Physiotherapist delivered Stress Modulation Training: A randomised Controlled Trial in Acute Whiplash Injury.

Physiotherapy Exercise and Stress Inocculation Training (SIT): Exercise: The 6-week exercise intervention includes 2 sessions/week in weeks 1-4 and 1 session/week in weeks 5-6. Each session will be a maximum of 50minutes (determined by the physiotherapist) and comprise of specific exercises to improve movement and control of the neck and shoulder girdles as well as exercises to improve eye/head co-ordination. The exercises will be tailored and supervised by the physiotherapist for each individual participant. Exercises are of a low load nature and designed to be pain free. Paricipants will perform exercises at home once/day and a log book will be completed by participants to record compliance with the exercises.Physiotherapists will also guide participants to return to normal daily activities. Stress Inoculation Training: Trained physiotherapists will provide information and strategies to assist participants in managing acute stress reactions following a motor vehicle accident. The Stress Inoculation Training will be delivered once per week and integrated with the exercise program sessions and incorporated into the 50minutes maximum session length to control for any attention placebo effect compared to the control group. The first session will include education about the effects of acute stress following an injury. At subsequent sessions additional strategies for managing stress will be introduced including abdominal breathing, progressive muscle relation, simple cognitive behavioural skills to encourage positive coping, reduce avoidance behaviours and develop problem solving skills. Participants will be required to perform daily practice of stress management skills and complete a log book to record compliance. Chief Investigator Kenardy will audit the SIT intervention to check for adherence.