None listed
Conditions
Brief summary
The aim of the proposed research is to determine the effectiveness of a comprehensive exercise program for chronic whiplash. Currently, for the majority of sufferers with chronic whiplash there are no proven therapies available to manage this personal and financially costly condition. Promising results have been identified in randomised controlled trials evaluating the effects of different exercise programs, graded activity and specific exercise. However, success rates from these studies were too low to represent a solution to the problem of chronic whiplash and further development was necessary. A comprehensive exercise program that combined both specific exercises and graded activity was developed. A small uncontrolled phase I/II trial provided evidence that this new exercise program had a much higher success rate with 56% of subjects having minimal or no disability at the end of the program. This success rate approximates that of radiofrequency neurotomy (58%) but avoids such invasive surgical techniques. Based upon the exciting results of the pilot study and the strong biological rationale for the superior results with the combined program we now propose to definitively establish the effectiveness of the new program in a large phase III randomised controlled trial.
Interventions
The educational booklet in conjunction with 20 one-hour sessions of the comprehensive exercise program over 12 weeks. The program begins with specific cervical spine and scapular motor relearning exercises (8 sessions over 4 weeks) and transitions to a graded whole body activity program focussing on functional activities (12 sessions over 8 weeks). All exercise sessions are conducted one-on-one with a physiotherapist.
Sponsors
The George Institute For International Health, The University of Sydney
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Key inclusion criteria: 1. Grade I or II whiplash of at least 3 months duration but less than 12 months duration. 2. Currently experiencing at least moderate pain OR moderate activity limitation due to pain (modified items 7 & 8 of SF36). 3. Not currently receiving care for whiplash. 4. Aged between 18 years and 65 years old. 5. Proficient in written and spoke English.
Exclusion criteria
Key exclusion criteria: 1. Known or suspected serious spinal pathology (e.g. metastatic disease of the spine). 2. Confirmed fracture or dislocation at time of injury. 3. Nerve root compromise. 4. Spinal surgery in the past 12 months. 5. Any coexisting medical condition which would severely restrict participation in the exercise program e.g. traumatic brain injury. 6. Any of the contraindications to exercise listed in the American College of Sports Medicine (ACSM) guideline screened using the Physical Activity Readiness Questionnaire (PAR-Q).
Outcome results
None listed