Neck-specific exercise for radiating pain and neurological deficits in chronic whiplash, a 1-year follow-up of a randomised clinical trial
Up to 90% of people with neurological deficits following whiplash injury report chronic symptoms. A recent unique study of neck-specific exercise showed positive results (post-intervention at 12 weeks), regarding arm pain and neurological deficits in people with chronic whiplash associated disorders (WAD). This 1-year follow-up of that randomised controlled study with assessor blinding aimed to examine whether neck-specific exercise with (NSEB) or without (NSE) a behavioural approach has long-term benefits over physical activity prescription (PPA) regarding arm pain and neurological deficits (n=171). Interventions were: NSE, NSEB, or PPA. Follow-up of arm pain, paraesthesia bothersomeness (questionnaires) and clinical neurological tests were performed after 3, 6 and 12 months and analysed with Linear Mixed Models and General Estimating Equations. The NSE and/or NSEB groups reported significantly less pain and paraesthesia bothersomeness as well as higher odds of normal key muscle arm strength and of normal upper limb neural tension over the year (all p<0.03), compared with PPA. In conclusion, results suggest that neck-specific exercise with or without a behavioural approach may have persisting long term benefits over PPA regarding arm pain and clinical signs associated with neurological deficits in chronic WAD. ; Funding Agencies|Swedish government through the REHSAM Foundation [RS2010/009]; Swedish Research CouncilSwedish Research Council [521-2014-2982]; County Council of ostergotland [LIO-533041, LIO-439541, LIO-197631, LIO-276151, LIO-354241]; Centre for Clinical Research Sormland at Uppsala University [DLL-553281, DLL-465071, DLL-221851, DLL-112241, DLL-376711]; Medical Research Council of Southeast Sweden [FORSS-472691, FORSS-302601, FORSS-384421]; Uppsala-orebro Regional Research Council [RFR-384651, RFR-150591, RFR-297301, RFR-215571]; Linkoping University, Sweden; Linkoping University; regional Centre for Clinical Research [LIO-533041, LIO-439541, LIO-197631, LIO-276151, LIO-354241]