Table 7.

Treatment interventions and the degrees of evidence in their support. WAD whiplash-associated disorders

Degree of evidencea
	Claim	Referencesb
1	Radiofrequency neurotomy reduces pain and psychological distress in patients with chronic WAD and zygapophysial joint pain	Lord 1996 [27], Wallis 1997 [55]
2	Melatonin therapy advances melatonin onset and sleep-wake rhythm in patients with chronic WAD and delayed melatonin onset	van Wieringen 2001 [52]
2	High-dose methylprednisolone therapy administered within 8 h of injury reduces sick leave	Pettersson 1998 [36]
2	Intra-articular corticosteroid therapy lacks effect in patients with chronic WAD and zygapophysial joint pain	Barnsley 1994 [1]
2	Electromagnetic Field therapy reduces pain and increases cervical range of motion in patients with acute WAD	Foley-Nolan 1992 [13], Thuile 2002 [50]c
2	Early physical activity reduces pain, increases cervical range of motion and reduces sick leave in patients with acute WAD	Bonk 2000 [5], Borchgrevink 1998 [6], Gennis 1996 [14}d, McKinney 1989 [30], Mealy 1986 [32], Pennie 1990 [35], Söderlund 2000 [45], Rosenfeld 2000 [39]e, Rosenfeld 2003 [40]e
2	Cognitive behavioural therapy combined with Physical therapy reduce pain and sick leave in patients with chronic WAD	Johansson 1998 [21}, Provinciali 1996 [37], Söderlund 2001 [44]
2	Coordination exercise therapy reduces pain in patients with chronic WAD	Fitz-Ritson 1995 [12]f, Humphreys 2002 [18]
3a	Ultra-reiz current therapy combined with physical therapy reduces pain and cervical range of motion in patients with acute WAD	Hendriks 1996 [16]
3a	Spinal manipulation therapy reduces pain and increases cervical range of motion in patients with neck pain with radiation to the trapezius musclef	Cassidy 1992 [10]
3a	Fluoxetine therapy provides similar pain reduction to that of Amitriptyline therapy in patients with chronic WAD	Schreiber 2001 [43]
3b	Subcutaneous sterile water injection therapy reduces pain and increases cervical range of motion in patients with chronic WAD	Byrn 1993 [9], Sand 1992[41]h

^a Rating system derived from the system utilized by the Cochrane Collaboration Back Group [52] (See “Methods”-section)

^b Studies presented by first author in alphabetical order where appropriate. Bold references denote studies defined as high quality

^c It was unclear if patients in this randomized controlled trial (RCT) suffered from acute or chronic whiplash-associated disorders (WAD)

^d The results of this RCT conflict with the claim

^e The two articles by Rosenfeld are based on the same data and should therefore be regarded as one RCT

^f The groups in this RCT were different at baseline

^g The claim refers to effects immediate following treatment. Long-term effects have not been studied

^h This RCT conflicts with the claim, and the study population is heterogeneous