Whiplash-associated disorder (WAD) causes substantial social and economic burden, with ≥70% patients classified as WADII. Effective management in the acute stage is required to prevent development of chronicity for approximately 60% patients. A novel Active Behavioural Physiotherapy Intervention (ABPI) addressing both physical and psychological components of WAD was developed and evaluated as a complex intervention for acute WADII through a sequential multiphase project. Each phase was conducted using rigorous, precise and transparent methodologies according to pre-defined protocols.
A systematic review and meta-analysis found that the combination of active physiotherapy and behavioural interventions may be a useful strategy.
A modified Delphi study (international research and UK clinical whiplash experts) identified the underlying principles, and physiotherapy and behavioural treatment components of the ABPI. As no underpinning psychological theory was identified, the ABPI was further developed employing self-efficacy enhancement from social-cognitive theory to enable individualised management.
A cluster-randomised, double-blind, parallel two-arm (ABPI: standard physiotherapy) pilot and feasibility trial (evaluating procedures, feasibility and acceptability ABPI) employed both quantitative and qualitative methods. Findings supported that the ABPI was potentially valuable (95% ABPI participants fully recovered with low number treatment sessions) and acceptable to physiotherapists and patients, supporting a definitive trial (with minor modifications)
