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

Eur Spine J. 2008 Jul;17(7):930-5. doi: 10.1007/s00586-008-0675-0. Epub 2008 Apr 22.


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.

Publication types

  • Historical Article

MeSH terms

  • Accidents, Traffic
  • Adolescent
  • Aged
  • Female
  • Follow-Up Studies
  • History, 16th Century
  • History, 17th Century
  • Humans
  • Male
  • Neck Pain / epidemiology*
  • Neck Pain / etiology
  • Risk Factors
  • Whiplash Injuries / classification*
  • Whiplash Injuries / complications
  • Whiplash Injuries / physiopathology