OPERATIONAL DEFINITIONS

Isolated Not associated with other injuries.
Obtunded Dulled consciousness.
FormRecording information from the history and physical examination, management decisions and grading of the WAD should be completed for all initial visits and for all reassessment visits for Grade I-III, and preferably on a standardized form (Appendix I).
History Includes characteristics of patient, prior history of medical and other pertinent factors, including neck problems, circumstances and mechanism of injury, nature and time of onset of all symptoms, and self-assessment of health status.
Physical examination Includes inspection, palpation, range of motion, neurological exam, assessment of associated injuries, general health and mental status; required details can be found on data form for all recommended visits (see Form, above).
Plain X rays Include anteroposterior, lateral and open-mouth views; all seven cervical vertebrae and the C7-T1 level should be included.
Reassurance Patients should be reassured that most WAD are benign and self-limiting, and should be encouraged to resume usual activities of life as soon as possible.
Prescribe activity Interventions should focus on promoting activity. Range of motion exercises should be implemented. Techniques that promote mobility of the cervical spine can be used, but should be applied by qualified personnel. Interventions that impede active mobilization of the neck are not indicated.
Return to usual activities Patients should be advised to resume their activities of daily living (work, studying, leisure, social, etc...), as soon as possible (usually immediately for Grade I). It should be explained to patients that usual activities may be temporarily painful but not harmful in WAD.
UnresolvedUnable to resume usual activities. A patient who still has residual pain or limitation of range of motion, but who is able to resume work and other usual activities is considered to have resolved WAD.
Specialized adviceConsultation with a health professional with in-depth formal training in managing WAD.
Reassessment Includes history taking and physical examination as during initial visit and specialized advice as required.
Multidisci-plinary team Health professionals with in-depth formal training in musculoskeletal disorders, psychosocial assessment and other specialties.