Evaluation of a physical activity promotion intervention for adults with whiplash associated disorders: a single-case experimental design study

Ritchie, Carrie; Clanchy, Kelly; Sterling, Michele; Tate, Robyn; Smits, Esther J.; Day, Melissa A.; Nikles, Jane; Liimatainen, Jenna; Tweedy, Sean M.

doi:10.1080/09638288.2021.1989062

Cited by 6 publications

(5 citation statements)

References 52 publications

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“…Both median physical and mental HRQoL for WAD were below population norms, levels consistently shown in WAD [ 18 , 36 ]. While physical HRQoL had a small positive association with objectively measured overall PA, increased mental HRQoL predicted increased objectively measured MVPA.…”

Section: Discussionmentioning

confidence: 99%

“…Participation in PA improves perceptions of quality of life. Previous research by our group showed SF12PCS and SF12MCS scores increased to levels above population norms in participants with persistent WAD following participation in a 12-week PA intervention [ 36 ]. Similarly, in general populations, both physical and mental HRQoL scores have been shown to improve following increased frequency of moderate PA [ 40 ], with a positive dose-response relationship between weekly MVPA and HRQoL reported across age groups [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

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Objectively and subjectively measured physical activity levels in individuals with whiplash associated disorder and aged-matched healthy controls

Ritchie,

Smits,

Armfield

et al. 2023

PLoS ONE

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Background Whiplash associated disorders (WAD) are the most common non-hospitalised injuries resulting from a motor vehicle crash. Half of individuals with WAD experience ongoing pain and disability. Furthermore, individuals with persistent WAD have lower levels of aerobic capacity and isometric strength compared with age-matched controls. It is not known whether these differences are associated with increased levels of pain and disability, or with reduced physical activity (PA) participation. Objective Our primary aim was to compare PA levels in individuals with persistent WAD with healthy controls. Secondary aims were to: compare objective and subjective measurements of PA; explore factors that may influence PA; and describe proportions of these populations meeting World Health Organisation PA guidelines. Methods Objective (ActiGraph accelerometer; seven days) and subjective (International Physical Activity Questionnaire (IPAQ)) PA data were collected for n = 53 age-matched participants (WAD n = 28; controls n = 25). Results Independent sample t-tests showed no significant difference in objectively measured PA (p>0.05) between WAD and controls. For the subjective measure (IPAQ), controls reported more overall weekly PA (t = 0.219, p<0.05), while WAD participants reported more weekly walking minutes (t = -0.712, p<0.05). Linear regression showed mental health quality-of-life predicted objectively measured moderate intensity PA (R2 = 0.225, F (2, 44) = 6.379, p<0.004) and subjectively reported overall PA (R2 = 0.132, F (1, 41) = 6.226, p<0.017). Bland-Altman analyses indicated that subjects over-reported MVPA and under-reported sedentary time using the IPAQ. Conclusions Individuals with WAD had levels of physical and mental health quality-of-life significantly lower than controls and below population norms yet participated in similar levels of PA. Given that increased perceptions of mental health quality-of-life were positively associated with objectively measured MVPA and subjectively reported overall PA, strategies to help people with WAD achieve adequate doses of MVPA may be beneficial. ActiGraph-measured and IPAQ-reported PA were discordant. Hence, IPAQ may not be a reliable measure of habitual PA in WAD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Objectively and subjectively measured physical activity levels in individuals with whiplash associated disorder and aged-matched healthy controls

Ritchie,

Smits,

Armfield

et al. 2023

PLoS ONE

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“…Confidence in performing daily activities was evaluated using the question “How confident are you in your ability to perform your daily tasks in the presence of your neck pain or disability?” with 1 indicating not at all confident; 2 indicating a little confident; 3 indicating moderately confident; 4 indicating very confident and 5 indicating extremely confident. This question has previously been used to evaluate self-efficacy in chronic WAD (Ritchie et al, 2021).…”

Section: Methodsmentioning

confidence: 99%

“…with 1 indicating not at all confident; 2 indicating a little confident; 3 indicating moderately confident; 4 indicating very confident and 5 indicating extremely confident. This question has previously been used to evaluate self-efficacy in chronic WAD (Ritchie et al, 2021).…”

Section: Study Personnelmentioning

confidence: 99%

The Efficacy of Multimodal Physiotherapy versus Usual Care in Chronic Whiplash-Associated Disorders With Facet-Mediated Pain Undergoing Platelet Rich Plasma treatment: A Series of Single Case Experimental Designs

