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APHA Scientific Session and Event Listing

Pierre Côté, PhD¹, Selahadin Ibrahim, MSc¹, Linda J. Carroll, PhD², John D. Cassidy, PhD, DrMedSc³, Dorcas Beaton, PhD¹, Vicki Kristman, MSc¹, and Sheilah Hogg-Johnson, PhD¹. (1) Institute for Work and Health, 481 University Avenue, Toronto, ON MSG 2E9, Canada, 416-927-2027, sibrahim@iwh.on.ca, (2) Department of Public Health Sciences, University of Alberta, 12-102 Clinical Sciences Building, Edmonton, AB T6G 2G3, Canada, (3) Toronto Western Research Institute, University Health Network, Fell Pavilion 4-114 399 Bathurst Street, Toronto, ON M5T 2S8, Canada

We studied a cohort of Saskatchewan residents with whiplash injuries to test whether resolution of impairment and coping mediate the association between physical/psychological impairment, activity limitations, and recovery. We included 1, 244 subjects who sustained a motor vehicle injury between 1997 and 1999 and reported pain that was at least moderate in intensity. Measures of impairment, depression and activity limitations were obtained at six-week post-collision. Self-reported recovery was measured three months after the collision. Mediators were measured at the three month follow-up. We built structural equation models to quantify the direct and indirect associations between impairment, activity limitations and self-reported recovery using Mplus. Depression modified the association between physical impairment and activity limitations and self-reported recovery. In patients with significant depression (n=468), the effect of impairment and activity limitations (measured at 6-weeks) were fully mediated by resolution of impairment and passive coping, but not active coping. Impairment and activity limitations were indirectly associated with self-reported recovery, with standardized path coefficients of -0.092 (p< .05) and -0.174 respectively (p< .01). In patients without depression (n=776), the effect of impairment and activity limitations were also mediated by resolution of impairment and passive coping, but not active coping. Again, impairment and activity limitations were indirectly associated with self-reported recovery, with standardized path coefficients of -0.182 (p< .001) and -0.153 (p< .001). The overall model goodness of fit was good. In conclusion, resolution of impairment and passive coping were significant mediators of the association between impairment, activity limitations and self-reported recovery.

Learning Objectives:

• 1.Describe the concept of "recovery" in patients with musculoskeletal soft-tissue injuries
• 2.Understand the relationship between pain, functional limitations, depression and coping and recovery from whiplash injuries
• 3.Explain the mediating role of coping on recovery from whiplash injuries

Keywords: Injuries, Recovery

Presenting author's disclosure statement:

Not Answered