Whiplash Injuries
Conditions
Brief summary
The goal of this clinical trial is to address the critical need for effective interventions by developing and testing an interdisciplinary values-based cognitive behavioral therapy (V-CBT) program for individuals with persistent whiplash. The main question it aims to answer are: * What is the treatment effect of the interdisciplinary values-based cognitive behavioral therapy (V-CBT) program on individuals with persistent whiplash? * What are the temporal relationships between primary and secondary outcome measures in the context of the V-CBT program? Participants will undergo a replicated multiple baselines single-case experimental design (SCED). Twelve participants who meet specific eligibility criteria will be block-randomized to a 1, 2, or 3-week baseline phase, serving as their own controls. The intervention involves an interdisciplinary team delivering a manualized adapted V-CBT program over ten sessions, focusing on psychological and physical rehabilitation. Participants will be required to attend these sessions as part of the treatment protocol. Data collection includes daily online self-reports and comprehensive measurements at pre-treatment, post-treatment, and a three-month follow-up.
Interventions
The intervention offers a 10-session treatment for chronic Whiplash-Associated Disorder (WAD). The manualized adapted version of value-based cognitive behavioral treatment (V-CBT) is conducted by interdisciplinary teams of psychologists and physiotherapists. The program, based on V-CBT principles, focuses on psychoeducation, fostering self-efficacy, and setting value-based goals in the initial three sessions. The subsequent seven sessions involve physiotherapists trained in V-CBT, addressing psychological, physical, social, and practical barriers hindering engagement in participants' lives. Each session combines psychologically informed themes and supervised exercises, aiming to enhance engagement in values-based activities.
Sponsors
University of Southern Denmark
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
A replicated multiple baselines single-case experimental design with three baseline phases. Baseline randomization into three tiers.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* have persistent symptoms after a whiplash injury that happened more than 3 months ago * have pain and disability defined as \> 35 % on Neck Disability Index (NDI) * be 18 years or older * speak and read Danish
Exclusion criteria
* denote headache as the primary problem * show red flags in the neurological and physiotherapeutic examination such as known or suspected serious spinal pathology, confirmed fracture or dislocation in the neck at the time of injury or signs of nerve root compromise (weakness, reflex changes or sensory loss) * have had spinal surgery within the past 12 months * are socially and occupationally unresolved * have daily significant functional limitations related to other pain conditions * have severe psychiatric illness * are pregnant * are not willing or able to respond to items on a daily basis.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Value-based living | Daily throughout baseline phase (1-3 weeks) and treatment phase (10 weeks). | Single item measure based on Engaged Living Scale. Scored on a scale from 0 to 10. Higher scores means greater levels of value-based living. |
| Pain interference | Daily throughout baseline phase (1-3 weeks) and treatment phase (10 weeks). | Three single items focused specifically on general activities, relations with other people, and sleep. Based on Brief Pain Inventory. All three are scored on a scale from 0 to 10. Higher scores means greater levels of pain interference. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain catastrophizing | Daily throughout baseline phase (1-3 weeks) and treatment phase (10 weeks). | Single item measure based on Daily Pain Catastrophizing Scale). Scored on a scale from 0 to 10. Higher scores means greater levels of pain catastrophizing. |
| Positive affect | Daily throughout baseline phase (1-3 weeks) and treatment phase (10 weeks). | Single item measure based on previous diary studies. Scored on a scale from 0 to 10. Higher scores means greater levels of positive affect. |
| Negative affect | Daily throughout baseline phase (1-3 weeks) and treatment phase (10 weeks). | Single item measure based on previous diary studies. Scored on a scale from 0 to 10. Higher scores means greater levels of negative affect. |
| Stress | Daily throughout baseline phase (1-3 weeks) and treatment phase (10 weeks). | Single item measure based on previous diary studies. Scored on a scale from 0 to 10. Higher scores means greater levels of stress. |
| Fatigue | Daily throughout baseline phase (1-3 weeks) and treatment phase (10 weeks). | Single item measure based on previous diary studies. Scored on a scale from 0 to 10. Higher scores means greater levels of fatigue. |
| Pain severity | Daily throughout baseline phase (1-3 weeks) and treatment phase (10 weeks). | Single item measure based on Brief Pain Inventory. Scored on a scale from 0 to 10. Higher scores means greater levels of pain severity. |
| Neck Disability | Pre-treatment, post-treatment (i.e., within one week from the day of last treatment), 3 months follow-up after treatment completion | Neck Disability Index. 10 item scale. Scored on a scale from 0 to 5. Higher total scores indicate greater disability. |
| Pain-related acceptance | Daily throughout baseline phase (1-3 weeks) and treatment phase (10 weeks). | Single item measure based on Chronic Pain Acceptance Questionnaire. Scored on a scale from 0 to 10. Higher scores means greater levels of acceptance. |
| Anxiety | Pre-treatment, post-treatment (i.e., within one week from the day of last treatment), 3 months follow-up after treatment completion | Generalized Anxiety Disorder (GAD-7). 7 items. Scored on a scale from 0 to 3. Higher total scores indicate greater levels of anxiety. |
| Health-related quality of life | Pre-treatment, post-treatment (i.e., within one week from the day of last treatment), 3 months follow-up after treatment completion | EuroQoL-5D-5L. 5 items scored on a 5-point scale and one item scored on a 0 to 100 scale. Higher scores on the first 5 items indicate reduced quality of life and higher scores on the last item indicates greater quality of life. |
| Sleep quality | Pre-treatment, post-treatment (i.e., within one week from the day of last treatment), 3 months follow-up after treatment completion | Karolinska Sleep Questionnaire. 4 items scores on a scale from 0 to 5. Higher total scores indicates poorer quality of sleep. |
| Self-perceived improvement | Pre-treatment, post-treatment (i.e., within one week from the day of last treatment), 3 months follow-up after treatment completion | Global Rating of Change. 1 item scored on a scale from 1 to 15. Higher scores indicate greater level of self-perceived improvement. |
| Satisfaction with treatment | Pre-treatment, post-treatment (i.e., within one week from the day of last treatment), 3 months follow-up after treatment completion | Self-developed NRS-item from 0 = not at all satisfied to 10 = completely satisfied. |
| Pain Disability | Pre-treatment, post-treatment (i.e., within one week from the day of last treatment), 3 months follow-up after treatment completion | Pain Disability Index. 7 items scored on a scale from 0 to 10. Higher total scores indicate greater disability. |
| Depression | Pre-treatment, post-treatment (i.e., within one week from the day of last treatment), 3 months follow-up after treatment completion | Patient Health Questionnaire (PHQ-9). 9 item scale. Scored on a scale from 0 to 3. Higher total scores indicate greater levels of depression. |
| Pain-related self-efficacy | Daily throughout baseline phase (1-3 weeks) and treatment phase (10 weeks). | Single item measure based on Pain Self-efficacy Questionnaire. Scored on a scale from 0 to 10. Higher scores means greater levels of self-efficacy. |
Countries
Denmark
Outcome results
None listed