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 - Scorecard - MDSpire
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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
Clinical Scorecard: Impact of Internet-Supported versus Traditional Neck-Specific Exercises on Psychological Outcomes in Chronic Whiplash-Associated Disorders
At a Glance
Category
Detail
Condition
Chronic whiplash-associated disorders (WAD)
Key Mechanisms
Interplay of physical symptoms and psychological factors including pain catastrophizing, fear-avoidance beliefs, self-efficacy, depression, and anxiety
Target Population
Adults with chronic WAD grades II and III
Care Setting
Physiotherapy clinic and internet-based intervention with limited clinical visits
Key Highlights
Internet-based neck-specific exercise program (NSEIT) with fewer clinic visits is as effective as traditional physiotherapist-led program (NSE) for psychological outcomes.
Both interventions showed significant improvements over time in cognitive-behavioral factors and emotional distress with small to intermediate effect sizes.
Baseline psychological factors did not moderate treatment effects on neck-specific disability.
Guideline-Based Recommendations
Diagnosis
Assess psychological factors such as pain catastrophizing, fear-avoidance beliefs, self-efficacy, depression, and anxiety in chronic WAD patients.
Management
Implement neck-specific exercise programs either via internet-based delivery with limited physiotherapist visits or traditional clinic-based sessions.
Exercise and patient education remain primary recommended interventions for chronic WAD.
Monitoring & Follow-up
Monitor changes in cognitive-behavioral factors and emotional distress over time during treatment.
Risks
Persistent symptoms in chronic WAD are linked to psychological factors rather than collision-related factors; consider psychological distress in management.
Patient & Prescribing Data
Individuals with chronic WAD grades II and III
Internet-based neck-specific exercises with minimal clinical visits provide comparable psychological benefits to traditional physiotherapy-led programs.
Clinical Best Practices
Consider internet-based neck-specific exercise programs to optimize resource use without compromising psychological outcomes.
Incorporate assessment and monitoring of psychological factors alongside physical symptoms in chronic WAD management.
Do not stratify treatment delivery based solely on baseline psychological characteristics as they do not moderate treatment effect on disability.
Background music and multimedia exposure were associated with lower patient-reported anxiety in a quasi-experimental ophthalmology clinic study that used existing clinic audiovisual infrastructure at no additional cost.
