Skip to main content

Advertisement

Log in

Does expecting mean achieving? The association between expecting to return to work and recovery in whiplash associated disorders: a population-based prospective cohort study

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

To determine the association between expectations to return to work and self-assessed recovery. Positive expectations predict better outcomes in many health conditions, but to date the relationship between expecting to return to work after traffic-related whiplash-associated disorders and actual recovery has not been reported. We assessed early expectations for return to work in a cohort of 2,335 individuals with traffic-related whiplash injury to the neck. Using multivariable Cox proportional hazard analysis we assessed the association between return to work expectations and self-perceived recovery during the first year following the event. After adjusting for the effects of sociodemographic characteristics, initial pain and symptoms, post-crash mood, prior health status and collision-related factors, those who expected to return to work reported global recovery 42% more quickly than those who did not have positive expectations (HRR = 1.42, 95% CI 1.26–1.60). Knowledge of return to work expectation provides an important prognostic tool to clinicians for recovery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Beaton DE, Tarasuk V, Katz JN, Wright JG, Bombardier C (2001) “Are you better?” A qualitative study of the meaning of recovery. Arthritis Rheum 45:270–279. doi:10.1002/1529-0131(200106)45:3<270::AID-ART260>3.0.CO;2-T

    Article  PubMed  CAS  Google Scholar 

  2. Berglund A, Bodin L, Jensen I, Wiklund A, Alfredsson L (2006) The influence of prognostic factors on neck pain intensity, disability, anxiety and depression over a 2-year period in subjects with acute whiplash injury. Pain 125:244–256. doi:10.1016/j.pain.2006.05.026

    Article  PubMed  Google Scholar 

  3. Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 305:160–164

    Article  PubMed  CAS  Google Scholar 

  4. Brison RJ, Hartling L, Dostaler S, Leger A, Rowe BH, Stiell I, Pickett W (2005) A randomized controlled trial of an educational intervention to prevent the chronic pain of whiplash associated disorders following rear-end motor vehicle collisions. Spine 30:1799–1807. doi:10.1097/01.brs.0000174115.58954.17

    Article  PubMed  Google Scholar 

  5. Carroll LJ, Holm LW, Ferrari R, Ozegovic D, Cassidy JD (2009) Recovery in whiplash associated disorders: do you get what you expect? J Rheum [Epub ahead of print]. doi:10.3899/jrheum.080680

  6. Cassidy JD, Carroll LJ, Cote P, Frank J (2007) Does multidisciplinary rehabilitation benefit whiplash recovery? Results of a population-based incidence cohort study. Spine 32:126–131. doi:10.1097/01.brs.0000249526.76788.e8

    Article  PubMed  Google Scholar 

  7. Cassidy JD, Carroll LJ, Cote P, Lemstra M, Berglund A, Nygren A (2000) Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. N Engl J Med 342:1179–1186. doi:10.1056/NEJM200004203421606

    Article  PubMed  CAS  Google Scholar 

  8. Cole DC, Mondloch MV, Hogg-Johnson S, Early Claimant Cohort Prognostic Modelling Group (2002) Listening to injured workers: how recovery expectations predict outcomes—a prospective study. CMAJ 166:749–754

    PubMed  Google Scholar 

  9. Cote P, Cassidy JD, Carroll L, Frank JW, Bombardier C (2001) A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine 26:E445–E458. doi:10.1097/00007632-200110010-00020

    Article  PubMed  CAS  Google Scholar 

  10. Cote P, Kristman V, Vidmar M, Van Eerd D, Hogg-Johnson S, Beaton D, Smith PM (2008) The prevalence and incidence of work absenteeism involving neck pain: a cohort of Ontario lost-time claimants. Spine 33:S192–S198

    Article  PubMed  Google Scholar 

  11. Dasinger LK, Krause N, Deegan LJ, Brand RJ, Rudolph L (1999) Duration of work disability after low back injury: a comparison of administrative and self-reported outcomes. Am J Ind Med 35:619–631. doi:10.1002/(SICI)1097-0274(199906)35:6<619::AID-AJIM9>3.0.CO;2-I

    Article  PubMed  CAS  Google Scholar 

  12. Dionne CE, Bourbonnais R, Fremont P, Rossignol M, Stock SR, Larocque I (2005) A clinical return-to-work rule for patients with back pain. CMAJ 172:1559–1567. doi:10.1503/cmaj.1041159

    PubMed  Google Scholar 

  13. Ferrari R (2002) Whiplash—review of a commonly misunderstood injury. Am J Med 112:162–163. doi:10.1016/S0002-9343(01)00953-6

    Article  PubMed  Google Scholar 

  14. Ferrari R, Lang C (2005) A cross-cultural comparison between Canada and Germany of symptom expectation for whiplash injury. J Spinal Disord Tech 18:92–97. doi:10.1097/01.bsd.0000138214.70260.91

    Article  PubMed  Google Scholar 

  15. Gross DPBM (2005) Work-related recovery expectations and the prognosis of chronic low back pain within a Workers’ Compensation setting. J Occup Environ Med 47:428–433

    Article  PubMed  Google Scholar 

  16. Gross DP, Battie MC (2005) Predicting timely recovery and recurrence following multidisciplinary rehabilitation in patients with compensated low back pain. Spine 30:235–240. doi:10.1097/01.brs.0000150485.51681.80

    Article  PubMed  Google Scholar 

  17. Guzman J, Hayden J, Furlan AD, Cassidy JD, Loisel P, Flannery J, Gibson J, Frank JW (2007) Key factors in back disability prevention: a consensus panel on their impact and modifiability. Spine 32:807–815. doi:10.1097/01.brs.0000259080.51541.17

