Effectiveness of additional cognitive behavioural interventions on pain, catastrophising, kinesiophobia and anxiety in people with whiplash-associated disorders compared to physiotherapy alone: A systematic review
DOI:
https://doi.org/10.59210/078vz911Keywords:
Whiplash Injuries, Cognitive Behavioural Therapy, Pain, Catastrophising, AnxietyAbstract
Background
Among patients with whiplash-associated disorders (WAD), psychological distress can appear in forms of anxiety, depression or behavioural irregularities. Cognitive behavioural interventions (CBI) aim to influence such issues and thereby the pain experience.
Objectives
The purpose of this review is to synthesise the current state of evidence regarding the effectiveness of additional CBIs on pain, kinesiophobia, catastrophising and anxiety in people with WAD compared to physiotherapy alone.
Data sources
AMED, CINAHL, MEDLINE, PsycARTICLES, SPORTDiscus, PubMed and PEDro were searched from inception to 9 February 2019, complemented with a search update up to September 2021.
Study selection
Randomised controlled trials were included.
Study appraisal and synthesis methods
Quality appraisal and reporting incorporated the Cochrane Risk of Bias 2 tool and GRADE approach.
Results
Six studies were included. The evidence for all outcomes was uncertain. The findings as to whether CBIs in addition to physiotherapy are more effective in reducing pain intensity, kinesiophobia and anxiety than physiotherapy alone are conflicting. Regarding catastrophising, there are consistent findings that additional CBIs are not more effective.
Limitations
The review was not registered beforehand. Only one reviewer performed study selection, appraisal and data synthesis.
Conclusion and implications of key findings
Due to high risk of bias and very low methodological quality, the evidence is very uncertain about the effectiveness of additional CBIs. Their general addition to physiotherapy should be recommended cautiously.
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References
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