Neck-related function and its connection with disability in chronic whiplash-associated disorders: secondary analysis of a randomized controlled study

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Fältnamn	Indikatorer	Metadata
000		05479naa a2200433 4500
001		oai:DiVA.org:uu-456841
003		SwePub
008		211028s2021 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:DiVA.org:liu-179630
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4568412 URI
024	7	a https://doi.org/10.23736/S1973-9087.21.06518-72 DOI
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-1796302 URI
040		a (SwePub)uud (SwePub)liu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Peterson, Gunnel,d 1959-u Linköpings universitet,Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Linköping Univ, Dept Hlth Med & Caring Sci, Physiotherapy, SE-58183 Linköping, Sweden,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Uppsala Univ, Sweden4 aut0 (Swepub:liu)gunpe95
245	1 0	a Neck-related function and its connection with disability in chronic whiplash-associated disorders :b secondary analysis of a randomized controlled study
264	1	b Edizioni Minerva Medica,c 2021
338		a print2 rdacarrier
500		a Funding Agencies\|Swedish government; Swedish Social Insurance Agency through the REHSAM foundation; Swedish Research Council, Centre for Clinical Research Sormland at Uppsala University SwedenSwedish Research Council; Uppsala-Orebro Regional Research Council Sweden; Medical Research Council of Southeast Sweden (FORSS)
520		a BACKGROUND: More than 40% of individuals with whiplash injury experience persistent neck pain and disability years later, called whiplash-associated disorders (WAD). A randomized controlled trial evaluated three exercise interventions in WAD and found that neck-specific exercise (NSE) and NSE with a behavioral approach (NSEB) significantly improve disability compared to prescribed physical activity (PPA). However, the relationship between neck-related function and disability is inconclusive and needs to be further investigated. AIM: The present study compares the effect of NSE, NSEB, and PPA on neck muscle endurance (NME), active cervical range of motion (AROM), grip strength, and pain intensity immediately before and after the physical tests, and neck disability in individuals who are below or above the cut-off for normative reference values regarding NME, AROM, and grip strength. DESIGN: Follow-up to a multicenter randomized clinical trial. SETTING: Primary healthcare centers and hospital outpatient services. POPULATION: The selected population of this study included 216 patients with persistent WAD grades II and III. METHODS: This is a secondary analysis including 12 months' follow-up. NME, AROM, grip strength, pain, and self-reported disability were recorded at baseline, 3, 6, and 12 months. Linear mixed models were used, and sub-group analyses evaluated by non-parametric tests. RESULTS : NSE and NSEB resulted in greater improvements compared to PPA (P<0.01) in ventral (only males) and dorsal NME, AROM, and pain intensity during testing. We found no significant between-group differences in grip strength and no significant differences between the NSE and NSEB groups. Improvement in disability was seen at the 12-month follow-up of NSE and/or NSEB for individuals both below and above the cut-off reference values for NME and AROM. Individuals in the PPA group below the reference values for NME and AROM reported increasing disability at 12 months compared to baseline. CONCLUSIONS: The results suggest that neck-specific exercises (i.e., NSE, NSEB) improve clinical function and decrease disability in chronic WAD compared to PPA, but PPA can increase disability for patients with low neck-related function. CLINICAL REHABILITATION IMPACT : Higher neck-related function seems to be important for reduced disability in persistent WAD grades II and III. Neck-specific exercises could lead to higher neck-related function.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Hälsovetenskapx Sjukgymnastik0 (SwePub)303072 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Health Sciencesx Physiotherapy0 (SwePub)303072 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Reumatologi och inflammation0 (SwePub)302102 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Rheumatology and Autoimmunity0 (SwePub)302102 hsv//eng
653		a Exercise therapy
653		a Whiplash injuries
653		a Neck pain
653		a Spine
700	1	a Landén Ludvigsson, Mariau Linköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Region Östergötland, Rehab Väst4 aut0 (Swepub:liu)marla49
700	1	a Peolsson, Anneliu Linköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten4 aut0 (Swepub:liu)annpe35
710	2	a Uppsala universitetb Centrum för klinisk forskning i Sörmland (CKFD)4 org
773	0	t European Journal of Physical and Rehabilitation Medicined : Edizioni Minerva Medicag 57:4, s. 607-619q 57:4<607-619x 1973-9087x 1973-9095
856	4	u https://liu.diva-portal.org/smash/get/diva2:1598646/FULLTEXT01.pdfx primaryx Raw objecty fulltext:postprint
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-456841
856	4 8	u https://doi.org/10.23736/S1973-9087.21.06518-7
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-179630

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