Effectiveness of conservative treatment in acute Whiplash Associated Disorder (WAD) II: a systematic review and meta-analysis of randomised controlled trials

Wiangkham, Taweewat; Duda, Joan L.; Haque, Mohammed S; Madi, Mohammad; Rushton, A.

doi:10.1016/j.physio.2015.03.1642

Cited by 2 publications

(4 citation statements)

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“…[14, 15, 19–21] Effective management in the acute stage is therefore an important challenge to prevent patients with WAD transitioning to chronicity. [19, 22–24]…”

Section: Introductionmentioning

confidence: 99%

“…Our recent rigorous systematic review[22, 23] evaluating the effectiveness of acute WADII management found that the combination of active physiotherapy and behavioural interventions termed ‘Active Behavioural Physiotherapy Intervention (ABPI)’, is a potentially effective strategy for the management of acute WADII and may therefore be valuable in preventing chronicity. Unfortunately, the existing evidence was insufficient to define an ABPI intervention.…”

Section: Introductionmentioning

confidence: 99%

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A cluster randomised, double-blind pilot and feasibility trial of an active behavioural physiotherapy intervention for acute whiplash-associated disorder (WAD)II

et al. 2019

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Whiplash-associated disorder (WAD) causes substantial social and economic burden, with ≥70% patients classified as WADII (neck complaint and musculoskeletal sign(s)). Effective management in the acute stage is required to prevent development of chronicity; an issue for 60% of patients. An Active Behavioural Physiotherapy Intervention (ABPI) was developed to address both physical and psychological components of WAD. The ABPI is a novel complex intervention designed through a rigorous sequential multiphase project to prevent transition of acute WAD to chronicity. An external pilot and feasibility cluster randomised double-blind (assessor, participants) parallel two-arm clinical trial was conducted in the UK private sector. The trial compared ABPI versus standard physiotherapy to evaluate trial procedures and feasibility of the ABPI for managing acute WADII in preparation for a future definitive trial. Six private physiotherapy clinics were recruited and cluster randomised using a computer-generated randomisation sequence. Twenty-eight (20 ABPI, 8 standard physiotherapy) participants [median age 38.00 (IQR = 21.50) years] were recruited. Data were analysed descriptively with a priori establishment of success criteria. Ninety-five percent of participants in the ABPI arm fully recovered (Neck Disability Index ≤4, compared to 17% in the standard physiotherapy arm); required fewer treatment sessions; and demonstrated greater improvement in all outcome measures (pain intensity, Cervical Range of Motion, Pressure Pain Threshold, EuroQol-5 Dimensions) except for the Impact of Events Scale and Fear Avoidance Beliefs Questionnaire. The findings support the potential value of the ABPI, and that an adequately powered definitive trial to evaluate effectiveness (clinical, cost) is feasible with minor modifications to procedures.

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“…[14, 15, 19–21] Effective management in the acute stage is therefore an important challenge to prevent patients with WAD transitioning to chronicity. [19, 22–24]…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A cluster randomised, double-blind pilot and feasibility trial of an active behavioural physiotherapy intervention for acute whiplash-associated disorder (WAD)II

et al. 2019

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“… 6 7 11 12 A focus on effective management in the acute stage is therefore required and may be able to prevent patients progressing to chronicity. 11 13 14 …”

Section: Introductionmentioning

confidence: 99%

“…Our systematic review of randomised controlled trials (RCTs) 13 14 evaluating the effectiveness of acute WADII management found that active intervention may be useful for pain reduction medium (95% CI −17.19 to −3.23, p=0.004) to long term (95% CI −26.39 to −10.08, p<0.0001). Interestingly, the active intervention is also strongly recommended within whiplash management guidelines.…”

Section: Introductionmentioning

confidence: 99%

Acute Whiplash Injury Study (AWIS): a protocol for a cluster randomised pilot and feasibility trial of an Active Behavioural Physiotherapy Intervention in an insurance private setting

et al. 2016

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IntroductionWhiplash-associated disorder (WAD) causes substantial social and economic burden internationally. Up to 60% of patients with WAD progress to chronicity. Research therefore needs to focus on effective management in the acute stage to prevent the development of chronicity. Approximately 93% of patients are classified as WADII (neck complaint and musculoskeletal sign(s)), and in the UK, most are managed in the private sector. In our recent systematic review, a combination of active and behavioural physiotherapy was identified as potentially effective in the acute stage. An Active Behavioural Physiotherapy Intervention (ABPI) was developed through combining empirical (modified Delphi study) and theoretical (social cognitive theory focusing on self-efficacy) evidence. This pilot and feasibility trial has been designed to inform the design of an adequately powered definitive randomised controlled trial.Methods and analysisTwo parallel phases. (1) An external pilot and feasibility cluster randomised double-blind (assessor and participants), parallel two-arm (ABPI vs standard physiotherapy) clinical trial to evaluate procedures and feasibility. Six UK private physiotherapy clinics will be recruited and cluster randomised by a computer-generated randomisation sequence. Sixty participants (30 each arm) will be assessed at recruitment (baseline) and at 3 months postbaseline. The planned primary outcome measure is the neck disability index. (2) An embedded exploratory qualitative study using semistructured indepth interviews (n=3–4 physiotherapists) and a focus group (n=6–8 patients) and entailing the recruitment of purposive samples will explore perceptions of the ABPI. Quantitative data will be analysed descriptively. Qualitative data will be coded and analysed deductively (identify themes) and inductively (identify additional themes).Ethics and disseminationThis trial is approved by the University of Birmingham Ethics Committee (ERN_15-0542).Trial registration numberISRCTN84528320.

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Effectiveness of conservative treatment in acute Whiplash Associated Disorder (WAD) II: a systematic review and meta-analysis of randomised controlled trials

Cited by 2 publications

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A cluster randomised, double-blind pilot and feasibility trial of an active behavioural physiotherapy intervention for acute whiplash-associated disorder (WAD)II

A cluster randomised, double-blind pilot and feasibility trial of an active behavioural physiotherapy intervention for acute whiplash-associated disorder (WAD)II

Acute Whiplash Injury Study (AWIS): a protocol for a cluster randomised pilot and feasibility trial of an Active Behavioural Physiotherapy Intervention in an insurance private setting

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