Neck Exercises, Training and Pain Management as a Treatment for Whiplash Patients With Chronic Neck Pain

Not Applicable

Completed

• Conditions: Neck Pain; Chronic Pain Syndrome
• Interventions: Other: Education and training; Behavioral: Pain management

• Registration Number: NCT01431261
• Lead Sponsor: University of Southern Denmark

Brief Summary

The purpose of this study is to test whether a physiotherapy intervention containing pain management, general training and specific neck exercises can improve function for patients with chronic neck pain.

Detailed Description

Neck pain is widespread problem. The prevalence of neck pain in the Scandinavian countries is 36%. Of the working population the prevalence of chronic neck pain is 10 - 20%.The National Board of Health estimates that 5-6000 subjects per year in Denmark are involved in a traffic accident evoking whiplash-induced chronic neck pain. The main problems for patients with chronic neck pain are cervical dysfunction, reduced neck mobility and stability in addition to local and possibly generalised pain Besides chronic neck pain, patients may suffer from poor pain coping strategies and physical inactivity which influences physical function, general health and causes a poor quality of life.

Physical training including specific exercises targeting the deep postural muscles of the spine is effective in reducing neck pain for patients with chronic neck pain. Physical behavioural graded activity is a treatment approach with focus on increasing general physical fitness, reducing fear of movements and increasing psychological function. Educational sessions, where the focus is on understanding complex chronic pain mechanisms and development of appropriate pain coping and/or cognitive behavioural strategies have shown reduced general pain.

Thus this project is formulated on the expectation that rehabilitation of patients with chronic neck pain after a whiplash accident must target cervical dysfunctions, training of physical function and the understanding and management of chronic pain in a combined therapy approach.

The study is designed as a randomized control study including 200 patients. All participate in the educational sessions. The training group receives on top of that instruction in specific neck exercises and general training.

Study Timeline

• Study First Submitted: 2011-08-30
• Study First Submitted QC: 2011-09-08
• Study First Posted: 2011-09-09
• Study Start: 2012-01
• Primary Completion: 2016-06
• Study Completion: 2016-06
• Status Verified: 2016-10
• Last Update Submitted: 2016-10-06
• Last Update Posted: 2016-10-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 200

Inclusion Criteria

• chronic neck pain for at least 6 months
• reduced physical neck function (NDI minimum 10)
• pain primarily in the neck region,
• finished any medical /radiological examinations
• able to read and understand Danish and
• able to participate in the exercise program.

Exclusion Criteria

• radiculopathies upper extremity
• neurological deficits
• in a process of examining for unknown pathology,
• experimental medical treatment,
• being in a unstable social situation
• pregnancy
• fractures
• suffering from depression
• other known coexisting medical conditions which would severely restrict participation in the exercise program

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Pain Management + Training	Education and training	Education in pain management strategies and treatment sessions including instructions in neck exercises and aerobic training
Pain Management	Pain management	Education in pain management strategies

Primary Outcome Measures

Name	Time	Method
Medical Outcomes Study Short Form 36 (SF36) - Physical Component Summary (PCS)	12 months

Secondary Outcome Measures

Name	Time	Method
TAMPA scale of Kinesiophobia	12 months	questionnaire
Pain Specific Functioning Scale	4 months and 12 months	questionnaire
Mechanical allodynia	12 months	Pressure pain treshold for selected points
Self-rated measure Global Perceived Effect	12 months	questionnaire
Pain Bothersomeness	12 months	questionnaire
craniocervical flexion test	12 months	test for the deep cervical flexor muscles
cervical range of motion	12 months
Impact of Event scale	12 months	questionnaire
neck positioning test	12 months	neck joint position error test and gaze stability test
Neck Disability Index	12 months	questionnaire
Euroqol-5D	12 months	questionnaire

Trial Locations

Locations (1)

University of Southern Denmark, Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics; 🇩🇰 Odense, Denmark