Research Team Members: Professor Michele Sterling (RECOVER), Professor Justin Kenardy (UQ), Professor Rob Smeets (Maastricht University).


This study compares the effectiveness of stress inoculation training integrated with physiotherapy exercise and delivered by physiotherapists compared to standard physiotherapy exercise for people with acute whiplash-associated disorder at risk of poor recovery.


  • The primary aim of this randomised controlled trial is to establish the effectiveness of an integrated intervention comprised of Stress Inoculation Training (SIT) and a standard clinical guideline recommended physiotherapy exercise approach program in decreasing pain and disability in individuals with acute (<4 weeks duration) whiplash injury.
  • The second aim is to investigate the effect of the intervention on post-traumatic stress symptoms, anxiety and depression.


This study is now complete.

Stakeholder engagement

Key stakeholders, the Motor Accident Insurance Commission (MAIC-QLD) and the NSW State Insurance Regulatory Authority (SIRA), were consulted at the time of the initial drafting of this project.


Three research papers have been published to date:

  • Sterling, M., Smeets, R., Keijzers, G., Warren, J. & Kenardy, J. (2019) Physiotherapist-delivered stress inoculation training integrated with exercise versus physiotherapy exercise alone for acute whiplash-associated disorder (StressModex): a randomised controlled trial of a combined psychological/physical intervention. British Journal of Sports Medicine, bjsports-2018. 
  • Kelly, J., Bunzli, S., Ritchie, C., Kenardy, J., Smeets, R., Sterling, M. Physiotherapist-delivered Stress Inoculation Training for acute whiplash-associated disorders: A qualitative study of perceptions and experiences. Musculoskeletal Science and Practice, 2018 38:30-36.
  • Ritchie, C., Kenardy, J., Smeets, R., Sterling, M. StressModEx – Physiotherapist-led stress inoculation training integrated with exercise for acute whiplash injury: study protocol for a randomised controlled trial (2015). Journal of Physiotherapy, 61(3):157.

The results have been presented to multidisciplinary audiences including:

  • MAIC Insurer Group, 2018
  • World Pain Congress, Boston in September, 2018
  • RECOVER Research Forum in November, 2018
  • South Australia CTP/ Return to Work SA Providers Forum in September, 2018
  • World Physiotherapy Congress, Geneva, 2019

Who benefits from this research?

The research will benefit claimants and motorists who are injured in road traffic crashes. The compulsory third party (CTP) scheme may also benefit if costs are reduced with more effective treatments.