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The effect of three exercise approaches on health-related quality of life, and factors associated with its improvement in chronic whiplash-associated disorders: analysis of a randomized controlled trial.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Rehab Väst.ORCID-id: 0000-0002-3259-3133
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.ORCID-id: 0000-0003-2492-0306
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.ORCID-id: 0000-0002-6075-4432
2019 (Engelska)Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 28, nr 2, s. 357-368Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

PURPOSE: The aim was to evaluate whether neck-specific exercise, with (NSEB) or without (NSE) a behavioural approach, improves health-related quality of life (HRQoL) compared to physical activity prescription (PPA) in chronic whiplash-associated disorders (WAD) grades 2 and 3. A secondary aim was to identify factors associated with HRQoL and HRQoL improvement following exercise interventions.

METHODS: This is a secondary analysis of a multicentre randomized clinical trial. Participants (n = 216) with chronic WAD grades 2 and 3 were randomized to 12 weeks of PPA or physiotherapist-led NSE or NSEB. The EQ-5D 3L/EQ-VAS and SF-36v2 physical (PCS) and mental (MCS) component summaries were collected together with several neck-related and psychosocial outcomes at baseline, after 3, 6 and 12 months, and were analysed with linear mixed models (all time points) and multivariate linear regressions (baseline, 6 months).

RESULTS: NSE/NSEB resulted in better outcomes than PPA (EQ-VAS and SF-36 PCS, both groups, p < 0.01) but not in a higher EQ-5D score. Improvement over time was seen in EQ-5D/EQ-VAS for the NSEB group (p < 0.01), and for NSE/NSEB as measured with the PCS (p < 0.01). Factors associated with baseline HRQoL and change to 6 months in HRQoL (R2 = 0.38-0.59) were both neck-related and psychosocial (e.g. depression, work ability).

CONCLUSION: Neck-specific exercise, particularly with a behavioural approach, may have a more positive impact on HRQoL than physical activity prescription in chronic WAD grades 2 and 3. HRQoL is however complex, and other factors also need to be considered. Factors associated with HRQL and improvements in HRQoL following exercise are multidimensional.

TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, No. NCT01528579.

Ort, förlag, år, upplaga, sidor
Springer, 2019. Vol. 28, nr 2, s. 357-368
Nyckelord [en]
Chronic, Exercise, Physiotherapy, Quality of life, Spine, Whiplash
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Sjukgymnastik
Identifikatorer
URN: urn:nbn:se:liu:diva-154060DOI: 10.1007/s11136-018-2004-3ISI: 000457880300006PubMedID: 30225786OAI: oai:DiVA.org:liu-154060DiVA, id: diva2:1282446
Anmärkning

Funding agencies: Vetenskapsradet [521-2014-2982]; Swedish Government through the REHSAM Foundation [RS2010/009]; Swedish Research Council; County Council of Ostergotland [LIO-533041, LIO-439541, LIO-197631, IO-276151, LIO-354241]; Centre for Clinical Research Sormland at 

Tillgänglig från: 2019-01-24 Skapad: 2019-01-24 Senast uppdaterad: 2019-03-07

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