The Effect of Neck-specific Exercise With, or Without a Behavioral Approach, on Pain, Disability, and Self-Efficacy in Chronic Whiplash-associated Disorders: A Randomized Clinical Trial
2015 (English)In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 31, no 4, 294-303 p.Article in journal (Refereed) Published
Objectives: The aim of this study was to compare the effect on self-rated pain, disability, and self-efficacy of 3 interventions for the management of chronic whiplash-associated disorders: physiotherapist-led neck-specific exercise (NSE), physiotherapist-led NSE with the addition of a behavioral approach, or Prescription of Physical Activity (PPA). Materials and Methods: A total of 216 volunteers with chronic whiplash-associated disorders participated in this randomized, assessor blinded, clinical trial of 3 exercise interventions. Self-rated pain/pain bothersomeness (Visual Analogue Scale), disability (Neck Disability Index), and self-efficacy (Self-Efficacy Scale) were evaluated at baseline and at 3 and 6 months. Results: The proportion of patients reaching substantial reduction in pain bothersomness (at least 50% reduction) was more evident (P less than 0.01) in the 2 NSE groups (29% to 48%) compared with the PPA group (5%) at 3 months. At 6 months 39% to 44% of the patients in the 2 neck-specific groups and 28% in the PPA group reported substantial pain reduction. Reduction of disability was also larger in the 2 neck-specific exercise groups at both 3 and 6 months (P less than 0.02). Self-efficacy was only improved in the NSE group without a behavioral approach (P = 0.02). However, there were no significant differences in any outcomes between the 2 physiotherapist-led NSE groups. Discussion: NSE resulted in superior outcomes compared with PPA in this study, but the observed benefits of adding a behavioral approach to the implementation of exercise in this study were inconclusive.
Place, publisher, year, edition, pages
Lippincott, Williams andamp; Wilkins , 2015. Vol. 31, no 4, 294-303 p.
chronic; whiplash; exercise; disability; pain
Medical and Health Sciences Health Sciences Physiotherapy
IdentifiersURN: urn:nbn:se:liu:diva-116944DOI: 10.1097/AJP.0000000000000123ISI: 000350986000002PubMedID: 24918474OAI: oai:DiVA.org:liu-116944DiVA: diva2:802624
Funding Agencies|Swedish government through the Swedish Research Council; Swedish Social Insurance Agency through the REHSAM foundation Stockholm, Sweden; Sormland, Sweden County Council; Uppsala, Sweden County Council; Swedish Research Council, Stockholm, Sweden; Health Practitioner Research Fellowship (Queensland Health); Health Practitioner Research Fellowship (University of Queensland, Brisbane, Australia [NHMRC CCRE Spinal Pain, Injury and Health])2015-04-132015-04-102016-04-05