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QUESTIONS: In patients with acute whiplash injuries, is an active treatment protocol more effective than standard treatment for reducing pain? Is early initiation better than delayed initiation of treatment?
Design
Randomised {allocation concealed*}†, unblinded, controlled trial with 6 months of follow up.
Setting
29 primary care units, 3 emergency wards, and several private clinics in Elfsborg County, southwestern Sweden.
Patients
102 patients who had an acute whiplash injury and could be randomised within 96 hours after the traumatic event. Exclusion criteria were cervical fractures, cervical dislocation, head injury, previously known symptomatic chronic neck problems, alcohol abuse, dementia, serious mental illness, or terminal illness. Follow up was 86% of randomised patients (mean age 36 y, 67% women).
Intervention
Patients were allocated to 1 of 4 groups: to active treatment within 96 hours (n=21) or after 2 weeks (n=22) …