Smith,

Gupta,

Stone

et al. 2023

Preprint

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Purpose: Chronic whiplash-associated disorders (WAD) is a heterogeneous condition with limited effective treatment options available. This study evaluated the effectiveness of multimodal physiotherapy versus usual care in chronic WAD with facet-mediated pain receiving platelet-rich plasma (PRP) injections to determine if pain interference and confidence completing activities in the presence of neck pain could be improved. Materials and Methods: A multiple-baseline, single-case experimental design was used to evaluate the 6-week effect of physiotherapy or usual care in two groups of three participants each. Results: All six participants demonstrated a significant reduction in pain interference, and three participants showed improved confidence to perform daily activities when in pain. Weighted Tau-U demonstrated a significant reduction of pain interference with large to very large effect sizes (> 0.75) for both interventions in all participants irrespective of treatment allocation with no significant group difference demonstrated. Similar effects were demonstrated for the confidence to perform daily activities with neck pain (ES > 0.46), although this was only evident in three participants (two PT and one UC). Generalization measures also showed improvements in pain and disability, psychological and quality of life outcomes. No adverse events were reported. Conclusions: Both physiotherapy and usual care demonstrated improvements in pain interference and confidence to perform activities of daily living with neck pain in people with chronic WAD following cervical facet joint PRP.

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“…Individual study characteristics are reported in Table 1. [1][2][3]5,6,8,9,11,12,19,23,25,29,31,32,34,35,43,[50][51][52][53][54]57,[61][62][63][64]66,70,72,[74][75][76][79][80][81] Of included RCTs, 4 explicitly identified the trial type as a preliminary, 70 feasibility, 75 or pilot trial. 31,64 Sample sizes of included trials ranged from 12 to 152.…”

Section: Characteristics Of Included Randomized Controlled Trialsmentioning

confidence: 99%

Psychological treatments for the management of pain after musculoskeletal injury: a systematic review and meta-analysis

Aaron

Rassu

Wegener

et al. 2023

Pain

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Musculoskeletal injury is a leading cause of pain and disability worldwide; 35% to 75% of people experience persistent pain for months and years after injury. Psychological treatments can reduce pain, functional impairment, and psychological distress but are not widely used after injury. This systematic review and meta-analysis (PROSPERO ID: CRD42021236807) aimed to synthesize the literature testing psychological treatments for pain after musculoskeletal injury. We searched EMBASE, MEDLINE, PubMed, PsycINFO, and CENTRAL from inception to May 2022. We extracted participant, treatment, and injury characteristics and primary (eg, pain intensity, functional impairment, depression, anxiety, and PTSD symptoms) and secondary (treatment feasibility and acceptability) outcomes. Twenty-four randomized controlled trials (N = 1966) were included. Immediately posttreatment, people who received psychological treatments (versus any control) reported lower pain intensity (standardized mean differences [SMD] = −0.25, 95% confidence interval [−0.49, −0.02]), functional impairment (SMD = −0.32 [−0.55, −0.09]), and symptoms of depression (SMD = −0.46 [−0.64, −0.29]), anxiety (SMD = −0.34 [−0.65, −0.04]), and PTSD (SMD = −0.43 [−0.70, −0.15]); at 6-month follow-up, only depression symptoms were significantly lower. Included trials varied widely in treatment and injury characteristics. The certainty of evidence was low or very low for most effects and heterogeneity moderate to substantial. Most studies had risk of bias domains judged to be high or unclear. Owing to very low certainty of results, we are unsure whether psychological therapies reduce pain and functional impairment after musculoskeletal injury; they may result in improved depression immediately posttreatment and at follow-up. More research is needed to identify treatments that result in enduring effects.

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Evaluation of a physical activity promotion intervention for adults with whiplash associated disorders: a single-case experimental design study

Cited by 6 publications

References 52 publications

Objectively and subjectively measured physical activity levels in individuals with whiplash associated disorder and aged-matched healthy controls

Objectively and subjectively measured physical activity levels in individuals with whiplash associated disorder and aged-matched healthy controls

The Efficacy of Multimodal Physiotherapy versus Usual Care in Chronic Whiplash-Associated Disorders With Facet-Mediated Pain Undergoing Platelet Rich Plasma treatment: A Series of Single Case Experimental Designs

Psychological treatments for the management of pain after musculoskeletal injury: a systematic review and meta-analysis

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