Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2015

Open Access 01-12-2015 | Study protocol

Value-based cognitive-behavioural therapy for the prevention of chronic whiplash associated disorders: protocol of a randomized controlled trial

Authors: Tonny Elmose Andersen, Sophie Lykkegaard Ravn, Kirsten Kaya Roessler

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

Login to get access

Abstract

Background

Whiplash injury is the most common traffic-related injury affecting thousands of people every year. Conservative treatments have not proven effective in preventing persistent symptoms and disability after whiplash injury. Early established maladaptive pain behaviours within the first weeks after the injury may explain part of the transition from acute to chronic whiplash associated disorder (WAD). Hence, early targeting of psychological risk factors such as pain catastrophizing, fear-avoidance-beliefs, depression, and symptoms of posttraumatic stress disorder (PTSD) may be important in preventing the development of chronic WAD. Some evidence exists that targeting fear-avoidance beliefs and PTSD with exposure strategies and value-based actions may prevent development of persistent disability after whiplash injury. Yet, the results have to be tested in a randomized controlled trial (RCT). The primary objective of the present study is to test whether a specifically tailored value-based cognitive-behavioural therapy program (V-CBT) is able to prevent the development of persistent disability, pain, and psychological distress if delivered within the first three months after a whiplash injury.

Methods/design

The current study is a two-armed randomized controlled study with a crossover design. Group A is scheduled for V-CBT within one week of randomization and group B with a delayed onset 3 months after randomization.

Discussion

If the study detects significant effects of V-CBT as a preventive intervention, the study will provide new insights of preventive treatment for patients with WAD and thereby serve as an important step towards preventing the chronic condition.

