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Satisfaction with the outcome of physical therapist-prescribed exercise in chronic whiplash associated disorders: secondary analysis of a randomized clinical trial [with consumer summary]
Ardern CL, Peterson G, Ludvigsson ML, Peolsson A
The Journal of Orthopaedic and Sports Physical Therapy 2016 Aug;46(8):640-649
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

STUDY DESIGN: Secondary analysis of a randomized clinical trial. BACKGROUND: Patients' perceptions of benefits gained from treatment are important, yet satisfaction with the outcome of treatment for chronic whiplash associated disorders (WAD) has not been investigated. OBJECTIVES: To investigate whether satisfaction with the outcome of treatment for chronic WAD changed over time, and whether there were group differences. METHODS: 216 people with chronic WAD (66% women; mean age 40.4 years) participated in a 3-month program of physical therapist-led neck-specific exercises with or without a behavioral approach, or received a prescription of general physical activity. The main outcome was satisfaction with the outcome of treatment, assessed at baseline, and 3, 6, and 12 months later. Additional outcomes were enablement and expectation fufillment. Results Satisfaction improved over time in the three groups (odds ratio, 95% CI 1.15, 1.10 to 1.20, p < 0.001). There was a significant group by time interaction (p < 0.001), with increased odds of being satisfied in the groups receiving neck-specific exercises compared to general physical activity. Enablement increased after completion of the intervention in all groups (p < 0.001). People who received neck-specific exercises reported greater enablement and expectation fulfillment than people prescribed general physical activity (p < 0.01). CONCLUSION: Exercise interventions for chronic WAD led to increased satisfaction for 12 months following treatment that was unrelated to the type of exercise intervention received. LEVEL OF EVIDENCE: Therapy, level 1b.

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