radiographic findings. Patients were categorized into “early recovery” or “delayed recovery” groups based on the time elapsed between the first assessment and the end of the treatment period. Logistic regression analysis identified cut-off values from receiver operating characteristic curves to help identify factors contributing to delays in the recovery process.

Results

Analysis showed that initial NDI and PCS-6 scores of ≥35% and ≥12, respectively, were significant predictors of delayed recovery, increasing the odds of delay by factors of 3.19 and 4.46, respectively.

Conclusions

Our findings may aid in appropriate clinical decision-making and lead to interventions to minimize the negative impact of prolonged treatment duration on patient recovery.