Shifting Away From Pain: Neurocognitive Approach to Explain and Predict the Response to the Modern Neuroscience Approach for Treating Patients With Whiplash Associated Disorders
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Whiplash Injuries
- Sponsor
- University Ghent
- Enrollment
- 95
- Locations
- 1
- Primary Endpoint
- blood oxygenation level dependent (BOLD) signal (functional MRI) during picture imagination task and during resting state
- Status
- Completed
- Last Updated
- 3 years ago
Overview
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.
Investigators
Eligibility Criteria
Inclusion Criteria
- •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).
Exclusion Criteria
- •Neuropathic pain
- •Being pregnant or having given birth in the preceding year
- •Chronic fatigue syndrome
- •Fibromyalgia
- •Cardiovascular disorders
- •Endocrinological disorders
- •Rheumatic disorders
- •Psychiatric disorders
- •History of neck surgery
- •Loss of consciousness during/after the whiplash trauma
Outcomes
Primary Outcomes
blood oxygenation level dependent (BOLD) signal (functional MRI) during picture imagination task and during resting state
Time Frame: 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)
Time Frame: 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