Neck-specific exercises with internet-based support compared to neck-specific exercises at a physiotherapy clinic for chronic whiplash-associated disorders: study protocol of a randomized controlled multicentre trial

Abstract

BackgroundGlobally, neck pain is the fourth most common condition associated with longer periods of living with disability. Annually, approximately 0.3% of the population of Western countries undergo whiplash trauma, and half of those individuals will develop chronic problems with high costs for the individual and society. Evidence for chronic whiplash-associated disorders (WAD) treatment is scarce, though neck-specific training at a physiotherapy clinic twice a week for 12 weeks has demonstrated good results. More efficient, flexible rehabilitation with reduced waiting times and lower costs is needed, ideally replacing lengthy on-site treatment series by healthcare providers. Internet-based care has been shown to be a viable alternative for a variety of diseases and interventions, but studies are lacking on Internet-based interventions for individuals with chronic neck problems. The aim of the trial described here is to compare the effects of an Internet-based neck-specific exercise programme to the same exercises performed at a physiotherapy clinic in regards to self-reported and clinical measures, as well as cost-effectiveness.MethodsThis prospective, randomized controlled trial will involve 140 participants. Measurements will be made at baseline, 3 months (end of treatment), and 15 months (12 months after end of intervention) and will include ratings of pain, disability, satisfaction with care, work ability, quality of life, and cost-effectiveness.DiscussionThe study results may contribute to the development of a more effective rehabilitation, flexible and equal care, shorter waiting times, increased availability, and lower costs for healthcare and society.Trial registrationClinicalTrials.gov Protocol ID: NCT03022812, initial release 12/20/2016.

Pathophysiology behind prolonged whiplash associated disorders: study protocol for an experimental study

“…The projects, include experimental sub-group trials, each independent of the others, but using the same cohort to obtain data, in a prospective, multicentre, randomized controlled trial (RCT) with two parallel treatment arms conducted in outpatient care in Sweden according to a protocol established before recruitment started. (For further information, please see ClinicalTrials.gov Protocol ID: NCT03022812 and Peolsson et al [24]) (Fig. 1).…”

“…Arranging an appointment for a physical examination and an additional interview for the present sub-group study is set up as the last step to ensure that the criteria for study participation are met. If all the study criteria are met, and written and oral informed consent are confirmed, the patient will complete a written questionnaire and have physical measurements taken of neck-related functions [24]. Baseline measurements must be completed for inclusion [24].…”

“…The projects aim to investigate muscle structure (neck and whole body muscle fatty infiltration, cross-sectional area, volume, inflammation), muscle function, brain structure and function related to pain, molecular biomarkers (for stress and inflammation), cervical kinaesthesia, postural sway and the association with pain, disability and other self-reported and physical outcomes in individuals with longstanding WAD before and after a neck-specific intervention [24]. Another aim is to compare individuals with WAD with healthy controls.…”

“…In an ongoing randomized controlled multicentre trial (ClinicalTrials.gov Protocol ID: NCT03022812 and Peolsson et al [24]), physiotherapist-led neck-specific exercise has previously [5, 22] shown to be effective for the current population and constitutes the control treatment for a new Internet-based neck-specific exercise treatment. For improved understanding not only of the best way of exercise distribution but also of pathophysiological mechanisms underlying whiplash injury and their importance for treatment success, investigation of such potential mechanisms is required.…”

Return to work a bumpy road: A qualitative study on experiences of work ability and work situation in individuals with chronic whiplash-associated disorders

“…Participants were recruited from an ongoing randomized controlled trial [23] evaluating two different ways of distributing neck-speci c exercises to individuals with chronic WAD Grade II and III [24] in primary health care in Sweden. Those who had completed at least half of the training sessions and the 1-year follow-up were eligible to participate in the present study.…”