617 - The Efficacy of Exercise Treatment for Whiplash-Associated Disorders: A Systematic Review

Objectives: Whiplash-associated disorders (WAD) are a highly prevalent etiology of neck pain syndrome. This narrative review assesses the efficacy of different variations in exercise therapy (ET) in individuals with WAD. The questions this review intends to answer include: What are the differences in efficacy for WAD patients using different types of ET? Is ET effective for patients with WAD? What variables can alter the efficacy of ET?

Design: 16 articles including RCTs, systematic reviews, and case series were reviewed regarding ET in individuals that had WAD. A PubMed search included the following key phrases: “whiplash exercise treatment”, “whiplash exercise therapy”. Studies that involved primarily exercise therapy for patients that had WAD were included and studies that did not involve WAD or ET as the primary condition and intervention were excluded.

Results: Numerous studies exist that evaluate exercise treatment outcomes in patients with whiplash-associated disorders, greatly varying in power and quality. Many reviews and RCTs conclude that there is no significant difference of exercise treatment in improving outcomes with WADs, although some outlier studies finding significance do exist. A number of RCTs and case studies note that neck-specific exercises provide superior outcomes compared to general exercise rehabilitation. Targeted exercises that focused on primarily targeting the neck were found to improve outcome measures. There were studies that also showed significant improvement with aerobic exercise treatment in WAD patients in comparison to strength exercise treatment.

Conclusions: Response to exercise greatly varies and is multifaceted, with minimal high-quality evidence showing that exercise therapy may reliably improve WAD pain. Exercise therapy that has an increased level of specificity to the neck and addresses particular injuries may be recommended. Overall, more high-quality research must be conducted on this topic.