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Qin L, Song P, Li X, Yang L, Xu F, Zhu X, Cai L, Hu G, Sun W, Zhang Y, Zhang L. Tension-Type Headache Management: A Systematic Review and Network Meta-analysis of Complementary and Alternative Medicine. Pain Ther 2024; 13:691-717. [PMID: 38748200 PMCID: PMC11254882 DOI: 10.1007/s40122-024-00600-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/31/2024] [Indexed: 07/18/2024] Open
Abstract
INTRODUCTION Tension-type headache (TTH) is common but challenging to manage due to limited effectiveness of conventional treatments. This study examines six complementary and alternative medicine (CAM) interventions through network meta-analysis to identify effective TTH management strategies. METHODS We searched PubMed, Embase, Web of Science, Cochrane Library, OVID, CNKI, Wanfang, VIP, and CBM databases for randomized controlled trials on CAM for TTH treatment. Headache frequency and intensity were the primary outcomes. Methodological quality was evaluated on the basis of the Cochrane risk of bias tool. We used R software to conduct this Bayesian network meta-analysis. We used mean difference (MD) with 95% credible intervals (CI) to calculate the continuous outcomes and analyzed the percentages of the surface under the cumulative ranking (SUCRA) curve. RESULTS In total, 32 randomized controlled trials (RCTs) with 2405 participants were analyzed. For reducing headache intensity, the network meta-analysis shows that acupuncture therapy combined with traditional Chinese medicine (AT_TCM), manual therapy (MT), psychological treatment (PT), and traditional Chinese medicine combined with acupuncture and manual therapy (TCM_AT_MT) are superior to Western medicine (WM). In the SUCRA curve, TCM_AT_MT is the best for reducing headache frequency (HF). CONCLUSIONS This review, assessed as low-quality evidence by GRADE, cautiously suggests potential benefits of PT over other CAM interventions for TTH and indicates TCM_AT_MT might better reduce HF. It proposes that combining CAM interventions could enhance outcomes. Due to the preliminary nature of these findings, further high-quality RCTs are essential to confirm these suggestions and provide clearer clinical guidance. PROSPERO REGISTRATION NUMBER CRD42021252073.
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Affiliation(s)
- Lingli Qin
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Haidian District, Beijing, 100091, China
| | - Ping Song
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Haidian District, Beijing, 100091, China
| | - Xian Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Haidian District, Beijing, 100091, China
| | - Longhui Yang
- China Academy of Chinese Medical Sciences, Dongcheng District, Beijing, 100700, China
| | - Feng Xu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Haidian District, Beijing, 100091, China
| | - Xueying Zhu
- Graduate School, Beijing University of Chinese Medicine, Chaoyang District, Beijing, 100029, China
| | - Lizhen Cai
- Graduate School, Beijing University of Chinese Medicine, Chaoyang District, Beijing, 100029, China
| | - Guangdi Hu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Haidian District, Beijing, 100091, China
| | - Weijia Sun
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Haidian District, Beijing, 100091, China
| | - Yunling Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Haidian District, Beijing, 100091, China.
| | - Lu Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Haidian District, Beijing, 100091, China.
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Deodato M, Granato A, Del Frate J, Martini M, Manganotti P. Differences in musculoskeletal dysfunctions and in postural alterations between chronic migraine and chronic tension type headache: A cross-sectional study. J Bodyw Mov Ther 2024; 37:404-411. [PMID: 38432837 DOI: 10.1016/j.jbmt.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/15/2023] [Accepted: 11/11/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVE The aim of present study is to assess postural alterations and musculoskeletal dysfunctions over all spine in patients with chronic migraine and chronic tension type headache, moreover to highlight the differences between these two forms of primary headache. METHODS A Cross sectional study was adopted to evaluate the musculoskeletal profile in patients with chronic migraine and with chronic tension type headache. The Bio photogrammetric evaluation was performed using the postural assessment software PAS/SAPO, while unilateral passive accessory intervertebral motion (PAIMs) were applied for manual examinations of spine segments from C0 to L5 vertebra. The One-way Analysis of Variance (ANOVA) test was used to compare the three groups with the software GraphPad InStat 3.06. RESULTS A total of 60 patients were recruited, 20 for chronic tension type group, 20 for chronic migraine group and 20 healthy controls. The most interesting findings was that patients with chronic primary headaches presented postural alterations in all parameters (cranio-vertebral angle and lumbar-pelvic angle) and musculoskeletal dysfunctions in all spine with respect to healthy controls. Finally, the most clinically relevant finding was that no differences were found between chronic migraine and chronic tension type headache concerning the postural alterations nor the musculoskeletal dysfunctions. CONCLUSION The sensitization acts as a substrate or consequence of these musculoskeletal dysfunctions in chronic primary headache. Therefore, non-pharmacological treatments targeted in the musculoskeletal system may be a good option in the management of chronic primary headache, especially when these therapies integrate various techniques that involve all spine.
