Whiplash-associated disorders (WAD) is a collective term describing a range of symptoms that may develop following injury to the soft tissues of the neck during sudden acceleration-deceleration events, such as those experienced in rear-end car accidents. Despite developments in understanding and managing WAD, it is estimated that almost half of those affected by whiplash continue to report pain and disability a year or more after their injury. Reduced endurance of the neck muscles has been identified as a risk factor for persistent WAD, but the effects of strengthening these muscles in a practical treatment setting have been less clear.
To examine this issue, a study conducted in May 2025 involved 140 individuals with chronic WAD, all of whom underwent initial evaluations measuring neck pain, disability related to the neck, overall neck function, and psychosocial factors. These participants were divided into two groups: one group performed exercises at home under Internet-based guidance, while the other received in-office instruction from a physiotherapist. Both groups participated in their assigned interventions two to four times per week over a twelve-week duration. The same assessments were then repeated at both three months and fifteen months after the treatment period ended.
Findings from the study showed that both methods—home-based and clinic-supervised exercise—led to comparable improvements in neck pain, disability, and function, with these benefits linked to greater neck muscle endurance. This suggests that directly targeting neck muscle endurance may help alleviate lasting WAD symptoms. Additionally, the study found noteworthy progress in psychosocial outcomes, including enhanced self-efficacy, reduced fear-avoidance beliefs, and decreases in depressive symptoms and catastrophizing. These factors are often observed soon after injury and are closely associated with the development of long-term WAD.
Although continued research is necessary to validate these results and further explore the physiological and psychological mechanisms at play, current evidence indicates that evaluating neck muscle endurance should form part of the standard clinical assessment. Tailored exercises may also be recommended for patients to perform between professional care sessions as needed. Successful recovery from WAD not only brings personal and familial advantages but may also offer broader economic benefits, such as increased productivity and lowered litigation expenses, contributing to potential reductions in automobile insurance costs.
