Table 6 Reported physical functioning and disability outcomes by study

 Bekkering, 2005 [29]

QBPDS

Physical Functioning improved in both groups (Passive implementation vs Active+Passive implementation). No difference between groups at any time point over 12 months (Χ² 4.88, df=4, P > 0.05).

Baseline: Intervention 38.0 (IQR 26.5 to 50.5), Control 40.5 (IQR 26.3 to 55.8)

6 weeks: Intervention 24.0 (IQR 13.0 to 40.0), Control 23.5 (IQR 11.0 to 37.8)

12 weeks: Intervention 20.0 (IQR 7.0 to 32.8), Control 17.5 (IQR 6.0 to 30.8)

26 weeks: Intervention 16.0 (IQR 5.0 to 32.0), Control 11.0 (IQR 4.0 to 29.0)

52 weeks: Intervention 17.0 (IQR 4.6 to 32.0), Control 13.0 9 (IQR 4.8 to 29.0)

 Hoeijenbos, 2005 [25]

EQ-5D

Baseline: intervention 0.6730 (SD 0.2042), Control 0.6134 (0.2661) P = .006

Lower self-care score at baseline in control group (values not provided)

6 weeks: intervention 0.7778 (SD 0.1978), Control 0.7497

12 weeks: intervention 0.8141 (SD 0.1988), Control 0.7873 (SD 0.2210)

No significant difference from 6 weeks onwards between groups

 Karlen, 2015 [36]

ODI

Change in ODI per visits 25.2 to 31.5%

Ave improvement in ODI/visit improved form 3.8% to 5.8%

Mean % ODI improvement:

2010: 25.2%

2011: 28.5%

2012: 30.4%

2013: 32.9%

2014: 31.5%

Mean % ODI Improvement per visit:

2010: 3.8%

2011: 4.5%

2012: 5.1%

2013: 5.4%

2014: 5.8%

 Kongsted, 2019 [32]

ODI

ODI:

Unadjusted: Before 1.8 (95% CI −1.2 to 4.8); After 4.4 (95% CI 1.7 to 7.1); GLA:D 6.5 (95% CI 4.6 to 8.4)

Adjusted: Before 2.4 (95% CI −0.5 to 5.3); After 4.8 (95% CI 1.9 to 7.6); GLA:D 5.7 (95% CI 3.3 to 8.1)

 Lemieux, 2021 [30]

Perceived Fitness, ODI

Perceived Physical Fitness

Pre-training median: 19, (Q1, Q3 16, 24); Post-training median 22 (Q1, Q3 15, 27); Difference in median 3, P=.031

ODI

Pre-training median 25, (Q1, Q3 16, 34); Post-training median 20 (Q1, Q3: 10, 28); Difference in median −5, P<.001

 Rutten, 2010 [35]

QBPDS

Association between % Guideline Adherence and QBPDS B= −0.35, Beta= −0.21, P = −.023

Significant Associations between Percentage of Adherence to Individual Steps of the Process and QBPDS:

History taking −0.16, P< .1

Analysis −0.17, P<.05

Evaluation −0.30, P<.001

Correlation of Adherence with QBPDS in subgroups:

Acute −.20, P>.05

Subacute −.15, P>.05

Chronic −.38, P<.05

 Sharma, 2019 [26]

PROMIS; 2-item Quality of Life

PROMIS short form sleep disturbance:

PEG Change (95% CI) 7.62 (95% CI 3.50 to 11.74), P< .01

CG Change 3.49 (95% CI −0.12 to 7.10) P > .05

Between groups: t = 1.58, difference 4.13 (95% CI −1.16 to 9.42) P > .05

2-item Quality of Life change:

PEG change −0.79 (95% CI −1.42 to −0.15), P< .05

CG change −0.47 (95% CI −1.04 to 0.09) P > .05

Between groups: t = −0.78, difference −0.32 ( 95% CI −1.13 to 0.50) P > .05

 Schroder

ODI, EQ-5D

Between-group difference for patients receiving CPQI adherent/Nonadherent care:

ODI:

Baseline: Non CPQI Adherent 32.4 (95% CI 27.5 to 37.3); CPQI Adherent 28.3 (95% CI 23.5 to 33.2)

3 months: Non CPQI Adherent −9.0 (95% CI −11.8 to −6.2) P< .001; CPQI Adherent−11.3 (95% CI −14.2 to −8.3) P< .001; Between-Group Effect 2.3 (−1.1 to 5.6) P = .178

6 months: Non CPQI Adherent −8.9 (95% CI −12.1 to −6.0) P< .001; CPQI Adherent −12.7 (95% CI −16.1 to −9.4) P< .001; Between-Group Effect 3.8 (0.3 to 7.6) P = .048

