Document Type

Case Report


Physical Therapy & Rehabilitation Science

Degree Name

DPT (Doctor of Physical Therapy)

Session and Year of Graduation

Fall 2018


Laura Frey Law


Background: Whiplash-Associated Disorders have a relatively high rate of chronicity with 30-50% of patients sustaining systematic whiplash injury reporting chronic symptoms. Physical therapy is often recommended as a treatment and this case report looks to contribute to the knowledge base for future evidence-based treatment of impairments in this population. Description: The patient was a 41-year-old male with complaint of cervical and thoracic stiffness and pain following a high speed (>45mph) motor vehicle accident (MVA). The patient was evaluated by a physician two weeks following accident and referred to therapy 4 weeks following MVA. Methods and Measures: An examination for physical impairments was performed, including the measurement of cervical range of motion using goniometry, and the assessment of soft tissue and segmental mobility of the upper thoracic and cervical spine regions. The FOTO (Focus on Therapeutic Outcomes) questionnaire was used at intake, 4 weeks and 8 weeks. Intervention: Manual therapy and therapeutic exercises were used to address the identified impairments. Manual therapy techniques included soft tissue mobilization, joint mobilization, and joint manipulation. The patient was seen for 8 visits scheduled over 8 weeks. Outcomes: The patient reported complete resolution of symptoms and demonstrated a 21-point increase in FOTO scores at 8 weeks. The patient also demonstrated significant improvements in cervical lateral flexion and rotation range of motion at the 8 weeks mark. Discussion: This case report highlights various interventions used to address cervical and thoracic spine impairment following a high-speed motor vehicle accident. The purpose of this case report is to describe the use of HVLAT manipulations to treat acute cervical impairments and therapeutic exercises and neuromuscular reeducation to address chronicity of symptoms. Conclusion: Addressing impairments of the cervical and thoracic spine with high-velocity low-amplitude thrust manipulations and therapeutic exercises in patients with whiplash-associated disorder is associated with reduced pain, decreased stiffness, improved functional outcome and increased cervical range of motion. More research and follow up is needed to look at the long-term efficacy of said treatment in the prevention of chronic whiplash symptoms.


Whiplash; thoracic spine; cervical spine; orthopedics; physical therapy; rehabilitation; high-velocity low-amplitude thrust; manipulation; FOTO


10 pages


Copyright © 2018 Alex Ferrer