Long-term recovery from post-traumatic neck pain - a prospective cohort study in the emergency department

Funding
Danish Victims Fund: 3.000.000 DKK
SDU: 1 year PhD stipendiat
NSR-Sygehus 1 year salary PhD

Background
Fifteen to twenty-five percent involved in an accident causing whiplash continue to experience moderate-to-severe symptoms and functional impairment one-year post-trauma. Factors such as age, high pain intensity, hypersensitivity to pain, and early post-traumatic hyperarousal are associated with persistent neck pain. However, research on recovery patterns and their predictors is still needed, including biomarkers for pre- and peri-traumatic stress, and the value of early prediction tools.
Aims
To explore recovery over time (3,6,12 MO post-injury) and to validate and compare two existing prediction and screening tools for long-term post-traumatic neck pain. Furthermore, to assess the predictive value of adding Heart Rate Variability measurements to the prediction models.
Methods
This prospective cohort study will include 100 participants (≥18 years) suffering from posttraumatic neck pain sustained within 72 hours of an accident. At baseline (a combination of inclusion and 1-week assessment), eligible participants will undergo a thorough evaluation, including assessment of descriptive characteristics, self-reported variables (e.g., pain, disability, sleep quality, and posttraumatic stress), biomarkers (e.g., heart rate variability and hair cortisol), and clinical tests (e.g., cervical range of motion). Follow-up will be conducted at 3-, 6-, and 12-months post-trauma. Further, register data (e.g., data on labour market attachment) will be added for the period. Among other methods, a receiver operating curve (ROC) and multivariable regression analyses will be used to evaluate performance and associations of the prediction tools and their associations with measures of heart rate variability.