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Affiliation(s)
- Manuela Deodato
- Department of Life Sciences, University of Trieste, Adress: via Pascoli 31, 34100, Trieste, Italy; Department of Medical, Surgical and Health Sciences, University of Trieste, Adress: via Pascoli 31, 34100, Trieste, Italy; Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy.
| | - Antonio Granato
- Department of Medical, Surgical and Health Sciences, University of Trieste, Adress: via Pascoli 31, 34100, Trieste, Italy; Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy.
| | - Jessica Del Frate
- Department of Medical, Surgical and Health Sciences, University of Trieste, Adress: via Pascoli 31, 34100, Trieste, Italy.
| | - Miriam Martini
- Department of Medical, Surgical and Health Sciences, University of Trieste, Adress: via Pascoli 31, 34100, Trieste, Italy.
| | - Paolo Manganotti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Adress: via Pascoli 31, 34100, Trieste, Italy; Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy.
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Comparison of Forces Exerted by a Chiropractor on Children and Adults During High-Speed, Low-Amplitude Spinal Manipulations: A Feasibility Study. J Manipulative Physiol Ther 2022. [DOI: 10.1016/j.jmpt.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Varangot-Reille C, Suso-Martí L, Dubuis V, Cuenca-Martínez F, Blanco-Díaz M, Salar-Andreu C, Casaña J, Calatayud J. Exercise and Manual Therapy for the Treatment of Primary Headache: An Umbrella and Mapping Review. Phys Ther 2022; 102:6515753. [PMID: 35084039 DOI: 10.1093/ptj/pzab308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 09/01/2021] [Accepted: 12/01/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The main aim of this study was to assess through systematic review the efficacy of exercise and manual therapy (MT) interventions in individuals with primary headache. METHODS In this umbrella review, 2 authors reviewed systematic reviews by searching the Cochrane Database of Systematic Reviews, MEDLINE, PEDro, Web of Science, and Google Scholar. Systematic reviews that evaluated the effectiveness of MT. Exercise-based interventions, or both in patients with primary headaches were included. Methodological quality was analyzed using the ROBIS scale, and the strength of evidence was established according to the Grading Criteria of the Physical Activity Guidelines Advisory Committee. RESULTS Thirty-one systematic reviews containing 79 trials and involving 9103 patients were included. The 7 exercise-related systematic reviews reported beneficial effects on primary headache based on unclear to moderate evidence. Of the 23 MT-related systematic reviews, 11 reported enhanced effectiveness compared with usual care; however, overall heterogeneity and risk of bias were high. Systematic reviews that evaluated the effectiveness of MT, exercise-based interventions, or both in patients with primary headaches were included. CONCLUSION Results show that exercise could be an effective therapy for the treatment of primary headache, with moderate to limited quality of evidence regarding the positive effects in terms of pain intensity and frequency and duration of headache. Moderate quality of evidence was found regarding the ability of MT to reduce pain intensity in patients with tension-type headaches, but quality of evidence was limited in terms of frequency of headache and disability and pain reduction in patients with migraine. IMPACT Exercise could be an effective treatment in patients with primary headache. Manual therapy showed limited evidence to reduce pain intensity in patients with tension-type headache. It is not possible to establish a preferential exercise protocol or MT program, so psychosocial and behavioral variables need to be considered in future studies.
