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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.
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Rehabilitation in Motala.ORCID iD: 0000-0002-3259-3133
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.ORCID iD: 0000-0003-2492-0306
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0002-6075-4432
2019 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 28, no 2, p. 357-368Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
Springer, 2019. Vol. 28, no 2, p. 357-368
Keywords [en]
Chronic, Exercise, Physiotherapy, Quality of life, Spine, Whiplash
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:liu:diva-154060DOI: 10.1007/s11136-018-2004-3ISI: 000457880300006PubMedID: 30225786OAI: oai:DiVA.org:liu-154060DiVA, id: diva2:1282446
Note

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 

Available from: 2019-01-24 Created: 2019-01-24 Last updated: 2019-03-07

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