ONE- AND TWO-YEAR FOLLOW-UP OF A RANDOMIZED TRIAL OF NECKSPECIFIC EXERCISE WITH OR WITHOUT A BEHAVIOURAL APPROACH COMPARED WITH PRESCRIPTION OF PHYSICAL ACTIVITY IN CHRONIC WHIPLASH DISORDER

• Published in: Journal of rehabilitation medicine Vol. 48; no. 1; p. 56
• Main Authors: Maria Landén Ludvigsson, Peterson, Gunnel, Dedering, Åsa, Peolsson, Anneli
• Format: Journal Article
• Language: English
• Published: Uppsala Journal of Rehabilitation Medicine 01.01.2016
• Subjects: Assessors; Behavior; Chronic pain; Clinical research; Clinical trials; Disability; Evidence-based medicine; Exercise; Fitness groups; Neck; Physical activity; Self evaluation; Self-efficacy; Time use; Volunteers; Whiplash injuries
• ISSN: 1650-1977

Objective: To explore whether neck-specific exercise, with or without a behavioural approach, has benefits after 1 and 2 years compared with prescribed physical activity regarding pain, self-rated functioning/disability, and self-efficacy in management of chronic whiplash. Design: Follow-up of a randomized, assessor blinded, clinical trial. Patients: A total of 216 volunteers with chronic whiplashassociated disorders, grades 2 or 3. Methods: Participants were randomized to 1 of 3 exercise interventions: neck-specific exercise with or without a behavioural approach, or physical activity prescription. Self-rated pain (visual analogue scale), disability/functioning (Neck Disability Index/Patient Specific Functional Scale) and self-efficacy (Self-Efficacy Scale) were evaluated after 1 and 2 years. Results: Both neck-specific exercise groups maintained more improvement regarding disability/functioning than the prescribed physical activity group at both time-points (p ≤ 0.02). At 1 year, 61% of subjects in the neck-specific group reported at least 50% pain reduction, compared with 26% of those in the physical activity prescription group (p < 0.001), but at 2 years the difference was not significant. Conclusion: After 1-2 years, participants with chronic whiplash who were randomized to neck-specific exercise, with or without a behavioural approach, remained more improved than participants who were prescribed general physical activity.