"I'm Not the Same as I Was Before": A Qualitative Evidence Synthesis Exploring the Experiences and Perceptions of Patients Living With Whiplash-Associated Disorders.

Abstract

OBJECTIVE: To summarize the perceptions and experiences of patients living with whiplash-associated disorders (WADs). DESIGN: Qualitative evidence synthesis. LITERATURE SEARCH: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Embase, Physiotherapy Evidence Database (PEDro), PsycINFO, MEDLINE, Scopus, SPORTDiscus, and Web of Science databases were searched up to June 2024 and updated in October 2024. STUDY SELECTION CRITERIA: Inclusion criteria were (1) qualitative primary studies or mixed methods studies with clear identification of participants and findings from the qualitative methods, (2) published in English or Italian, (3) included participants aged ≥16 years, and (4) focused on participants' experiences with a diagnosis of WAD. DATA SYNTHESIS: Metasummary and metasynthesis processes were conducted following Sandelowski and Barroso's methodology. The confidence of the findings was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach. RESULTS: Eighteen studies were included, comprising a total of 349 participants. Overall, 330 target findings were collected, analyzed, and grouped into 15 categories attributable to 5 main themes: (1) "WAD changed my body," (2) "WAD destabilized my daily life," (3) "WAD has consumed my thoughts," (4) "The recovery journey from WAD," (5) "Life goes on after WAD." The methodological quality of all studies revealed only minor concerns. The GRADE-CERQual assessment indicated moderate confidence in the findings, due to serious concerns regarding their relevance to the patient experience of WAD. CONCLUSION: People with WAD experienced a wide range of interconnected physical, emotional, cognitive, and social challenges. Addressing these multifaceted needs through a biopsychosocial approach can guide more effective management strategies and improve long-term outcomes for patients with WAD. J Orthop Sports Phys Ther 2025;55(9):1-19. Epub 25 July 2025. doi:10.2519/jospt.2025.13156.