None listed
Conditions
Brief summary
Some people with chronic whiplash have increased sensitivity to various stimuli such as pressure and cold. These people don’t respond as well to standard exercise based approaches to treatment. Dry-needling techniques have been shown to decrease the sensitivity in other conditions, but the effects for people with whiplash it not known. Dry needling is one of many techniques used by physiotherapists. It involves tapping a very fine needle into the tender muscle areas and it is similar to acupuncture. This study aims to find out whether or not dry-needling added to a standard exercise program will decrease pain and disability in people with chronic whiplash. We also need to know whether or not the effects are better than those of ‘sham’ dry-needling and exercise. It is hypothesised that dry needling will decrease pain and hypersensitivity associated with chronic whiplash and thus facilitate the effects of the exercise program.
Interventions
Dry-needling, advice and exercise:
Participants receive a copy of the educational booklet ‘Whiplash injury recovery: a self management guide’ published by the Motor Accident Insurance Commision, Queensland (MAIC). This booklet will be issued on completion of the initial assessment session at the Whiplash Laboratory and inclusion in the trial.
The intervention is a 6 week programme which includes 6 x 30 minute treatments of dry-needling and exercise delivered in the first 3 weeks, followed by
Dry-needling, advice and exercise: Participants receive a copy of the educational booklet ‘Whiplash injury recovery: a self management guide’ published by the Motor Accident Insurance Commision, Queensland (MAIC). This booklet will be issued on completion of the initial assessment session at the Whiplash Laboratory and inclusion in the trial. The intervention is a 6 week programme which includes 6 x 30 minute treatments of dry-needling and exercise delivered in the first 3 weeks, followed by 4 exercise only sessions in the following 3 weeks. Dry needling involves tapping a very fine filament needle into senstive muscle areas identified by the physiotherapist. The muscles that mat be treated include the posterior muscles of the neck and shoulder girdle region. The exercise component will comprise of specific exercises to improve range of neck movement, muscle control of the neck flexors and extensors and postural control of the neck and shoulder girdles. All exercises will be low load and sub-maximal in nature and are designed to be pain-free. Participants will attend the physiotherpist for education of this exercise programme and they are encouraged to carry-out their home exercise programme 2-3 x a day, each session lasting 10 minutes. The postural corrections and similar components of the programme should be incorporated in the participants' every day activities. The participant is encouraged to continue their exercise programme and self manage on completion of the 6 week programme.
Sponsors
A/Prof Michele Sterling
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Whiplash associated disorder Grade II of at least 3 months duration but less than 12 months duration. Whiplash causes at least moderate pain and disability with scores of greater or equal to 28/100 on the Neck Disability Index (NDI). The presence of sensory hypersensitivity, defined as the presence of 2 out of a possible 3 of the following: cold pain threshold (> 15 degrees celcius, males and females); pressure pain thresholds over the cervical spine (females < 185 kPa. Males < 210 kPa); pressure pain thresholds over the median nerve (females < 210 kPa. Males < 250 kPa) Not currently receiving care for whiplash. Participants should be naïve to the use of dry needling in the treatment of musculoskeletal pain.
Exclusion criteria
Known or suspected serious spinal pathology (e.g. metastatic, inflammatory or infective diseases of the spine). Confirmed fracture or dislocation at time of injury. Nerve root compromise (at least 2 of the following signs: weakness/reflex changes/sensory loss, associated with the same spinal nerve). Spinal surgery in the past 12 months.
Outcome results
None listed