Shifting Away From Pain: a Neurocognitive Approach in Treatment of Whiplash
Condition: Whiplash Injuries
MeSH terms: Whiplash Injuries
Study type: Interventional

Summary: 
      The broad aim of this study is to investigate the effect of a modern neuroscience approach,
      which combines education on pain neuroscience with cognition-targeted exercise therapy and
      stress management, on brain structure and networks in patients with chronic
      whiplash-associated disorders (CWAD) in comparison to a control physiotherapy treatment.
    

Detailed description: 
      This project runs in parallel to a larger randomized-controlled trial (RCT) in which the
      'modern neuroscience approach to WAD' is compared to usual care evidence-based physiotherapy
      (clinical trial registration number: NCT03239938). For the current study, additional magnetic
      resonance imaging (MRI) measures will be taken in a subsample of patients, who will be
      recruited from this larger RCT. In addition, a pain-free age- and sex-matched control group
      will be recruited for comparison.

      The current study consists of 2 MRI measurements that will take place at the University
      Hospital of Ghent (UZ Gent): baseline (pre-treatment) and follow-up (post-treatment;
      approximately 16 weeks after baseline). After pre-treatment assessment, the patients will be
      randomly allocated to the modern neuroscience approach or usual care physiotherapy, as part
      of the RCT.
    

Intervention name(s): Modern pain neuroscience approach; Usual care physiotherapy
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Modern pain neuroscience approach. The modern pain neuroscience approach includes 3 sessions (1 group and 2 individual sessions) of therapeutic pain neuroscience education followed by 15 individual sessions of dynamic and functional cognition-targeted exercise therapy and stress management techniques. In addition, participants will be instructed to perform a daily set of home exercises. The exercises will be performed in a time-contingent way. The 18 sessions will be spread over a period of 16 weeks.; Usual care evidence-based physiotherapy The usual care evidence-based physiotherapy includes 3 sessions (1 group and 2 individual sessions) of neck school followed by 15 individual sessions of graded and active exercise therapy focusing on strength, flexibility, endurance, and ergonomic principles. In addition, participants will be instructed to perform a daily set of home exercises. The exercises will be performed in a symptom-contingent way. The 18 sessions will be spread over a period of 16 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The other trial (NCT03239938) will randomize patients with chronic WAD to the experimental (modern neuroscience approach) or the control treatment (usual care physiotherapy). The WAD patient sample for the present MRI study will be a subsample recruited from this larger RCT. After inclusion in the large RCT, participants will be asked about the possibility of participating in the additional MRI study.
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Basic Science