J Man Manip Ther. 2026 Aug 29:1-12. doi: 10.1080/10669817.2026.2720771. Online ahead of print.
ABSTRACT
BACKGROUND: Road Traffic Injuries affect more than 50 million people each year. Whiplash-associated disorders (WAD) are among the most common musculoskeletal conditions resulting from these injuries, affecting up to 83% of individuals exposed to this type of trauma. Approximately 50% of affected individuals experience incomplete recovery. Although specific neck exercises are recommended, the effectiveness of device-guided craniocervical training administered via telerehabilitation for subacute grade I-II WAD remains unknown.
OBJECTIVE: To evaluate the preliminary effectiveness and feasibility of a device-guided craniocervical exercise program delivered via telerehabilitation on pain and disability in individuals with subacute grade I-II WAD.
METHODS: A multicentre, assessor-blinded, randomized pilot feasibility trial with a 1:1:1 allocation ratio was conducted. Thirty-three participants were randomized into three groups: device-guided training, active exercise or usual care. The exercise groups received 12 supervised online sessions over a 6-week period. Disability, pain, and eight self-reported outcome measures were assessed at baseline, 6 weeks, and 12 weeks.
RESULTS: Statistical analysis showed significant between-group differences in disability and pain intensity at T1 and T2 in favor of the device-guided training group (p < 0.05). No statistically significant between-group differences were found for secondary outcomes. Recruitment rate was 3.3 participants per month, adherence was 77%, and 16 mild transient adverse events were reported (27%). The estimated sample size for a future definitive trial was 94 participants.
CONCLUSIONS: A device-guided craniocervical exercise program delivered via telerehabilitation appears feasible, safe, and associated with greater reductions in disability and pain than conventional specific neck exercise and usual care in subacute WAD. While findings are preliminary, they support progression to a definitive multicentre randomized controlled trial currently underway to confirm effectiveness.Registration: ClinicalTrials.gov – NCT06580990.
PMID:42667605 | DOI:10.1080/10669817.2026.2720771
