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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
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
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2015 (English)In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 31, no 4, 249-303 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES:: The aim of this study was to compare the effect on self-rated pain, disability and self-efficacy of three interventions for the management of chronic Whiplash Associated Disorders (WAD): physiotherapist-led neck-specific exercise, physiotherapist-led neck-specific exercise with the addition of a behavioral approach, or prescription of physical activity.

METHODS:: Two hundred and sixteen volunteers with chronic WAD participated in this randomized, assessor blinded, clinical trial of three 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 three and six months.

RESULTS:: The proportion of patients reaching substantial reduction in pain bothersomness (at least 50% reduction) was more evident (P<0.01) in the two neck-specific exercise groups (29-48%) compared to the prescription of physical activity group (5%) at three months. At six months 39-44% of the patients in the two neck-specific groups and 28% in the prescription of physical activity group reported substantial pain reduction. Reduction of disability was also larger in the two neck-specific exercise groups at both three and six months (P<0.02). Self-efficacy was only improved in the neck-specific exercise group without a behavioral approach (P=0.02). However there were no significant differences in any outcomes between the two physiotherapist-led neck-specific exercise groups.

DISCUSSION:: Neck-specific exercise resulted in superior outcomes compared to prescription of physical activity 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
2015. Vol. 31, no 4, 249-303 p.
National Category
Anesthesiology and Intensive Care Neurosciences
URN: urn:nbn:se:uu:diva-239323DOI: 10.1097/AJP.0000000000000123ISI: 000350986000002PubMedID: 24918474OAI: diva2:774218

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

Available from: 2014-12-22 Created: 2014-12-22 Last updated: 2015-09-22Bibliographically approved

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