12 months: Non CPQI Adherent −10.7 (95% CI −13.9 to −7.6) P< .001; CPQI Adherent−13.2 (95% CI −16.5 to −9.8) P< .001; Between-Group Effect 2.4 (−1.4 to 6.2) P = .207

EQ-5D:

Baseline: Non CPQI Adherent 0.51 (95% CI 0.45 to 0.57); CPQI Adherent 0.59 (95% CI 0.52 to 0.65)

3 months: Non CPQI Adherent 0.12 (95% CI 0.05 to 0.18) P< .001; CPQI Adherent 0.15 (95% CI 0.09 to 0.22) P< .001; Between-Group Effect −0.03 (95% CI −0.11 to 0.03) P = .294

6 months: Non CPQI Adherent 0.14 (95% CI 0.08 to 0.20) P< .001; CPQI Adherent 0.19 (95% CI 0.13 to 0.26) P< .001; Between-Group Effect −0.05 (95% CI −0.12 to 0.02) P = .161

12 months: Non CPQI Adherent 0.19 (95% CI 0.13 to 0.25) P< .001; CPQI Adherent 0.19 (95% CI 0.12 to 0.25) P< .001; Between-Group Effect 0.00 (95% CI −0.07 to 0.07) P = .985

Between-Group Effects for outcomes in Control and intervention group:

ODI:

Baseline: Control 31.6 (95% CI 27.2 to 36.1) Intervention 30.4 (95% CI 25.6 to 35.3)

3 months: Control −10.5 (95% CI −13.4 to −7.6) P< .001; Intervention −8.7 (95% CI −11.2 to −6.2) P< .001; Between-Group Effect −1.8 (−5.0 to 1.3) P = .248

6 months: Control −10.9 (95% CI −14.1 to −7.7) P< .001; Intervention −10.2 (95% CI −12.9 to −7.5) P< .001; Between-Group Effect −0.7 (95% CI −4.2 to 2.7) P = 0.674

12 months: Control −14.2 (95% CI −17.3 to −11.1) P< .001; Intervention −11.3 (95% CI −13.9 to −8.6) P< .001; Between-Group Effect −3.0 (−6.3 to 0.4) P = .081

EQ-5D index:

Baseline: Control 0.55 (95% CI 0.50 to 0.60); Intervention 0.52 (95% CI 0.46 to 0.58)

3 months 0.12 (95% CI 0.06 to 0.18) P< .001; Intervention 0.15 (95% CI 0.10 to 0.21) P< .001; Between-Group Effect −0.03 (95% CI −0.10 to 0.04) P = .381

6 months: Control 0.13 (95% CI 0.07 to 0.19) P< .001; Intervention 0.20 (95% CI 0.15 to 0.25) P< .001; Between-Group Effect −0.07 (95% CI −0.14 to −0.01) P = .034

12 months: Control 0.19 (95% CI 0.13 to 0.25) P< .001; Intervention 0.20 (95% CI 0.14 to 0.25) P< .001; Between-Group Effect −0.01 (95% CI −0.07 to 0.06) P = .838

* Bonferroni corrected significance thresholds of P ≤ 0.017

 Fritz, 2007 [17]

Modified ODI

All patients 47.9% (570) achieved at least 50% improvement.

Between groups, achieved at least 50% improvement:

Adherent 64.7%; Nonadherent 36.5% P< 0.001

Change in Oswestry:

All 19.8 (SD 18.3); Adherent 25.1 (SD 18.3); Nonadherent 16.3 (SD 17.5)

Percent Change in Oswestry:

All 44.9% (SD 37.7); Adherent 59.4% (SD 35.2); Nonadherent 35.1% (SD 36.1)

 Fritz, 2008 [18]

Modified ODI

Percent change in ODI: Adherent group 53.7% (SD 33.1), Nonadherent group 37.5% (SD 33.3), P< .05

Mean difference 16.2%, (95% CI 9.5 to 22.9)

Successful outcome of physical therapy (achieving at least 50% improvement on the OSW-disability score): Adherent 59.1%, Nonadherent 37.8%, P< .05.

 Van der Roer, 2008 [24]

RMDQ, EQ-5D

RMDQ:

No statistically significant differences between groups

Function 0.06 points (95% CI −2.22 to 2.34)

EQ-5D

No statistically significant difference between groups

QALYs 0.03 (95% CI −0.06 to 0.12).

