Evidens-based exercise for chronic neck pain - implementation of a digital program in primary care

Important results from the project

The aim of the project was to implement two internet-based neck-specific exercise programs in primary health care in 7 county councils in Sweden. The two programs were WAD ExerciseIT (for patients with whiplash-associated disorders) and Neck ExerciseIT (for patients with non-specific neck pain), available on-line via the Swedish National Support and Treatment Services, Inera. Result achieved: Seven county councils in Sweden participated and reg. physiotherapists (n=98) from 20 physiotherapy clinics in primary health care were included.

Expected long term effects

The results will be evaluated in a prospective cluster-randomized mixed-design study with hybrid 2 trial design. The primary implementation outcome is proportion of patients with neck pain receiving neck-specific exercise. The primary outcome in the patient evaluation is self-reported neck disability (Neck Disability Index). The project has significant importance to gaining understanding about factors that will promote the implementation in primary care, to evaluate the effectiveness of the method and give guidance in large-scale implementation in primary care.

Approach and implementation

The two internet-based exercise programs, the theoretical and parctical instruction to physiotherapists, the questionnaires and interview guides were completed in January 2022. From April to May 2022 were physiotherapists from primary care clinics educated in the method. Additional clinics were recruited and all education was completed in October 2022.The two internet-based exercise programs were transferred to 7 county councils. Inclusion of county councils, primary care centers and education of physiotherapists is finished, which was the goal with funds sought.