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Affiliation(s)
- Clovis Varangot-Reille
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Luis Suso-Martí
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Valentin Dubuis
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Ferran Cuenca-Martínez
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - María Blanco-Díaz
- Surgery and Medical Surgical Specialities Department, Faculty of Medicine and Health Sciences, University of Oviedo, Oviedo, Asturias, Spain
| | - Cristina Salar-Andreu
- Department of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, Elche, Spain
| | - Jose Casaña
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
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Cumplido-Trasmonte C, Fernández-González P, Alguacil-Diego IM, Molina-Rueda F. Manual therapy in adults with tension-type headache: A systematic review. NEUROLOGÍA (ENGLISH EDITION) 2021; 36:537-547. [PMID: 34537167 DOI: 10.1016/j.nrleng.2017.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 12/01/2017] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Tension-type headache is the most common primary headache, with a high prevalence and a considerable socioeconomic impact. Manual physical therapy techniques are widely used in the clinical field to treat the symptoms associated with tension-type headache. This systematic review aims to determine the effectiveness of manual and non-invasive therapies in the treatment of patients with tension-type headache. DEVELOPMENT We conducted a systematic review of randomised controlled trials in the following databases: Brain, PubMed, Web of Science, PEDro, Scopus, CINAHL, and Science Direct. Ten randomised controlled trials were included for analysis. According to these studies, manual therapy improves symptoms, increasing patients' well-being and improving the outcome measures analysed. CONCLUSIONS Manual therapy has positive effects on pain intensity, pain frequency, disability, overall impact, quality of life, and craniocervical range of motion in adults with tension-type headache. None of the techniques was found to be superior to the others; combining different techniques seems to be the most effective approach.
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Affiliation(s)
| | - P Fernández-González
- Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Laboratorio de Análisis del Movimiento, Biomecánica, Ergonomía y Control Motor (LAMBECOM), Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - I M Alguacil-Diego
- Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Laboratorio de Análisis del Movimiento, Biomecánica, Ergonomía y Control Motor (LAMBECOM), Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - F Molina-Rueda
- Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Laboratorio de Análisis del Movimiento, Biomecánica, Ergonomía y Control Motor (LAMBECOM), Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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Effectiveness of Exercise and Manual Therapy as Treatment for Patients with Migraine, Tension-Type Headache or Cervicogenic Headache: An Umbrella and Mapping Review with Meta-Meta-Analysis. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11156856] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The aim of the study was to perform a mapping and umbrella review with meta-meta-analysis (MMA) to synthesise and critically evaluate the effectiveness of manual therapy (MT) and aerobic exercise (AE) in relation to pain intensity, frequency, disability and quality of life in patients with migraines, tension-type headaches (TTH) and cervicogenic headaches (CGH). A systematic search was conducted in PubMed, PEDro, Scielo and Google Scholar up to December 2020. A total of 18 articles met the inclusion criteria, and only 8 were included in the quantitative analysis. The MMA showed results in favour of the interventions in terms of pain intensity and quality of life in migraine, TTH and CCH. Data were also in favour of the intervention in terms of pain frequency in migraine and in terms of disability in TTH. However, there were no significant effects on pain frequency in TTH and CGH. The results showed moderate evidence to suggest that AE reduces pain intensity in patients with migraine. In addition, the evidence in favour of MT or a mixed intervention (including therapeutic exercise) was also moderate in terms of reducing pain intensity in patients with TTH.
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Chiropractic Care for the Pregnant Body. Clin Obstet Gynecol 2021; 64:602-610. [PMID: 33882524 DOI: 10.1097/grf.0000000000000621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Chiropractic care is a commonly used treatment modality for musculoskeletal pain in pregnancy. Low back pain, pelvic pain, and other neuromuscular complaints are prevalent in pregnancy and contribute to significant maternal discomfort in many women. Nonpharmacologic therapies to relieve pain are increasingly important during pregnancy because of the opioid epidemic. Chiropractic treatment is one of the potential therapies that offers intervention without medications. This article provides an evidence-based review of the epidemiology of chiropractic use in obstetrics, commonly treated conditions, related physiology of pregnancy, and safety of spinal manipulation.
