Background

To address the need for a better treatment of chronic whiplash associated disorders (WAD), a contemporary neuroscience approach can be proposed.

Objective

To examine the effectiveness of a contemporary neuroscience approach, comprising pain neuroscience education, stress management, and cognition-targeted exercise therapy versus conventional physical therapy for reducing disability (primary outcome measure) and improving quality of life and reducing pain, central sensitization, and psychological problems (secondary outcome measures) in people with chronic WAD.

Methods

The study is a multi-center, two-arm randomized, controlled trial with 1-year follow-up and will be performed in two university-based and one regional hospital. People with chronic WAD (n = 120) will be recruited. The experimental group will receive pain neuroscience education followed by cognition-targeted exercise therapy, and stress management. The control group will receive biomedically focused education followed by graded and active exercise therapy focusing on muscle endurance, strength, and flexibility, and ergonomic principles. The treatment will have a duration of 16 weeks. Functional status (Neck Disability Index) is the primary outcome measure. Secondary outcome measures include quality of life, pain, central sensitization, and psychological and socio-economic factors. In addition, electroencephalography will measure brain activity at rest and during a conditioned pain modulation paradigm. Assessments will take place at baseline, immediately post-treatment and at 6 and 12 months follow-up.

Conclusions

This study will examine whether a contemporary neuroscience approach is superior over conventional physical therapy for improving functioning, quality of life, and reducing pain, central sensitization, and psychological problems in people with chronic WAD.

中文翻译：

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一种当代神经科学方法与以生物医学为重点的教育相结合的慢性鞭打相关疾病患者的症状偶然运动疗法：随机对照试验方案

背景

为了满足更好地治疗慢性挥鞭相关疾病 (WAD) 的需求，可以提出一种现代神经科学方法。

客观的

检验当代神经科学方法的有效性，包括疼痛神经科学教育、压力管理和以认知为目标的运动疗法与传统物理疗法在减少残疾（主要结果测量）和改善生活质量和减轻疼痛、中枢敏化和心理方面的有效性慢性 WAD 患者的问题（次要结果测量）。

方法

该研究是一项多中心、双臂随机对照试验，随访期为 1 年，将在两所大学和一家地区医院进行。患有慢性 WAD 的人 ( n  = 120) 将被招募。实验组将接受疼痛神经科学教育，然后进行以认知为目标的运动疗法和压力管理。对照组将接受以生物医学为重点的教育，然后进行以肌肉耐力、力量和灵活性以及人体工程学原理为重点的分级和主动运动疗法。治疗将持续 16 周。功能状态（颈部残疾指数）是主要的结果指标。次要结果指标包括生活质量、疼痛、中枢敏感性以及心理和社会经济因素。此外，脑电图将测量休息时和条件性疼痛调节范式期间的大脑活动。评估将在基线、治疗后立即以及 6 个月和 12 个月的随访中进行。

结论

这项研究将检验现代神经科学方法是否优于传统物理疗法，以改善慢性 WAD 患者的功能、生活质量以及减轻疼痛、中枢敏感和心理问题。