Trial reportPain medicine (Malden, Mass.)2026
Efficacy of neck-specific exercises with and without internet-based support on psychological factors in chronic whiplash-associated disorders: secondary analyses of a randomized controlled trial.
Trial report in Pain medicine (Malden, Mass.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03022812 (Is E-health a Way to Increase Ability and Health and Make Health Care More Effective in Chronic Whiplash? A Prospective Randomized Controlled Multicenter Trial), which is not on this map. Not yet cited in PubMed.
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Is E-health a Way to Increase Ability and Health and Make Health Care More Effective in Chronic Whiplash? A Prospective Randomized Controlled Multicenter Trial
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4 authors.
Funding
Abstract
objectiveChronic whiplash-associated disorders (WAD) can involve complex interactions between physical symptoms and psychological factors, and long-term effects of exercise programs are of interest. This study aimed to evaluate the effects of a predominantly internet-based neck-specific exercise program (NSEIT) compared with the same neck-specific exercises (NSE) performed at a physiotherapy clinic on psychological outcomes in chronic WAD, including cognitive-behavioral factors (pain catastrophizing, fear-avoidance beliefs, self-efficacy), emotional distress (symptoms of depression, anxiety), and cognitive functioning. A further objective was to assess whether psychological factors moderated treatment effects on the primary outcome, neck-specific disability.
methodsThis secondary analysis was based on a randomized multicenter trial. Participants (n = 140) were randomized to NSEIT or NSE. Outcomes were assessed at baseline, 3 months, and 15 months. Psychological outcomes were analyzed with mixed-design analysis of variance. Moderation effects were tested by adding interaction terms (psychological factor×group) in linear regression models of neck-specific disability.
resultsNo significant group differences or group×time interactions were found for psychological outcomes. However, there were significant main effects of time for cognitive-behavioral factors and emotional distress in both groups (all P < .01), with small to intermediate effect sizes. Psychological factors did not moderate the treatment effects on neck-specific disability.
conclusionThe internet-based format (NSEIT), involving fewer clinical visits, did not differ from the more comprehensive physiotherapist-led program (NSE) with regard to psychological outcomes. Improvements in cognitive-behavioral factors and emotional distress occurred over time in both groups. The internet-based format might be suitable regardless of psychological characteristics at baseline. CLINICAL
trial registrationwww.ClinicalTrials.gov ID: NCT03022812 (December 20, 2016).
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