title: Factors associated with pain and disability reduction following exercise interventions in chronic whiplash.
abstract: BACKGROUND
  Some studies support the prescription of exercise for people with whiplash-associated disorders (WAD); however, the response is highly variable. Further research is necessary to identify factors which predict response.
  
  
  METHODS
  This is a secondary analysis of a randomized, multicentre controlled clinical trial of 202 volunteers with chronic WAD (grades 2 and 3). They received either neck-specific exercise with, or without a behavioural approach, or prescription of physical activity for 12 weeks. Treatment response, defined as a clinical important reduction in pain or disability, was registered after 3 and 12 months, and factors associated with treatment response were explored using logistic regression.
  
  
  RESULTS
  Participation in the neck-specific exercise group was the only significant factor associated with both neck pain and neck disability reduction both at 3 and 12 months. Patients in this group had up to 5.3 times higher odds of disability reduction and 3.9 times higher odds of pain reduction compared to those in the physical activity group. Different baseline features were identified as predictors of response depending on the time point examined and the outcome measure selected (pain vs. disability).
  
  
  CONCLUSIONS
  Factors associated with treatment response after exercise interventions differ in the short and long term and differ depending on whether neck pain or disability is considered as the primary outcome. Participation in a neck-specific exercise intervention, in contrast to general physical activity, was the only factor that consistently indicated higher odds of treatment success. These results support the prescription of neck-specific exercise for individuals with chronic WAD.
authors.affiliation: Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Sweden.|Rehab Väst, County Council of Östergötland, Sweden.
authors.forename: M L
authors.initials: ML
authors.lastname: Ludvigsson
authors.affiliation: Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Sweden.|Centre for Clinical Research Sörmland, Uppsala University, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Peterson
authors.affiliation: Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.|Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Å
authors.initials: Å
authors.lastname: Dedering
authors.affiliation: Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Germany.|Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology (BFNT) Göttingen, Bernstein Center for Computational Neuroscience, University Medical Center Göttingen, Georg-August University, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Falla
authors.affiliation: Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Peolsson
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D010147:Pain Measurement; D016896:Treatment Outcome; D014911:Whiplash Injuries / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*