The effect of neck-specific exercise with or without a behavioral approach on psychological factors in chronic whiplash-associated disorders: A randomized controlled trial with a 2-year follow-up

• Published in: Medicine (Baltimore) 2016-08, Vol.95 (34), p.e4430-e4430
• Main Authors: Overmeer, Thomas, Peterson, Gunnel, Landén Ludvigsson, Maria, Peolsson, Anneli
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anxiety - etiology; Behavioral medicine; Catastrophization - etiology; Clinical Trial/Experimental Study; Cognitive Behavioral Therapy; Depression - etiology; Disability Evaluation; Exercise; Exercise Therapy; Female; Follow-Up Studies; Humans; Male; Middle Aged; Movement; Neck; Neck Pain - etiology; Neck Pain - therapy; Patient Education as Topic; Phobic Disorders - etiology; Single-Blind Method; Spine; Treatment Outcome; Whiplash injuries; Whiplash Injuries - complications; Whiplash Injuries - psychology; Whiplash Injuries - therapy; Young Adult
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000004430

To investigate the effect of neck-specific exercise with (NSEB) or without (NSE) a behavioural approach and prescribed physical activity (PPA) on general pain disability and psychological factors in chronic whiplash-associated disorders (WAD), grade 2 and 3, with a 2-year follow-up. A randomized controlled multi-centre study of 3 exercise interventions (NSE, NSEB or PPA) including a 2-year follow-up. A total of 216 volunteers with chronic WAD were recruited and 194 were analyzed, mean age 40.4 (Standard Deviation [SD] 11.4). Measures of general pain disability, pain catastrophizing, anxiety and depression, and kinesiophobia were evaluated at baseline, and 3, 6, 12 and 24 months with linear mixed models. General pain disability decreased by 28% in the NSEB group from baseline to 3 months (P  0.43). Pain catastrophizing decreased in the NSE group from baseline to 6 and 12 months (P  0.02), but not in the NSEB (P > 0.25) or the PPA (P > 0.50) groups. The PPA had no effect on general disability or any of the measured psychological factors. This randomised controlled trial with a 2-year follow-up shows that physiotherapist-led neck-specific exercise with or without the addition of a behavioural approach had superior outcome on general disability and most psychological factors compared to the mere prescription of physical activity.