    Article  PubMed  Google Scholar 

  18. Hagen EM, Svensen E, Eriksen HR (2005) Predictors and modifiers of treatment effect influencing sick leave in subacute low back pain patients. Spine 30:2717–2723. doi:10.1097/01.brs.0000190394.05359.c7

    Article  PubMed  Google Scholar 

  19. Hendriks EJ, Scholten-Peeters GG, van der Windt DA, Neeleman-van der Steen CW, Oostendorp RA, Verhagen AP (2005) Prognostic factors for poor recovery in acute whiplash patients. Pain 114:408–416. doi:10.1016/j.pain.2005.01.006

    Article  PubMed  Google Scholar 

  20. Hogg-Johnson S, van der Velde G, Carroll LJ, Holm LW, Cassidy JD, Guzman J, Cote P, Haldeman S, Ammendolia C, Carragee E, Hurwitz E, Nordin M, Peloso P, Bone and Joint Decade (2008) The burden and determinants of neck pain in the general population: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine 33:S39–S51

    Article  PubMed  Google Scholar 

  21. Holm LW, Carroll LJ, Cassidy JD, Skillgate E, Ahlbom A (2008) Expectations for recovery important in the prognosis of whiplash injuries. PLoS Med 5:e105. doi:10.1371/journal.pmed.0050105

    Article  PubMed  Google Scholar 

  22. Hudak PL, Cole DC, Haines AT (1996) Understanding prognosis to improve rehabilitation: the example of lateral elbow pain. Arch Phys Med Rehabil 77:586–593. doi:10.1016/S0003-9993(96)90300-7

    Article  PubMed  CAS  Google Scholar 

  23. Iles RA, Davidson M, Taylor NF (2008) A systematic review of psychosocial predictors of failure to return to work in non-chronic non-specific low back pain. Occup Environ Med 65:507–517. doi:10.1136/oem.2007.036046

    Article  PubMed  CAS  Google Scholar 

  24. Janzen JA, Silvius J, Jacobs S, Slaughter S, Dalziel W, Drummond N (2006) What is a health expectation? Developing a pragmatic conceptual model from psychological theory. Health Expect 9:37–48. doi:10.1111/j.1369-7625.2006.00363.x

    Article  PubMed  Google Scholar 

  25. Jensen MPTJRJK (1991) Coping with chronic pain: a critical review of the literature. Pain 47:249–283. doi:10.1016/0304-3959(91)90216-K

    Article  PubMed  CAS  Google Scholar 

  26. Karjalainen K, Malmivaara A, Mutanen P, Pohjolainen T, Roine R, Hurri H (2003) Outcome determinants of subacute low back pain. Spine 28:2634–2640. doi:10.1097/01.BRS.0000099097.61495.2E

    Article  PubMed  Google Scholar 

  27. Margolis RBTRKSJ (1986) A rating system for use with patient drawings. Pain 24:57–65. doi:10.1016/0304-3959(86)90026-6

    Article  PubMed  CAS  Google Scholar 

  28. Mondloch MV, Cole DC, Frank JW (2001) Does how you do depend on how you think you’ll do? A systematic review of the evidence for a relation between patients’ recovery expectations and health outcomes. CMAJ 165:174–179

    PubMed  CAS  Google Scholar 

  29. Radloff LS (1977) The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401. doi:10.1177/014662167700100306

    Article  Google Scholar 

  30. Rothman KJ, Greenland S (2005) Causation and causal inference in epidemiology. Am J Public Health 95(Suppl 1):S144–S150. doi:10.2105/AJPH.2004.059204

    Article  PubMed  Google Scholar 

  31. Sandstrom J, Esbjornsson E (1986) Return to work after rehabilitation. The significance of the patient’s own prediction. Scand J Rehabil Med 18:29–33

    PubMed  CAS  Google Scholar 

  32. Shaw WS, Huang YH (2005) Concerns and expectations about returning to work with low back pain: identifying themes from focus groups and semi-structured interviews. Disabil Rehabil 27:1269–1281. doi:10.1080/09638280500076269

    Article  PubMed  Google Scholar 

  33. SPSS Inc (2004) SPSS for Windows. Version 16. Prentice Hall, Upper Saddle River

    Google Scholar 

  34. Sterling M (2005) Physical and psychological factors predict outcome following whiplash injury. Pain 114:141–148. doi:10.1016/j.pain.2004.12.005

    Article  PubMed  Google Scholar 

  35. Sterling M (2006) Physical and psychological factors maintain long-term predictive capacity post-whiplash injury. Pain 122:102–108. doi:10.1016/j.pain.2006.01.014

    Article  PubMed  Google Scholar 

  36. Suissa S, Harder S, Veilleux M (2001) The relation between initial symptoms and signs and the prognosis of whiplash. Eur Spine J 10:44–49. doi:10.1007/s005860000220

    Article  PubMed  CAS  Google Scholar 

  37. Turner JA, Franklin G, Fulton-Kehoe D, Sheppard L, Wickizer TM, Wu R, Gluck JV, Egan K (2006) Worker recovery expectations and fear-avoidance predict work disability in a population-based workers’ compensation back pain sample. Spine 31:682–689. doi:10.1097/01.brs.0000202762.88787.af

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dejan Ozegovic.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ozegovic, D., Carroll, L.J. & David Cassidy, J. Does expecting mean achieving? The association between expecting to return to work and recovery in whiplash associated disorders: a population-based prospective cohort study. Eur Spine J 18, 893–899 (2009). https://doi.org/10.1007/s00586-009-0954-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-009-0954-4

Keywords

Navigation