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Whiplash Intervention Trial

Background: Whiplash-associated disorders (WAD) is the most common traffic injury and leads to a significant burden of disability and health care utilization. The clinical management of acute WAD is complex. The type, intensity, and timing of health care delivery varies greatly with some approaches potentially delaying recovery. Rising health care costs and increasing disability rates have led various governments and insurers to develop and implement guidelines for the treatment of WAD. Most guidelines emphasize education, reassurance, mobility, return-to-activity, and exercise despite their being little evidence to support their effectiveness. In Ontario, the provincial government introduced guidelines (in the form of regulations) in an attempt to ensure timely access to rehabilitation services, improve the utilization of health care resources, and establish consistent fee schedules for insurers and health care providers.

Aim: To evaluate the effectiveness  of an Ontario government-regulated rehabilitation guideline for the treatment of acute whiplash injuries.


  1. Evaluate the effectiveness of a government-regulated rehabilitation guideline compared to education and activation by general practitioners, and to a preferred-provider insurance-based rehabilitation program on self-reported global recovery from acute whiplash-associated disorders (WAD) grades I-II.
  2. Determine which of the three interventions was more effective in reducing time on insurance benefits, neck pain intensity, whiplash-related disability, depressive symptoms, and in improving health-related quality of life.

Implications: This work provides evidence of the effectiveness of a government-regulated guideline for the rehabilitation of whiplash-associated disorders. The implementation of such a guideline could promote faster recovery compared to education and activation by general practitioners, or a preferred-provider insurance-based rehabilitation.

Funding: The trial was funded by grants from Aviva Canada

Team Members: 

Pierre Côté DC, PhD (Principal Investigator)
Eleanor Boyle PhD (Co-Principal Investigator
David Cassidy DC, PhD (Co-Prinicipal investigator)
Gabrielle van der Velde DC, PhD (Co-investigator)
Simon Carette, MD (Co-investigator)
Carlo Ammendolia DC, PhD (Co-investigator)
Jill Hayden DC, PhD (Co-investigator)
Maurits van Tulder PhD (Co-Investigator)
John Frank MD, MSc (Co-Investigator)
Heather Shearer DC, MSc, PhD (candidate) (Research Coordinator)
Maja Stupar DC, PhD (Research Coordinator)
Craig Jacobs DC, MSc (Research Coordinator)
Poonam Cardoso BHS, PMP (Research Administration Officer)