 Hahne, 2017 [27]

Modified ODI

Baseline: Intervention 36.8 (SD 14.1), Control 37.5 (SD 16.1)

5 weeks: Intervention 27.4 (SD 15.5), Control 28.5 (SD 17.7), Adjusted SMD 0.0 (95% CI −0.5 to 0.6), Adjusted between-group difference 0.4 (95% CI −7.0 to 7.8) P = .92

10 weeks: Intervention 20.5 (SD 12.9), Control 28.9 (SD 21.6), Adjusted SMD 0.4 (95% CI −0.1 to 1.0), Adjusted between-group difference 7.7 (95% CI 0.3–15.1) P= .04

26 weeks: Intervention16.4 (SD 13.0), Control 22.8 (SD 19.9), Adjusted SMD 0.3 (95% CI −0.2 to 0.9), Adjusted between-group difference 5.7 (95% CI −1.7 to 13.1) P = .13

52 weeks: Intervention 14.2 (SD 15.4), Control 22.9 (SD 21.2), Adjusted SMD 0.4 (95% CI −0.1 to 1.0), Adjusted between-group difference 8.2 (95% CI 0.7–15.6) P= .03

 Cote, 2019 [28]

Whiplash Disability Questionnaire, SF-36

Whiplash Disability Questionnaire:

6 weeks: Government guideline 0.0 (95% CI −8.4 to 8.4), Preferred-provider 0.2 (95% CI −9.2 to 9.5), GP Education and activation 0.2 (95% CI − 8.7 to 9.0)

3 months: Government guideline 3.0 (95% CI −6.2 to 12.2), Preferred-provider −1.1 (95% CI −10.9 to 8.7), GP Education and activation 1.9 (95% CI −7.5 to 11.2)

6 months: Government guideline −5.5 (95% CI −15.9 to 4.9), Preferred-provider −2.7 (95% CI −13.2 to 7.8), GP Education and activation −8.2 (95% CI −18.7 to 2.2)

9 months: Government guideline −1.8 (95% CI −13.2 to 9.6), Preferred-provider 2.8 (95% CI −8.7 to 14.3), GP Education and activation 1.0 (95% CI −10.1 to 12.0)

12 months: Government guideline −4.8 (95% CI −15.2 to 5.6), Preferred-provider 3.3 (95% CI −7.3 to 14.0), GP Education and activation −1.5 (95% CI −12.3 to 9.3)

No difference between groups (P > 0.05)

SF-36 Physical Component:

6 weeks: Government guideline 0.4 (95% CI −2.8 to 3.7), Preferred-provider 0.2 (95% CI −3.2 to 3.5), GP Education and activation 0.6 (95% CI −2.4 to 3.7)

3 months: Government guideline 0.4 (95% CI −3.0 to 3.9), Preferred-provider −0.2 (95% CI −3.9 to 3.5), GP Education and activation 0.2 (95% CI −3.1 to 3.5)

6 months: Government guideline 0.4 (95% CI −3.0 to 3.8), Preferred-provider −1.0 (95% CI −5.0 to 2.9), GP Education and activation −0.7 (95% CI −4.4 to 3.1)

9 months: Government guideline 3.8 (95% CI −0.5 to 8.2), Preferred-provider −2.9 (95% CI −7.4 to 1.6), GP Education and activation 0.9 (95% CI −3.1 to 4.9)

12 months: Government guideline 1.6 (95% CI −2.0 to 5.1), Preferred-provider −2.1 (95% CI −6.1 to 2.0), GP Education and activation −0.5 (95% CI −4.4 to 3.4)

No difference between groups (P > 0.05)

SF-36 Mental Component:

6 weeks: Government guideline −3.3 (95% CI −7.4 to 0.9), Preferred-provider −0.8 (95% CI −4.9 to 3.2), GP Education and activation −4.1 (95% CI −8.4 to 0.3)

3 months: Government guideline −0.7 (95% CI −5.4 to 4.0), Preferred-provider −0.7 (−95% CI 5.3 to 4.0), GP Education and activation −1.3 (95% CI −6.2 to 3.6)

6 months: Government guideline 2.2 (95% CI −2.7 to 7.1), Preferred-provider 0.3 (95% CI −4.1 to 4.7), GP Education and activation 2.6 (95% CI −2.5 to 7.6)

9 months: Government guideline −0.3 (95% CI −6.1 to 5.5), Preferred-provider 1.8 (95% CI −3.6 to 7.2), GP Education and activation 1.5 (95% CI −4.1 to 7.1)

12 months: Government guideline −1.5 (95% CI −6.7 to 3.8), Preferred-provider −0.6 (95% CI −5.2 to 4.0), GP Education and activation −2.1 (95% CI −7.2 to 3.0)

No difference between groups (P > 0.05)

 Horn, 2016 [19]

NDI

No significant different between groups for disability score P = .32