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  • Overmeer, Thomas, et al. (författare)
  • The effect of neck-specific exercise with or without a behavioral approach on psychological factors in chronic whiplash-associated disorders: A randomized controlled trial with a 2-year follow-up
  • 2016
  • Ingår i: Medicine (Baltimore, Md.). - LIPPINCOTT WILLIAMS & WILKINS. - 0025-7974. ; 95:34, s. e4430
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:To investigate the effect of neck-specific exercise with (NSEB) or without (NSE) a behavioural approach and prescribed physical activity (PPA) on general pain disability and psychological factors in chronic whiplash-associated disorders (WAD), grade 2 and 3, with a 2-year follow-up.Methods:A randomized controlled multi-centre study of 3 exercise interventions (NSE, NSEB or PPA) including a 2-year follow-up. A total of 216 volunteers with chronic WAD were recruited and 194 were analyzed, mean age 40.4 (Standard Deviation [SD] 11.4). Measures of general pain disability, pain catastrophizing, anxiety and depression, and kinesiophobia were evaluated at baseline, and 3, 6, 12 and 24 months with linear mixed models.Results:General pain disability decreased by 28% in the NSEB group from baseline to 3 months (Pamp;lt;0.001) and the improvements in disability were maintained over time (6, 12 and 24 months Pamp;lt;0.01) compared to the NSE (Pamp;gt;0.42) and PPA groups (Pamp;gt;0.43). Pain catastrophizing decreased in the NSE group from baseline to 6 and 12 months (Pamp;lt;0.01) and in the NSEB group from baseline to 3 and 24 months (Pamp;lt;0.01) compared to the PPA group (Pamp;gt;0.82) that showed no change over time. The NSE group improved in kinesiophobia over time from baseline to12 months (Pamp;lt;0.01) compared to the NSEB (P=0.052) and the PPA groups (Pamp;gt;0.74). Anxiety decreased over time from baseline to 12 and 24 months in the NSE group (Pamp;gt;0.02), but not in the NSEB (Pamp;gt;0.25) or the PPA (Pamp;gt;0.50) groups. The PPA had no effect on general disability or any of the measured psychological factors.Conclusion:This randomised controlled trial with a 2-year follow-up shows that physiotherapist-led neck-specific exercise with or without the addition of a behavioural approach had superior outcome on general disability and most psychological factors compared to the mere prescription of physical activity.
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