Persistent pain and disability in whiplash-associated disorders (WAD) grade II and III are common. Randomized controlled studies (RCTs) have shown promising result for neck-specific exercise (NSE) programmes in chronic WAD with clinically and statistically significant improvement in pain and disability. Neck-specific exercise with internet support (NSEIT) and four visits to a physiotherapist was non-inferior to NSE at a physiotherapist clinic 2 times a week in 12 weeks (24 visits). The aims of the proposed study are to evaluate an implementation strategy for NSE and NSEIT in primary health care and to evaluate the effectiveness of NSE and NSEIT in clinical practice.
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Implementation - Adoption of neck-specific exercise programmes
Timeframe: Baseline to 3 and 12 months (proportions of 500 patients with neck pain from 20 physiotherapy clinics)
Patient Effectiveness - Neck Disability Index
Timeframe: Change from baseline to 3 months (after treatment) and 12 months follow-up