Effectiveness of an Educational Video Following Acute Whiplash Trauma
Condition: Whiplash Injuries
MeSH terms: Whiplash Injuries
Study type: Interventional

Summary: 
      The purpose of this study is to examine the effect of an educational video on intensity of
      neck pain, disability, illness perceptions and work ability following acute whiplash trauma
      caused by motor vehicle accidents.
    

Detailed description: 
      Whiplash injuries affect 1-3 per 1000 inhabitants each year (Jansen et al. 2008). Most
      patients only experience transitory neck complaints and recover within weeks. However, an
      estimated 10% will develop severe persistent pain seriously affecting long term well-being
      and work ability. The exact mechanisms behind the variation in recovery remain elusive, and
      our knowledge on how to prevent the transition from acute to chronic neck pain is sparse.
      Guidelines for management of acute whiplash emphasize the importance of patient information,
      but there is limited evidence as to how information should be provided in order to improve
      recovery. Nevertheless, recent studies indicate that patient education by video may be a
      beneficial method to improve early management of neck pain (Oliveira et al. 2006, Brison et
      al. 2005).

      Using a randomized controlled design this study aims to determine the efficacy of an
      educational video concerning whiplash injuries in comparison with an active comparator
      condition consisting of a relaxation video. The anticipated study population is 300
      consecutive patients with acute neck complaints following motor vehicle accidents recruited
      at two major Emergency Departments in Denmark.

      Following completion of the standard care in the emergency room, patients who have given
      consent to participate are randomized to either intervention (educational video) or
      comparison group (relaxation video). Randomization is achieved by emergency room staff
      handing out sequentially numbered, sealed envelopes, which have been prepared at the Research
      Clinic for Functional Disorders and Psychosomatics. The randomization list is
      computer-generated in blocks of 20 and stratified according to place of treatment
      (participating emergency wards). The envelope contains a letter with a personal code giving
      the participant access to a secure website on which to view the video at home.

      The educational video will explain the nature of whiplash injuries and provide a
      biopsychosocial model for neck pain incorporating both physiological and
      cognitive-behavioural aspects, reassurance and basic advice on pain relief. The comparison
      condition is a relaxation video detailing simple relaxation exercises such as breathing
      exercises which can be safely used by whiplash patients. The relaxation video contains no
      explanatory information concerning whiplash injuries or the related symptoms.

      The participants are followed for 12 months after visiting the emergency room. Self-report
      data are obtained from questionnaires at 1-week, 3- and 12-month follow-up. Data on health
      care use and absence from work due to illness will be retrieved from public registers
      throughout the follow-up period. The study has been approved by The Central Region Committees
      on Biomedical Research Ethics, Denmark and the Danish Data Protection Agency. The project is
      funded by a single grant from the Tryg Foundation, Denmark.

      The transition from acute to chronic pain after whiplash trauma poses a threat to the
      well-being of the individual as well as leading to extensive health care costs and loss of
      work days (Leth-Petersen & Rotger 2009, Holm et al. 1999). The development of cost-effective
      preventive interventions which can be added to the usual treatment in the early stages of
      whiplash associated disorders could potentially contribute to reducing suffering for patients
      and financial costs for society. This study will hopefully contribute to the development of
      effective and evidence-based treatment of whiplash associated disorders. In the long term,
      the study may also aid the development of patient education for other patient groups at risk
      of developing a chronic disorder.
    

Intervention name(s): Psychoeducational video; Relaxation video
Intervention type(s): Behavioral; Other
Intervention description(s): The educational video will explain the nature of whiplash injuries and provide a biopsychosocial model for neck pain incorporating both physiological and cognitive-behavioural aspects, reassurance and basic advice on pain relief.; The comparison condition is a relaxation video detailing simple relaxation exercises such as breathing exercises which can be safely used by whiplash patients. The relaxation video contains no explanatory information concerning whiplash injuries or the related symptoms.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Whiplash injuries; patient education; illness perceptions; RCT; motor vehicle accidents