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.
Objective Chronic 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 pr...
| Publicado en: | Pain Medicine Vol. 12; no. 7; pp. 794 - 804 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Jul2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=195099785&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 195099785 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15262375 FRX jtl: Pain Medicine issn: 15262375 maglogo: N pubinfo: dt: Jul2026 vid: 12 iid: 7 pid: 10398 pub: Oxford University Press / USA artinfo: ui: 195099785 195099785 195099785 10.1093/pm/pnaf179 195099785 ppf: 794 ppct: 10 formats: tig: atl: 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. aug: au: Zetterberg, Hedvig Boersma, Katja Peolsson, Anneli Peterson, Gunnel affil: Department of Psychology and Social Work, Mid Sweden University, Östersund, SE-831 25, SwedenCenter for Health and Medical Psychology (CHAMP), School of Behavioral, Social, and Legal Sciences, Örebro University, Örebro, SE-701 82, Sweden sug: subj: Whiplash Injuries Rehabilitation Treatment Outcomes Therapeutic Exercise Methods Internet-Based Intervention Catastrophization Prevention and Control Fear Prevention and Control Avoidance (Psychology) Evaluation Self-Efficacy Evaluation Psychological Distress Prevention and Control Cognition Evaluation Neck Pathology Human Ambulatory Care Facilities Secondary Analysis Linear Regression After Care Male Female Checklists Questionnaires Data Analysis Software Descriptive Statistics Analysis of Variance Post Hoc Analysis Multiple Regression Funding Source Male Female ab: Objective Chronic 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. Methods This 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. Results No 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. Conclusion The 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 registration www.ClinicalTrials.gov ID: NCT03022812 (December 20, 2016). pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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