Shifting Away From Pain: a Neurocognitive Approach in Treatment of Whiplash
- Conditions
- Whiplash Injuries
- Interventions
- Behavioral: Modern pain neuroscience approachBehavioral: Usual care physiotherapy
- Registration Number
- NCT04077619
- Lead Sponsor
- University Ghent
- Brief Summary
The broad aim of this study is to investigate the effect of a modern neuroscience approach, which combines education on pain neuroscience with cognition-targeted exercise therapy and stress management, on brain structure and networks in patients with chronic whiplash-associated disorders (CWAD) in comparison to a control physiotherapy treatment.
- Detailed Description
This project runs in parallel to a larger randomized-controlled trial (RCT) in which the 'modern neuroscience approach to WAD' is compared to usual care evidence-based physiotherapy (clinical trial registration number: NCT03239938). For the current study, additional magnetic resonance imaging (MRI) measures will be taken in a subsample of patients, who will be recruited from this larger RCT. In addition, a pain-free age- and sex-matched control group will be recruited for comparison.
The current study consists of 2 MRI measurements that will take place at the University Hospital of Ghent (UZ Gent): baseline (pre-treatment) and follow-up (post-treatment; approximately 16 weeks after baseline). After pre-treatment assessment, the patients will be randomly allocated to the modern neuroscience approach or usual care physiotherapy, as part of the RCT.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 95
- Experienced a whiplash trauma which is at least 3 months old and causes pain since at least 3 months, with pain experience with a mean pain frequency of 3 or more days per week, and with self-reported moderate to severe pain-related disability, established by a score of 15 or more of a maximum of 50 on the Neck Disability Index
- Patients classified as WAD II or WAD III on the modified Quebec Task Force Scale
- Native Dutch speaker
- Not starting new treatments or medication and continuing their usual care 6 weeks prior to and during study participation (to obtain a steady state)
- Refraining from consuming caffeine, alcohol and nicotine in the hour before the MRI scans (in both measurement times: before the start of the rehabilitation and after the end of the rehabilitation).
- Neuropathic pain
- Being pregnant or having given birth in the preceding year
- Chronic fatigue syndrome
- Fibromyalgia
- Cardiovascular disorders
- Epilepsy
- Endocrinological disorders
- Rheumatic disorders
- Psychiatric disorders
- History of neck surgery
- Loss of consciousness during/after the whiplash trauma
- MRI incompatible health condition (e.g., pacemaker, metal prosthetic devices)
- Psychiatric condition and ongoing medication that would alter emotional or sensory processing
- Claustrophobia.
Healthy volunteers: (matched for age and gender). Additional exclusion criteria include for healthy volunteers
- a history of a chronic pain syndrome
- a pain condition in the last six months for which treatment was sought
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Modern pain neuroscience approach Modern pain neuroscience approach Behavioral: Modern pain neuroscience approach Usual care evidence-based physiotherapy Usual care physiotherapy Behavioral: Usual care evidence-based physiotherapy
- Primary Outcome Measures
Name Time Method blood oxygenation level dependent (BOLD) signal (functional MRI) during picture imagination task and during resting state Baseline (pre-treatment) assessment and follow-up assessment after 16 weeks of therapy (end of treatment). change between baseline assessment and the follow-up assessment after 16 weeks (after end of treatment) will be examined
structural MRI measures (i.e., grey and white matter) Baseline (pre-treatment) assessment and follow-up assessment after 16 weeks of therapy (end of treatment). change between baseline assessment and the follow-up assessment after 16 weeks (after end of treatment) will be examined
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Department of rehabilitation sciences (Ghent University)
🇧🇪Ghent, Belgium