title: One- and two-year follow-up of a randomized trial of neck-specific exercise with or without a behavioural approach compared with prescription of physical activity in chronic whiplash disorder.
abstract: OBJECTIVE
  To explore whether neck-specific exercise, with or without a behavioural approach, has benefits after 1 and 2 years compared with prescribed physical activity regarding pain, self-rated functioning/disability, and self-efficacy in management of chronic whiplash.
  
  
  METHODS
  Follow-up of a randomized, assessor blinded, clinical trial.
  
  
  METHODS
  A total of 216 volunteers with chronic whiplash-associated disorders, grades 2 or 3.
  
  
  METHODS
  Participants were randomized to 1 of 3 exercise interventions: neck-specific exercise with or without a behavioural approach, or physical activity prescription. Self-rated pain (visual analogue scale), disability/functioning (Neck Disability Index/Patient Specific Functional Scale) and self-efficacy (Self-Efficacy Scale) were evaluated after 1 and 2 years.
  
  
  RESULTS
  Both neck-specific exercise groups maintained more improvement regarding disability/functioning than the prescribed physical activity group at both time-points (p ≤ 0.02). At 1 year, 61% of subjects in the neck-specific group reported at least 50% pain reduction, compared with 26% of those in the physical activity prescription group (p < 0.001), but at 2 years the difference was not significant.
  
  
  CONCLUSIONS
  After 1-2 years, participants with chronic whiplash who were randomized to neck-specific exercise, with or without a behavioural approach, remained more improved than participants who were prescribed general physical activity.
authors.affiliation: Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, SE-581 83 Linköping, Sweden. maria.landen.ludvigsson@liu.se.
authors.forename: Maria Landén
authors.initials: ML
authors.lastname: Ludvigsson
authors.forename: Gunnel
authors.initials: G
authors.lastname: Peterson
authors.forename: Åsa
authors.initials: Å
authors.lastname: Dedering
authors.forename: Anneli
authors.initials: A
authors.lastname: Peolsson
mesh_terms: D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy; D004185:Disability Evaluation; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D064232:Visual Analog Scale; D014911:Whiplash Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D055815:Young Adult