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Peolsson A.1, Landén Ludvigsson M.1,2, Peterson G.1,3
1Linköping University, Medical and Health Sciences, Physiotherapy, Linköping, Sweden, 2Rehab Väst, County Council of Östergötland, Motala, Sweden, 3Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
Background: There is limited evidence reagrding the best exercise strategies for individuals with chronic whiplash associated disorders (WAD).
Purpose: To investigate if there were differences between 3 different exercise strategies regarding neck muscle endurance (NME) and health related quality of life (HRQL) for individuals with chronic WAD and to investigate if a change in NME was related to a change in HRQL.
Methods: This was a prospective randomized, multi-center, assessor-blinded trial with a 12 months follow-up. Participants with WAD grade II or III (n=216, mean age 40 years (SD 11.4)) were randomized to 3 months of neck specific exercises without (NSE) or with an additional behavioral approach (NSEB), or to prescribed general physical activity (PPA). Ventral and dorsal NME was measured in seconds and HRQL was measured with EuroQol 5 dimension (EQ-5D) and EQ thermometer (EQ-VAS). Data were analyzed with linear mixed model or if not normally distributed with Kruskal Wallis followed by Mann-Whitneys U-test. Spearman´s rank correlation coefficient was used to investigate correlations between NME and HRQL.
Results: For dorsal NME there was a significant (p=0.03) group x time interaction effect with improvement in both the NSEB and NSE groups from baseline to 12 months (mean improvement of 81 and 79 seconds, respectively, p 0.001), compared with the PPA group (mean improvement of 9 seconds, p=1.0). There were no significant group x time interaction effect for ventral NME (p= 0.68) or EQ-VAS (0.06). The NSE and NSEB groups significantly improved in EQ-5D compared with the PPA group (≤0.05). There were low (r= 0.25 to 0.27), but significant (p= 0.001 to 0.002) correlations between change in NME variables and change in HRQL variables from baseline to the 12 months follow-up.
Conclusion(s): The NSE and NSEB groups were improved in dorsal NME and EQ-5D with strong tendencies also for EQ-VAS. There were low correlations between change in NME and change in HRQL.
Implications: Dorsal NME, but not ventral NME improved from neck-specific exercises. Larger future emphasizes is necessary to improve ventral NME and to investigate the role of NME regarding patient reported outcomes.
Funding acknowledgements: Governmental Research Councils, County Council of Östergötland and Sörmland and Linköping University.
Topic: Musculoskeletal: spine
Ethics approval: Approved by the Regional Ethics Committee of Linköping, Sweden
All authors, affiliations and abstracts have been published as submitted.
