None listed
Conditions
Brief summary
Posttraumatic stress reactions have been indetified as a predictor or poorer outcomes for individuals with whiplash injury in longitudinal studies and poorer response to physical therapy in previous research. This study aims to investigate whether or not stress innoculation training added to standard exercise program will decrease pain and disability in people with acute whiplash injury. It is hypothesised that stress iccoculation will decrease physiological arousal and stress reponses in those at risk individuals and thus facilitate the effects of the exercise program.
Interventions
Physiotherapy Exercise and Stress Inocculation Training (SIT):
Exercise: The 6-week exercise intervention includes 2 sessions/week in weeks 1-4 and 1 session/week in weeks 5-6. Each session will be a maximum of 50minutes (determined by the physiotherapist) and comprise of specific exercises to improve movement and control of the neck and shoulder girdles as well as exercises to improve eye/head co-ordination. The exercises will be tailored and supervised by the physiotherapist for each individu
Physiotherapy Exercise and Stress Inocculation Training (SIT): Exercise: The 6-week exercise intervention includes 2 sessions/week in weeks 1-4 and 1 session/week in weeks 5-6. Each session will be a maximum of 50minutes (determined by the physiotherapist) and comprise of specific exercises to improve movement and control of the neck and shoulder girdles as well as exercises to improve eye/head co-ordination. The exercises will be tailored and supervised by the physiotherapist for each individual participant. Exercises are of a low load nature and designed to be pain free. Paricipants will perform exercises at home once/day and a log book will be completed by participants to record compliance with the exercises.Physiotherapists will also guide participants to return to normal daily activities. Stress Inoculation Training: Trained physiotherapists will provide information and strategies to assist participants in managing acute stress reactions following a motor vehicle accident. The Stress Inoculation Training will be delivered once per week and integrated with the exercise program sessions and incorporated into the 50minutes maximum session length to control for any attention placebo effect compared to the control group. The first session will include education about the effects of acute stress following an injury. At subsequent sessions additional strategies for managing stress will be introduced including abdominal breathing, progressive muscle relation, simple cognitive behavioural skills to encourage positive coping, reduce avoidance behaviours and develop problem solving skills. Participants will be required to perform daily practice of stress management skills and complete a log book to record compliance. Chief Investigator Kenardy will audit the SIT intervention to check for adherence.
Sponsors
University of Queensland
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
- Whiplash Associated Disorder grade II of less than 6weeks duration. - Currenting experiencing at least moderate pain (VAS > 5/10)or moderate disability due to pain (NDI > 30%).
Exclusion criteria
- Not currently recieving any care for whiplash. - Known or suspected serious spinal pathology (e.g. metastatic, inflamatory or inefective disease in the spine) - Confirmed fractur or dislocation at the time of injury (i.e. WAD IV). - nerve root compromise with atleast two of the following signs: weakness/reflex changes/sensory loss, associated with the same spinal nerve (i.e. WAD III). - Spinal surgery in the past 12months - Meeting criteria for a probably diagnosis of Acute Stress Disorder on te ASDS. - Current diagnosis for major depressive episode requiring treatment or medicaiton. - A history of psychosis, biopolar disorder, organic brain disprder or severe depression.
Outcome results
None listed