Values-based Cognitive Behavioral Therapy for the Prevention of Chronic Whiplash Associated Disorders: A Randomized Controlled Trial

Background

Whiplash is a common traffic‐related injury with up to 50% of those affected continuing to experience symptoms one‐year post‐injury. Unfortunately, treatments have not proven highly effective in preventing and treating chronic symptomatology. The overall aim of this study was to test the effectiveness of an early values‐based cognitive‐behavioural therapeutic intervention (V‐CBT) delivered within 6 months post‐injury in preventing chronic symptomatology compared to wait list controls.

Methods

The study was a two‐armed randomized controlled trial. Participants (n = 91) experienced pain, disability and at least one psychological risk factor (e.g. enhanced pain‐catastrophizing) after a whiplash trauma no later than 6 months prior. Participants were randomized to 10 sessions of V‐CBT starting 1 week (group A) or 3 months (group B) post‐randomization. The primary outcome was pain‐related disability, while secondary outcomes were pain intensity, neck‐pain related disability, depression, anxiety, PTSD symptoms, pain‐catastrophizing and kinesiophobia. These were evaluated at baseline and at 3, 6, 9 and 12 months post‐randomization.

Results

At 3 months, group A demonstrated clinically important effects on all outcomes that were significantly better than group B (waitlist). When group B received the intervention at 6 months, they also demonstrated clinically important effects on all outcomes. However, there was a significant difference at 12 months for the primary outcome, in which group B increased their disability levels, while group A remained stable.

Conclusions

While this indicates that an intervention window for early prevention of disability after whiplash injury may exist, this needs to be tested in a truly early intervention.

Significance

An early Values‐based Cognitive Behavioural Therapeutic intervention delivered within 6 months post‐injury (mean days 117) was effective in reducing pain‐related disability and psychological distress compared to the control group that received the intervention later after a three months wait‐list period. The effects were sustained at 12 months follow‐up. The early intervention was significantly more effective in reducing pain‐related disability compared to the control group, indicating that an intervention window for early prevention of disability after whiplash injury may exist.

Does work-site physical activity improve self-reported psychosocial workplace factors and job satisfaction? A randomized controlled intervention study

PURPOSE

To investigate whether a work-site strength-training program has a positive effect on self-reported psychosocial workplace factors and job satisfaction.

METHODS

We conducted a randomized controlled trial among laboratory technicians implementing neck and shoulder exercises for pain relief, with 199 participants in the training group and 228 in the control group. Influence at work, sense of community, time pressure, and job satisfaction were measured with the Copenhagen Psychosocial Questionnaire at baseline and post-intervention after 20 weeks.

RESULTS

There was no statistically significant change in any of the four variables in the training group from baseline to follow-up (all p ≥ 0.39). When we used MANOVA to test for between-group effects over time, we did not find any statistically significant result (all p > 0.14).

CONCLUSIONS

This study does not provide evidence for an effect of a work-site strength-training program on self-reported psychosocial workplace factors and job satisfaction.

Successful talent development in track and field: considering the role of environment

Track and field includes a number of high-intensity disciplines with many demanding practices and represents a motivational challenge for talented athletes aiming to make a successful transition to the senior elite level. Based on a holistic ecological approach, this study presents an analysis of a particular athletic talent development environment, the IFK Växjö track and field club, and examines key factors behind its successful history of creating top-level athletes. The research takes the form of a case study. Data were collected from multiple perspectives (in-depth interviews with administrators, coaches and athletes), from multiple situations (observation of training, competitions and meetings) and from the analysis of documents. The environment was characterized by a high degree of cohesion, by the organization of athletes and coaches into groups and teams, and by the important role given to elite athletes. A strong organizational culture, characterized by values of open co-operation, by a focus on performance process and by a whole-person approach, provided an important basis for the environment's success. The holistic ecological approach encourages practitioners to broaden their focus beyond the individual in their efforts to help talented junior athletes make a successful transition to the elite senior level.