Therapeutic Exercise for Chronic Whiplash-Associated Disorders: A Systematic Review of Randomized Controlled Trials on Pain, Disability, and Kinesiophobia

Background/Objectives: Chronic whiplash-associated disorders (WAD) are a common cause of persistent neck pain and disability. Therapeutic exercise is widely used, but its effectiveness remains uncertain. This systematic review evaluated the effects of therapeutic exercise, alone or combined with other interventions, on pain, neck-related disability, and kinesiophobia in adults with chronic WAD.

Methods

PubMed, PEDro, and the Cochrane Library were searched from inception to December 2025 for randomized controlled trials (RCTs) including adults with chronic WAD (>3 months). Eligible studies compared exercise-based interventions with minimal intervention, usual care, or other active treatments. Primary outcomes were pain and neck-related disability, with kinesiophobia as a secondary outcome. Methodological quality was assessed using the PEDro scale, risk of bias using Cochrane RoB 2, and certainty of evidence using GRADE. Due to heterogeneity, findings were synthesized without meta-analysis using SWiM principles.