Basic body awareness therapy or exercise therapy for the treatment of chronic whiplash associated disorders: a randomized comparative clinical trial

Abstract

Purpose: Chronic whiplash-associated disorders (WAD) incur both costs and suffering. Treatments that can relieve chronic WAD are therefore needed. Exercise therapy (ET) has been shown to provide pain relief. Another often used treatment for chronic pain in Scandinavia is basic body awareness therapy (BAT). We compared the effectiveness of 10 weeks of twice-weekly, 90-min sessions of either ET or BAT in a randomized comparative trial. Method: We recruited 113 patients suffering from chronic WAD grades I–III and several years’ duration of symptoms in a primary health care setting. 57 were allocated to ET and 56 to BAT. Primary outcome measures were Neck Disability Index and SF-36 v.2. Results: From baseline to post-treatment, the BAT group increased their physical functioning (median 5, IQR = 15) more than the ET group (median = 0, IQR = 15), p = 0.032, effect size −0.54. Three months after the end of treatment, the BAT group had less bodily pain (m = 17.5, 95% CI 6.9–17.6) than the ET group (m = 4.9, 95% CI −0.1 to 9.8), p = 0.044, effect size −0.4. The BAT group had also increased their social functioning (m = 13.3, 95% CI 6.6–19.9) more than the ET group (m = 3.5, 95% CI −3 to 9.9), p = 0.037, effect size −0.41. No statistically significant differences between groups were found for the change of other outcomes. No serious adverse effects were found in either groups. Conclusions: The present trial indicates that BAT led to greater improvements than ET for the patients with chronic WAD.

Implications for Rehabilation

• Chronic whiplash-associated disorders are disabling and incur great costs to society often through inability to work.

• Exercise therapy (ET) may alleviate symptoms of chronic WAD.

• Basic body awareness therapy (BAT) is often a component of multimodal pain rehabilitation programs.

• In this randomized comparative trial, BAT increased physical functioning and led to greater pain reduction and social functioning 3 months after the end of treatment.

• Body awareness therapy
• exercise
• Neck Disability Index
• SF-36
• whiplash

Acknowledgements

We thank the Psychiatric Physiotherapy Unit Björkängen for providing a location for the trial site. The authors would also like to thank all who took part in the intervention and enabled the trial to take place.

Declaration of interest

The authors report no declarations of interest. This trial was funded by research grants VGFOUREG-11419, VGFOUREG-24191, VGFOUREG-5525 by the The Health & Medical Care Committee of the Region Västra Götaland and grants VGFOUSA-162631, VGFOUSA-38041, VGFOUSA-43901, VGFOUSA-87931 by the Research and development council of the county Södra Älvsborg. Aris Seferiadis’ research post was in part funded by the Health Care Strategy Unit at Södra Älvsborg Hospital and the Research Fund of the Division Management of Psychiatry at Södra Älvsborg Hospital.