International Journal of Health Sciences & Research (www.ijhsr.org) 176 Vol.4; Issue: 9; September 2014 International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Coping, Trigger Points and Ability to Work in Patients after Whiplash Injury: A Prospective Longitudinal Pilot Study Daniel Lacher 1 , Robert Stoffel 2 , Corina Schuster 1,3 , Markus Stocklin 4 , Udo Kischka 1,5 , Thierry Ettlin 1,6 1 Research Department, Reha Rheinfelden, Rheinfelden, Switzerland 2 Department of Physical Therapy, Reha Rheinfelden, Rheinfelden, Switzerland 3 Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences, Burgdorf, Switzerland 4 Faculty of Psychology, Basel University, Basel, Switzerland 5 Oxford Centre for Enablement, Oxford, United Kingdom 6 Faculty of Medicine, Basel University, Switzerland Corresponding Author: Daniel Lacher Received: 14/07//2014 Revised: 02/08/2014 Accepted: 06/08/2014 ABSTRACT Background: Chronification mechanisms after Whiplash injuries, leading to Whiplash associated disorder (WAD) are not yet fully understood. Psychological and physical factors such as coping strategies and persistence of myofascial trigger points (TPs) might be of importance. The aim of the study was to investigate the influence of illness behaviour on the improvement of health and functioning in patients with a WAD. Methods: In a prospective longitudinal study in- and outpatients were tested within 6 months after acute whiplash trauma and at follow up (FU) one year after their injury. Coping styles were assessed with the Freiburg Questionnaire of Coping with Illness (FQCI). Use of medical support and the improvement of health were evaluated with the Freiburg Complaints List (FCL) and by assessing the ability to work. Pain intensity was measured with a Numerical Rating Scale (NRS). Presence and amount of TPs were examined by a standardized procedure. The Symptom Checklist (SCL-90-R) was used to screen for psychopathology. Results: 40 patients were included into the study (26 females, mean age 38.0±11.7 years, mean time since injury 108±11.6 days). Passive coping was negatively (r= -.34, p<0.05) and coping with distraction was positively associated (r= -.35, p<0.05) with improvement of the ability to work. Active coping (r= .42, p<0.01) and coping with distraction (r= .34, p<0.05) were associated with an improvement of pain. Patients with a higher number of TPs indicated higher pain intensity, fear, and depression levels (all p<0.01). These patients also claimed for more therapies at FU (r= .38, p<0.05). Conclusions: Passive Coping and coping with distraction might be linked with the ability to work and with subjective experience of pain. Myofascial TPs might be associated with more claiming for therapies and use of medical support, and higher levels of depression and fear. The presence of myofascial TPs seems to be associated with an increased risk for chronification. Treatment should focus on physical and psychological aspects, in particular on coping mechanisms to help preventing chronification processes after a WAD. Keywords: Chronification, coping, trigger points, whiplash associated disorder, pain.