303: Latent Profile Analysis of Chronic Whiplash-Associated Disorders Identifies Four Meaningful Classes

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Assessment and Measurement of Pain/Nociception

Background and Aims: People with chronic whiplash-associated disorders (WAD) demonstrate a heterogeneous symptom profile (1). It is unclear if distinct subgroups exist within chronic WAD, which may assist with defining possible future treatment options. The purpose of this study was to identify meaningful subgroups of chronic WAD with similar clinical characteristics.

Methods: Responses to five indicator variables associated with chronic WAD were collected via intake questionnaires. The five variables were depression(DASS-21), spread of pain(number of painful body sites), traumatic brain injury symptom cluster(sum of loss of consciousness, dizziness, headache and nausea symptoms), sleep(PSQI score) and self confidence to perform activities when in pain.
Maximum likelihood estimation-based latent profile analysis was used to identify clinically and statistically meaningful profiles using the five variables. To facilitate interpretation, the clusters were subsequently compared across a series of external health outcomes (pain intensity, pain interference, disability, physical activity, physical and mental health, and posttraumatic stress severity).

Results: Data from 509 people with chronic WAD were available for analysis. The results indicated a 4-profile structure (with acceptable fit indicators) was optimal for explaining the patterns of responses within the data. These were: Mild TBI (29%), Mood-Dominant (16%), Complex (9%) and Otherwise Resilient (46%). The complex group demonstrated higher values on all five indicator variables. Patterns of differences in the external variables supported the interpretation of these clusters.

Conclusions: The four profiles appear to represent distinct clinical subgroups that are expected to be amenable to different intervention strategies. Further validation will occur through prognostic and intervention studies.

References: 1. Sarkilahti et al., J Bodyw Mov Ther 2024;40:706-725. DOI: 10.1016/j.jbmt.2024.05.018

Presenting Author: Ashley Smith
Submitting Author: Ashley Smith

Senior Author: Dave Walton

IASP 2026 Global Year theme of Neuropathic Pain: No

• Dave Walton: PhD - Western University