Trauma-focused cognitive behavioural therapy and exercise for chronic whiplash with comorbid posttraumatic stress disorder: a randomised controlled trial.

Loading...
Thumbnail Image
File version

Accepted Manuscript (AM)

Author(s)
Andersen, Tonny Elmose
Ravn, Sophie Lykkegaard
Armfield, Nigel
Maujean, Annick
Requena, Simone Scotti
Sterling, Michele
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
2020
Size
File type(s)
Location
Abstract

Many people with chronic whiplash associated disorders (WAD) also have symptoms of posttraumatic stress disorder (PTSD), but this is rarely considered in usual predominantly exercise based interventions. We aimed to investigate the effectiveness of combined trauma focused cognitive behavioural therapy (TF-CBT) and exercise compared to supportive therapy (ST) and exercise for people with chronic WAD and PTSD. A randomised controlled multi-centre trial with concealed allocation, assessor blinding, and blinded analysis was conducted. 103 participants with chronic WAD (>3 months and <5 years, grade II) and PTSD were randomised to TF-CBT and exercise (n=53) or ST and exercise (n=50). Both interventions comprised 10 weeks of TF-CBT or ST followed by 6 weeks of exercise. Outcomes were measured at baseline, 10 weeks, 16 weeks, 6 months, and 12 months post-randomisation. Analysis was intention to treat using linear mixed models. There was no difference between the interventions on the primary outcome of neck pain related disability at any time point. At 16 weeks, the treatment effect on the 0-100 Neck Disability Index was 0.59 (95% CI 5.51 to -4.33), at 6 months 1.18 (6.15 to -3.78), and at 12 months 1.85 (6.81 to -3.11). In addition, there was no difference between the interventions for the majority of secondary outcomes at any time. Exceptions were in favour of TF-CBT and exercise, where improvements in PTSD symptoms were found at 16 weeks. From 16 weeks onwards, both groups achieved a clinically important improvement in neck pain related disability. However, both groups remained moderately disabled.

Journal Title

Pain

Conference Title
Book Title
Edition
Volume
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement

© 2020 International Association for the Study of Pain. Published by Elsevier Ltd. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.

Item Access Status
Note

This publication has been entered in Griffith Research Online as an advanced online version.

Access the data
Related item(s)
Subject

Biomedical and clinical sciences

Psychology

Persistent link to this record
Citation

Andersen, TE; Ravn, SL; Armfield, N; Maujean, A; Requena, SS; Sterling, M, Trauma-focused cognitive behavioural therapy and exercise for chronic whiplash with comorbid posttraumatic stress disorder: a randomised controlled trial., Pain, 2020

Collections