Professor Michele Sterling’s research has created a paradigm shift in the way road traffic injuries are managed.
“Up until fairly recently, all people who presented with whiplash injuries following a car crash were treated the same,” Professor Sterling said.
“It was mainly thought of as a physical injury, but we realise now that with any injury there is distress and stress, particularly with traumatic events such as motor vehicle accidents.”
Professor Sterling says the added trauma of seeking compensation and processing a car crash can have lasting effects.
“These types of injuries can have an added stress for people as well because they have to deal with compensation systems,” she said.
“There are all sorts of influences on people’s recovery.
“Some people recover well, while others transition to chronic pain, and we’re still trying to figure out why.”
About half of patients recover fully, while 25 per cent develop mild levels of disability and the other 25 per cent suffer on-going moderate to severe pain and disability.
With this in mind, Professor Sterling and colleagues at the RECOVER Injury Research Centre set about developing a risk-screening tool for the assessment of people with acute whiplash injury.
The tool, WhipPredict, is for healthcare practitioners, such as physiotherapists and general practitioners.
It aims to identify, very soon after injury, which people are at risk of not recovering and which people should recover well.
“WhipPredict automatically calculates the risk classification making it easy and quick for use in the clinic,” Professor Sterling said.
“This allows for targeted treatment to be provided to those at risk of developing chronic pain and disability.”
WhipPredict is endorsed by the Australian Physiotherapy Association and recommended by Physiopedia.
It is used by 75 per cent of Queensland physiotherapists and it has been implemented by government injury insurance regulators, the Motor Accident Insurance Commission (MAIC) Transport Accident Commission (TAC), where they recommend its use by clinicians, Professor Sterling said.
WhipPredict has also been translated into Danish and Icelandic.
Image: Michele Sterling
Translating research into practice
The research informing WhipPredict has been gathered through a series of longitudinal cohort studies funded by ARC Linkage Grants, with support from the MAIC and Suncorp.
Professor Sterling said that the 15 years of clinical trials and predictive studies have informed an extensive research evidence base.
“We’ve shown that usual treatments of exercise and activity are effective for some and not others which is how we realised that perhaps we need to screen injured people early on so that rather than supply the same treatment to everyone we are able to tailor treatment to the individual,” she said.
The team at RECOVER has used this evidence base to create a suite of measures.
Along with WhipPredict, Professor Sterling has co-led three editions of the patient resource Whiplash Injury Recovery: a Self-Help Guide. The most recent edition was published in 2019.
Published by the MAIC, the booklet provides information about what to expect with a whiplash injury and includes evidence-based exercises and strategies such as stress management.
More than 17,000 copies of the booklet have been distributed by Queensland emergency departments and primary care practices.
It is also available on the websites of government regulators in Queensland, New South Wales, South Australia and Victoria.
The Whiplash Navigator “brings everything together”, Professor Sterling explained.
“It’s an online resource for everybody – for injured people, for health practitioners, for insurers,” she said.
“It has WhipPredict in it and a section for injured people with advice and exercises, a suite of tools for healthcare providers treating patients, and a regularly-updated evidence base for insurers and researchers to access.”
The one-stop shop for whiplash resources was initially funded through a National Health and Medical Research Council (NHMRC) partnership grant, with additional support from state government regulators of the Compulsory Third Party compensation scheme.
Image: Michele Sterling
The story so far:
- 2005 Whiplash Injury Recovery: a Self-Help Guide first published
- 2013 WhipPredict first published
- 2015 WhipPredict validated
- 2017 My Whiplash Navigator website published
Professor Sterling’s work was recognised with a 2020 Research Translation Award from the UQ Faculty of Health and Behavioural Sciences.
Having worked as a clinical physiotherapist for 20 years before undertaking her PhD, Professor Sterling is ranked the world’s leading researcher in the area of whiplash injury.
She is currently Program Lead of the Improving health outcomes after musculoskeletal injury research program in the RECOVER Injury Research Centre. She is also the Director of the NHMRC Centre of Research Excellence (CRE) in Road Traffic Injury Recovery.
As a musculoskeletal specialist, she has “always been interested in why some people develop chronic pain after an injury and others don’t”.
“For a given injury some people recover really well and others don’t, and we still don’t really understand why that’s the case, and this is what really drives me," she said.