A multimodal approach to the physical therapy management of whiplash associated disorder

A 74-year-old female with acute whiplash associated disorder was seen for physical therapy treatment for 12 sessions over 6 weeks in an outpatient physical therapy clinic. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist. The patient was evaluated with upper cervical instability tests, the numeric pain rating scale, bubble inclinometry, goniometry, cervical and thoracic joint mobility, the craniocervical flexion test, manual muscle testing, Impact of Events Scale-Revised, Neck Disability Index, Tampa Scale for Kinesiophobia and patient report of ability to complete daily tasks, golf and drive in the community. Primary goals set for the patient were to decrease pain, increase cervical active range of motion, increase deep neck flexor strength and motor control, improve ability to perform daily tasks, decrease degree of kinesiophobia, and improve participation with golf and driving in the community. Interventions used included patient education, manual therapy, stretching and strengthening therapeutic exercises, motor control training, modalities and a home exercise program. The patient improved in cervical pain, active range of motion, deep neck flexor strength and motor control, functional ability to perform daily tasks and participation in modified golf. The patient was discharged to the care of another physical therapist to continue making functional gains due to the student physical therapist nearing the end of her clinical rotation.