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Effects of a Guided Neck-Specific Exercise Therapy on Recovery After a Whiplash: A Systematic Review and
Pablo Muñoz Lazcano1, Daniel Rojano Ortega, Isidro Fernández López
1From the Residencia y Centro de Día Montehermoso, Madrid, Spain (PML); Department of Informatics and Sports, Universidad Pablo de Olavide, Sevilla, Spain (DRO); Holystic Centro de Recuperación, Madrid, Spain (IFL); and Faculty of Nursery, Physiotherapy and Podiatry, Universidad Complutense, Madrid, Spain (IFL).
Objective:
To analyze the effects on pain and disability recovery after a whiplash of a guided neck-specific exercise therapy, compared to a different or an unguided neck-specific exercise therapy.
Design:
A literature search was conducted from inception to May 31, 2023, in three electronic databases: PubMed, ScienceDirect, and Web of Science. Eleven randomized controlled trials were included. Meta-analyses were performed with Review Manager software. The standardized mean difference with a 95% confidence interval was used to measure the effect sizes and only short-term time points were considered.
Results:
Not all studies reported a significant decrease of pain and disability in the neck-specific exercise group compared to controls. However, meta-analyses demonstrated a significantly greater decrease in neck pain (standardized mean difference: -0.25; 95% confidence interval: [-0.38, -0.12]; P = 0.0002) and neck-disability index (standardized mean difference: -0.35; 95% confidence interval: [-0.54, -0.15]; P = 0.0005) in the neck-specific exercise group.
Conclusions:
In addition to the benefits that a guided neck-specific exercise therapy has on motivation and program adherence, it provides greater benefits in pain and disability than a different or unguided neck-specific exercise therapy. Positive results are observed primarily with intervention periods of more than 6 wks and at least two sessions per week.
To Claim Cme Credits:
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.
Cme Objectives:
Upon completion of this article, the reader should be able to: (1) Determine the impact that whiplash-associated disorders have on a patient's life; (2) Identify and recognize the greater benefits of a supervised exercise therapy on recovery after a whiplash injury; and (3) Differentiate between the different exercise protocols conducted (types of exercises and duration) and incorporate therapy appropriately as part of an effective treatment plan.
Level:
Advanced.
Accreditation:
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
