A three-group study, internet-based, face-to-face based and standard- management after acute whiplash associated disorders (WAD) - choosing the most efficient and cost-effective treatment: study protocol of a randomized controlled trial.
BACKGROUND
The management of whiplash associated disorders is one of the most complicated challenges with high expenses for the health care system and society. There are still no general guidelines or scientific documentation to unequivocally support any single treatment for acute care following whiplash injury. The main purpose of this study is to try a new behavioural medicine intervention strategy at acute phase aimed to reduce the number of patients who have persistent problems after the whiplash injury. The goal is also to identify which of three different interventions that is most cost-effective for patients with whiplash associated disorders. In this study we are controlling for two factors. First, the effect of behavioural medicine approach is compared with standard care. Second, the manner in which the behavioural medicine treatment is administered, Internet or face-to-face, is evaluated in it's effectiveness and cost-effectiveness.


METHODS
The study is a randomized, prospective, experimental three-group study with analyses of cost-effectiveness up to two-years follow-up. Internet - based programme and face-to-face group treatment programme are compared to standard-treatment only. Patient follow-ups take place three, six, twelve and 24 months, that is, short-term as well as long-term effects are evaluated. Patients will be enrolled via the emergency ward during the first week after the accident.


CONCLUSIONS
This new self-help management will concentrate to those psychosocial factors that are shown to be predictive in long-term problems in whiplash associated disorders, i.e. the importance of self-efficacy, fear of movement, and the significance of catastrophizing as a coping strategy for restoring and sustaining activities of daily life. Within the framework of this project, we will develop, broaden and evaluate current physical therapy treatment methods for acute whiplash associated disorders. The project will contribute to the creation of a cost-effective behavioural medicine approach to management of acute whiplash associated disorders. The results of this study will answer an important question; on what extent and how should these patients be treated at acute stage and how much does the best management cost.


BACKGROUND
Current Controlled Trials ISRCTN61531337.
Söderlund
Anne
A
Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Box 833 SE-721 23 Västerås, Sweden. anne.soderlund@mdh.se
Bring
Annika
A
Asenlöf
Pernilla
P
D000203:Activities of Daily Living; D000208:Acute Disease; D000223:Adaptation, Psychological; D001521:Behavior Therapy; D003362:Cost-Benefit Analysis; D005239:Fear; D015438:Health Behavior; D017048:Health Care Costs; D006801:Humans; D020407:Internet; D018579:Patient Selection; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D019057:Quality-Adjusted Life Years; D012107:Research Design; D012648:Self Care; D020377:Self Efficacy; D012657:Self-Help Groups; D013997:Time Factors; D016896:Treatment Outcome; D014911:Whiplash Injuries / Q000191:economics / Q000523:psychology / Q000628:therapy*