Pain Science Education, Stress Management, and Cognition-Targeted Exercise Therapy in Chronic Whiplash Disorders

Is the modern pain neuroscience approach (MPNA) more effective than usual care physiotherapy in improving disability, pain, function, quality of life, and cost utility in chronic whiplash-associated disorders (cWAD)?This randomized clinical trial of 120 participants found a negative result for the prespecified primary outcome (ie, disability at 6-month follow-up). However, secondary analysis showed that MPNA was cost-effective and reduced disability immediately after treatment and at 12-month follow-up and better addressed fear avoidance and central sensitization symptoms.MPNA appears promising for cWAD management in the absence of strong guidelines, although further research is needed to optimize its delivery and identify responders.

Corresponding Author: Anneleen Malfliet, PhD, Vrije Universiteit Brussel, Brussels Health Campus, Laarbeeklaan 103, BE-1090 Brussels (Jette), Belgium (Anneleen.Malfliet@vub.be).

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