Research Team Members: Professor Michele Sterling (RECOVER), Emeritus Professor Justin Kenardy (UQ), Professor Rob Smeets (Maastricht University), Dr Rachel Elphinston (RECOVER).
Background
This study compared the effectiveness of stress inoculation training integrated with physiotherapy exercise and delivered by physiotherapists to standard physiotherapy exercise for people with acute whiplash-associated disorder at risk of poor recovery.
Aims
- The primary aim was to establish the effectiveness of an integrated intervention comprised of Stress Inoculation Training (SIT) and a standard clinical guideline recommended physiotherapy exercise approach program to decrease pain and disability in individuals with acute (<4 weeks duration) whiplash injury.
- The second aim was to investigate the effect of the intervention on post-traumatic stress symptoms, anxiety and depression.
Progress
This study is now complete.
Stakeholder engagement
Key stakeholders, the Motor Accident Insurance Commission (MAIC) and the NSW State Insurance Regulatory Authority (SIRA), were consulted at the time of the initial drafting of this project.
Dissemination
Five research papers have been published:
- Elphinston, Rachel A., Sterling, Michele, Kenardy, Justin, Smeets, Rob, and Armfield, Nigel R. (2020). The mechanisms of effect of a physiotherapist-delivered integrated psychological and exercise intervention for acute whiplash-associated disorders: secondary mediation analysis of a randomized controlled trial. Pain Reports 5 (5) e835 e835.
- 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, S3(19) 100139 1240-1247.
- Kelly, J., Bunzli, S., Ritchie, C., Kenardy, J., Smeets, R., Sterling, M. (2018) Physiotherapist-delivered stress inoculation training for acute whiplash-associated disorders: A qualitative study of perceptions and experiences. Musculoskeletal Science and Practice, 38:30-36.
- Ritchie, Carrie, Kenardy, Justin, Smeets, Rob, and Sterling, Michele (2016). Erratum to 'StressModEx - Physiotherapist-led Stress Inoculation Training integrated with exercise for acute whiplash injury: Study protocol for a randomised controlled trial' [JPHYS 61/3 (2015) 157] DOI: 10.1016/j.jphys.2015.04.003. Journal of Physiotherapy 62 (2) 59-59.
- Ritchie, C., Kenardy, J., Smeets, R., Sterling, M. (2015) StressModEx – Physiotherapist-led stress inoculation training integrated with exercise for acute whiplash injury: study protocol for a randomised controlled trial. Journal of Physiotherapy, 61(3):157.
The results have been presented to multidisciplinary audiences including:
- MAIC Insurer Group (2018)
- World Pain Congress, Boston (September 2018)
- RECOVER Research Forum (November 2018)
- South Australia CTP/Return to Work SA Providers Forum (September 2018)
- World Physiotherapy Congress (Geneva 2019)
Outcomes
- Following a secondary analysis using structural equation modelling of the randomized controlled trial, reductions in stress mediated the effect of the integrated intervention on disability and health-related quality of life at 12 months.
- Funded by MAIC QLD, the StressModex training modules for clincians, developed by Professor Michele Sterling, Dr Rachel Elphinston, Dr Yanfei Xie and Chloe-Emily Eather, are now available in the mywhiplashnavigator online resource.
Who benefits from this research?
Clinicians and claimants/motorists injured in road traffic crashes. The compulsory third party (CTP) scheme may also benefit if costs are reduced with more effective treatments.