Factors associated with work ability following exercise interventions for people with chronic whiplash-associated disorders: Secondary analysis of a randomized controlled trial

Abstract

This study found that neck-specific exercise with a behavioural approach intervention was better at improving self-reported work ability than neck-specific exercise or prescribed physical activity. Improvement in work ability is associated with a variety of factors.

Cognitive behavioural interventions, and function and pain outcomes among patients with chronic neck pain managed with the McKenzie approach

“…Our findings related to the efficacy of CBA interventions are consistent with both systematic reviews (Monticone et al, ; Shearer et al, ). They are also consistent with seven of the eight aforementioned randomized clinical trials specifically addressing GA/GEX on function and/or pain in patients with CNSNP (Lo et al, ; Ludvigsson et al, ; Monticone et al, ; Overmeer et al, ; Pool et al, ; Thompson et al, ; Vonk et al, ). These studies collectively concluded that augmenting interventions with GA/GEX did not have a meaningful impact on patient outcomes.…”

“…When considering GA, one study (Vonk et al, ) concluded that there was no difference between intervention groups, whereas a second study (Pool et al, ) reported outcomes in favour of the GA group that were statistically significant but not clinically relevant. In a third study (Lo et al, ), the authors stated that the group receiving GA demonstrated a statistically significant improvement in functional outcomes, although the investigators in this latter study did not address clinical relevance. Similarly, two studies (Monticone et al, ; Overmeer et al, ) reported statistically significant (Monticone et al, ; Overmeer et al, ) and clinically relevant (Monticone et al, ) outcomes in which GEX was more effective in relation to change in function, whereas three studies (Ludvigsson et al, ; Monticone et al, ; Thompson et al, ) found no effect.…”

“…Several studies, all randomized controlled trials, specifically addressed the efficacy of GA/GEX in combination with other interventions when compared with active interventions that did not include GA/GEX in patients with subacute and/or chronic neck pain (Lo et al, 2018;Ludvigsson, Peterson, O'Leary, Dedering, & Peolsson, 2015;Monticone et al, 2017;Monticone et al, 2012;Overmeer, Peterson, Ludvigsson, & Peolsson, 2016;Pool et al, 2010;Thompson, Oldham, & Woby, 2016;Vonk et al, 2009). In each of these reports, subjects in the comparison group received exercise and/or manual therapy, but there was no standardization of exercise or manual therapy interventions or adherence to any specific treatment approach in the comparison groups in any of these studies.…”

Return to work a bumpy road: A qualitative study on experiences of work ability and work situation in individuals with chronic whiplash-associated disorders

“…Poor work ability is related to the personal factors higher age, neck pain, multiple pain locations, cognitive dysfunction, low health-related quality of life, and pessimistic illness perceptions [7][8][9][10] as well as work-related stress and work dissatisfaction [7]. Associations have been found between pain relief, functional improvement and improvement in work capacity [11]; however, there are few studies evaluating the effect of rehabilitation on work ability or work capacity for individuals with chronic WAD, and thus far the effect is inconclusive [12][13][14]. Adams et al reported only marginal improvement in work ability despite rehabilitation [12].…”

“…Adams et al reported only marginal improvement in work ability despite rehabilitation [12]. Work ability was, however, improved after a multi-professional rehabilitation programme with cognitive behavioural therapy [13] and after neck-speci c exercises with and without a behavioural approach [14].…”