The effect of two exercise regimes; motor control versus endurance/strength training for patients with whiplash-associated disorders: a randomized controlled pilot study

Abstract

Objective: To compare the effect of exercise regimes with focus on either motor control training or endurance/strength training for patients with whiplash-associated disorders in subacute phase. Design: Randomized controlled trial. Setting: An outpatient spine clinic in Norway. Participants: Twenty-five subjects with a whiplash-associated disorder still having symptoms or disability six weeks after injury. Interventions: The participants received 6—10 sessions of physiotherapy for six weeks with focus on either motor control or endurance and strength of neck muscles. Measurements: The primary outcome measure was the Neck Disability Index. Secondary outcome measures were pain intensity, neck functioning and sick leave. Results: No statistical significant differences concerning primary and secondary outcome measures were demonstrated between the groups. Approximately half of the participants in both groups obtained a clinically important change (improvement) on perceived disability assessed by Neck Disability Index at six weeks and one-year follow-up. The changes within both groups were statistically significant at six weeks, but not at one-year follow-up. For most pain-related variables clinical significant improvement was demonstrated in both groups at six weeks, but for fewer participants at one year. There was also statistical significant improvement within groups in some of the physical performance tests at one-year follow-up. Conclusion: The changes associated with motor control training and endurance/ strength training of neck muscles were similar for reduced disability, pain and for improving physical performance. With a low number of participants and no control group, however, we cannot be sure whether the improvements are due to interventions or other reasons.