{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T06:15:35Z","timestamp":1793254535307,"version":"4.5.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T00:00:00Z","timestamp":1728259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Sweden\u2019s Innovation Agency","award":["2018-02244"],"award-info":[{"award-number":["2018-02244"]}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2018-02476"],"award-info":[{"award-number":["2018-02476"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Clinical Research S\u00f6rmland","award":["DLL-854531"],"award-info":[{"award-number":["DLL-854531"]}]},{"name":"Medical Research Society","award":["SLS-691041"],"award-info":[{"award-number":["SLS-691041"]}]},{"DOI":"10.13039\/100016670","name":"Region \u00d6sterg\u00f6tland","doi-asserted-by":"publisher","award":["R\u00d6-847691"],"award-info":[{"award-number":["R\u00d6-847691"]}],"id":[{"id":"10.13039\/100016670","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010805","name":"Forskningsr\u00e5det i Syd\u00f6stra Sverige","doi-asserted-by":"publisher","award":["FORSS-563491"],"award-info":[{"award-number":["FORSS-563491"]}],"id":[{"id":"10.13039\/100010805","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003945","name":"Link\u00f6pings Universitet","doi-asserted-by":"publisher","award":["Peolsson, time for research included in the position as Professor"],"award-info":[{"award-number":["Peolsson, time for research included in the position as Professor"]}],"id":[{"id":"10.13039\/501100003945","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Aim<\/jats:title>\n<jats:p>To investigate the effectiveness in individuals with chronic whiplash-associated disorders (WADs) of neck-specific exercise (NSE) supervised by a physiotherapist twice a week for 12 weeks versus neck-specific exercise with internet support and four physiotherapy visits (NSEIT) regarding dizziness, unsteadiness and balance, and to investigate the differences between WAD grades.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>This is a secondary analysis of a prospective randomised multicentre study (RCT) with concealed allocation (ClinicalTrials.gov Protocol ID: NCT03022812). The outcomes were dizziness measured on the Dizziness Handicap Inventory (DHI); dizziness at rest and during activity and unsteadiness using visual analogue scales; and standing on one leg with eyes closed (SOLEC). Participants (n = 140) were randomised to NSE or NSEIT. Measurements were obtained at baseline, and at three- and 15-month follow-ups by assessor-blinded investigators.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>There were no significant differences between NSEIT and NSE in any of the outcomes (p&gt;0.38). Both NSEIT and NSE improved over time (p&lt;0.02; effect size (ES) = 0.74\u20131.01) in DHI score and dizziness during activity. There was a significant group-by-time interaction effect in dizziness (at rest: p = 0.035; ES: 0.66; and during activity: p = 0.016; ES: 1.24) between WAD grades. Individuals with WAD grade 3 had dizziness\/unsteadiness to a greater extent and improved in all outcomes over time (p&lt;0.04) compared to those with WAD grade 2, except for SOLEC.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>There were no significant group differences between NSEIT and NSE. Both groups decreased in terms of self-reported dizziness (DHI, dizziness during activity), with medium to large effect size. Those with WAD grade 3 have dizziness\/unsteadiness to a greater extent than those with WAD grade 2. Despite improvements, many participants still reported dizziness at 15-month follow-up, and additional balance training and\/or vestibular exercise may be investigated for potential additional effect.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0311145","type":"journal-article","created":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T17:26:56Z","timestamp":1728322016000},"page":"e0311145","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness of neck-specific exercises with and without internet-based support on dizziness\/unsteadiness in chronic whiplash-associated disorders: Secondary analyses of a randomised controlled 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