Trial registration

Current Controlled Trials Registration September 19, 2014: NCT02251028
Literature
1.
2.
Caroll LJ, Holm LW, Hogg-Johnson S, Côté P, Cassidy D, Haldeman S, et al. Course and prognostic factors for neck pain in whiplash-associated disorders (WAD). Results of the bone and joint decade 2000–2010 task force on neck pain and it’s associated disorders. Eur Spine J. 2009;17:83–92.CrossRef
3.
Buitenhuis J, de Jong PJ, Jaspers JPC, Groothoff JW. Work disability after whiplash: a prospective cohort study. Spine. 2009;34:262–7.CrossRefPubMed
4.
Kasch H, Bach FW, Jensen TS. Handicap after acute whiplash injury: a 1-year prospective study of risk factors. Neurology. 2001;1:1637–43.CrossRef
5.
Zebis MK, Andersen LL, Pedersen MT, Mortensen P, Andersen CH, Pedersen MM, Boysen M, Roessler KK, Hannerz H, Mortensen OS, Sjøgaard G. Implementation of neck/shoulder exercises for pain relief among industrial workers: A randomized controlled trial. BMC Musculoskelet Disord 2011;12. http://​dx.​doi.​org/​10.​1186/​1471-2474-12-205
6.
Kongsted A, Qerama E, Kasch H, Bendix T, Winther F, Korsholm L. Neck collar, “act-as-usual” or active mobilization for whiplash injury? A randomized parallel-group trial. Spine. 2007;32:618–26.CrossRefPubMed
7.
Sterling M. Clinical presentation of whiplash associated disorders. In: Sterling M, Kenardy J, editors. Whiplash, Evidence Base for Clinical Practice. Australia: Elsevier; 2011. p. 9–15.
8.
Kamper SJ, Maher CG, Costa LCM, McAuley JH, Husk JM, Sterling M. Does fear of movement mediate the relationship between pain intensity and disability in patients following whiplash injury? A prospective longitudinal study. Pain. 2012;153:113–9.CrossRefPubMed
9.
Vangronsveld K, Peters M, Goossens M, Linton S, Vlaeyen J. Applying the fear-avoidance model to the chronic whiplash syndrome. Pain. 2012;130:258–61.
10.
Buitenhuis J, de Jong PJ, Jaspers JPC, Groothoff JW. Relationship between posttraumatic stress disorder symptoms and the course of whiplash complaints. J Psychosom Res. 2006;61:681–9.CrossRefPubMed
11.
Williamson E, Williams M, Gates S, Lamb SE. A systematic review of psychological factors and the development of Whiplash associated disorder. Pain. 2008;135:20–30.CrossRefPubMed
12.
Andersen TE, Brink O, Elklit A. PTSD symptoms mediate the effect of attachment on pain and somatisation after whiplash injury. Clin Pract Epidemiol Ment Health. 2013;9:75–83.CrossRefPubMedPubMedCentral
13.
14.
Kongsted A, Bendix T, Qerama E, Kasch H, Bach FW, Korsholm L, et al. Acute stress response and recovery after whiplash injuries. A one-year prospective study. Eur J Pain. 2008;12:455–63.CrossRefPubMed
15.
Asmundson GJG, Katz J. Understanding the co-occurrence of anxiety disorders and chronic pain: state-of-the-art. Depress Anxiety. 2009;26:888–901.CrossRefPubMed
16.
Sterling M, Chadwick BJ. Psychological processes in daily life with chronic whiplash: relations of posttraumatic stress symptoms and fear-of-pain to hourly pain and uptime. Clin J Pain. 2010;26:573–82.CrossRefPubMed
17.
Dunne RL, Kenardy J, Sterling M. A randomized controlled trial of cognitive-behavioral therapy for the treatment of PTSD in the context of chronic whiplash. Clin J Pain. 2012;28:755–65.CrossRefPubMed
18.
Robinson JP, Theodore BR, Dansie EJ, Wilson HD, Turk DC. The role of fear of movement in subacute whiplash-associated disorders grades I and II. Pain. 2013;155:393–401.CrossRef
19.
Wicksell RK, Ahlqvist J, Bring A, Melin L, Olsson GL. Can exposure and acceptance strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (WAD)? A randomized controlled trial. Cog Behav Ther. 2008;37:169–82.CrossRef
20.
Adams H, Ellis T, Stanish WD, Sullivan MJL. Psychosocial factors related to return to work following rehabilitation of whiplash injuries. J Occup Rehab. 2007;17:305–15.CrossRef
21.
Sullivan MJL, Adams H, Rhodenizer T, Stanish WD. A psychological risk factor targeted intervention for the prevention of chronic pain and disability following whiplash injury. Phys Ther. 2006;86:8–18.PubMed
22.
Vlaeyen J, Kole-Snijners A, Boeren R, Van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995;62:363–72.CrossRefPubMed
23.
Spitzer WO, Skovron ML, Salmi LR, Cassidy JD, Duranceau J, Suissa S, et al. Scientific monograph of Quebec Task Force on whiplash associated disorders: redefining “whiplash” and its management. Spine. 1995;20:1S–73.CrossRefPubMed
24.
25.
Vernon HT, Mior SA. The neck disability index: a study of reliability and validity. J Manipulative Physiol Ther. 1991;14:409–15.PubMed
26.
Andersen TE. Forebyggelse af vedvarende gener og begrænsninger efter en nakkeskade. Et arbejdshæfte (patientmanual til RCT studie). ISBN: 978-87-996878-0-0; 2014.
27.
Fordyce WE. Behavioral methods for chronic pain and illness. Saint Louis: Mosby; 1976.
28.
Hayes SC, Smith S. Get out of your mind and into your life: the new acceptance and commitment therapy. Oakland: New Harbinger Publications; 2005.
29.
McCracken LM. Contextual cognitive-behavioral therapy for chronic pain. Seattle: IASP Press; 2005.
30.
Tait RC, Pollard CA, Margolis RB, Duckro PN, Krause SJ. The pain disability index: psychometric and validity data. Arch Phys Med Rehabil. 1987;68:438–41.PubMed
31.
Tait RC, Chibnall JT, Krause S. The pain disability index: psychometric properties. Pain. 1990;40:171–82.CrossRefPubMed
32.
Turk DC, Melzack R. Handbook of pain assessment. 2nd ed. New York: Guilford Press; 2001. p. 295–314.
33.
Miller RP, Kori S, Todd D. The Tampa Scale: a measure of kinesiophobia. Clin J Pain. 1991;7:51–2.CrossRef
34.
Roelofs J, Goubert L, Peters ML, Vlaeyen JWS, Crombez G. The tampa scale for kinesiophobia: further examination of psychometric properties in patients with chronic low back pain and fibromyalgia. Eur J Pain. 2004;8:495–502.CrossRefPubMed
35.
Sullivan MJL, Bishop SR, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess. 1995;7:524–32.CrossRef
36.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiat Scand. 1983;67:361–70.CrossRefPubMed
37.
Andersen TE. Does attachment insecurity affect the outcomes of a multidisciplinary pain management program? The association between attachment insecurity, pain, disability, distress, and the use of opioids. Soc Sci Med. 2012;74:1461–8.CrossRefPubMed
38.
Mollica RF, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Lavelle J. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis. 1992;180:111–6.CrossRefPubMed
39.
Kemani MK, Olsson GL, Lekander M, Hesser H, Andersson E, Wicksell RK. Efficacy and cost-effectiveness of acceptance and commitment therapy and applied relaxation for longstanding pain: a randomized controlled trial. Clin J Pain. 2015. doi:10.​1097/​AJP.​0000000000000203​.PubMed
40.
Metadata
Title
Value-based cognitive-behavioural therapy for the prevention of chronic whiplash associated disorders: protocol of a randomized controlled trial
Authors
Tonny Elmose Andersen
Sophie Lykkegaard Ravn
Kirsten Kaya Roessler
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-015-0687-y

Other articles of this Issue 1/2015

BMC Musculoskeletal Disorders 1/2015 Go to the issue

Research article

Cartilage boundary lubrication synergism is mediated by hyaluronan concentration and PRG4 concentration and structure

Erratum

Erratum to: Effectiveness of intra-articular injections of sodium bicarbonate and calcium gluconate in the treatment of osteoarthritis of the knee: a randomized double-blind clinical trial

Research article

Reliability and validity of the Chinese version of the Short Musculoskeletal Function Assessment questionnaire in patients with skeletal muscle injury of the upper or lower extremities

Study protocol

Physical therapy vs. internet-based exercise training (PATH-IN) for patients with knee osteoarthritis: study protocol of a randomized controlled trial

Debate

Requirements for more effective prevention of work-related musculoskeletal disorders

Research article

Prediction of pain outcomes in a randomized controlled trial of dose–response of spinal manipulation for the care of chronic low back pain