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Effect of 4 Weeks of Cervical Deep Muscle Flexion Exercise on Headache and Sleep Disorder in Patients with Tension Headache and Forward Head Posture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073410. [PMID: 33806089 PMCID: PMC8037445 DOI: 10.3390/ijerph18073410] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to investigate the effect of flexion exercise of the deep cervical muscles on headache and sleep disorders in patients with tension headaches and forward head posture. A total of 32 patients with tension headaches and forward head posture were randomly assigned to two groups: an experimental group (n = 16) and a control group (n = 16). The experimental group performed cervical deep muscle flexion exercises for 4 weeks, whereas the control group performed stretching exercises for the same period. The Henry Ford Hospital Headache Disability Inventory (HDI) was used for headache assessment, and the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K) was used for sleep disorder assessment. The experimental group showed a significant reduction in both HDI and PSQI-K score after 4 weeks of intervention (p < 0.001), while no significant difference was found in the control group (p > 0.05). On comparing the experimental and control groups, we found a significant difference in changes in the HDI and PSQI-K between the groups (p < 0.05). The results indicate that flexion exercise of the deep cervical muscles in patients with tension headache and forward head posture will improve the quality of life and activities of daily life by mitigating headaches and sleep disorders.
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Wayne P, Bernstein C, Kowalski M, Connor J, Osypiuk K, Long C, Vining R, Macklin E, Rist P. The Integrative Migraine Pain Alleviation through Chiropractic Therapy (IMPACT) trial: Study rationale, design and intervention validation. Contemp Clin Trials Commun 2020; 17:100531. [PMID: 32043014 PMCID: PMC6997836 DOI: 10.1016/j.conctc.2020.100531] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/06/2020] [Accepted: 01/19/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Approximately 15% of the US population experiences migraine, with women afflicted three times as often as men. While medications are often used as first-line treatments, up to 50% of people with migraine pursue complementary and integrative medicine. One promising non-pharmacological approach for migraine is chiropractic care, due to the co-occurrence of migraine disease and musculoskeletal tension and pain. To date, no large-scale trials have evaluated the impact of a comprehensive model of chiropractic care on migraine. METHODS The Integrative Migraine Pain Alleviation through Chiropractic Therapy (IMPACT) study is a two-arm pilot pragmatic randomized clinical trial evaluating a multimodal chiropractic care intervention plus enhanced usual care (UC) vs. enhanced UC alone for adult women with episodic migraine. A total of 60 women aged 20-55 who meet criteria for episodic migraine will be randomly assigned to an evidence-informed, musculoskeletal focused multimodal chiropractic care (10 sessions over 14 weeks) plus enhanced UC vs. enhanced UC alone. Enhanced UC includes conventional care, migraine education materials, and biweekly check-in phone calls. Study specific aims include: 1) Determine safety and feasibility of the study design; 2) Provide preliminary data on the effectiveness of chiropractic care on migraine frequency, severity, duration and medication use; and 3) Provide preliminary estimates of the effects of chiropractic care on disability, health-related quality of life, and psychosocial well-being. DISCUSSION Findings will be used to inform the design of a full-scale trial evaluating chiropractic care for women with episodic migraines.
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Affiliation(s)
- P.M. Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
- Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - C. Bernstein
- John Graham Headache Center, Department of Neurology, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
- Osher Clinical Center, Brigham and Women's Hospital, Boston, MA, USA
| | - M. Kowalski
- Osher Clinical Center, Brigham and Women's Hospital, Boston, MA, USA
| | - J.P. Connor
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - K. Osypiuk
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - C.R. Long
- Palmer College of Chiropractic, Davenport, IA, USA
| | - R. Vining
- Palmer College of Chiropractic, Davenport, IA, USA
| | - E. Macklin
- Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - P.M. Rist
- Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
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Driehuis F, Hoogeboom TJ, Nijhuis-van der Sanden MWG, de Bie RA, Staal JB. Spinal manual therapy in infants, children and adolescents: A systematic review and meta-analysis on treatment indication, technique and outcomes. PLoS One 2019; 14:e0218940. [PMID: 31237917 PMCID: PMC6592551 DOI: 10.1371/journal.pone.0218940] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/12/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Studies on effectiveness and safety of specific spinal manual therapy (SMT) techniques in children, which distinguish between age groups, are lacking. OBJECTIVE To conduct a systematic review of the evidence for effectiveness and harms of specific SMT techniques for infants, children and adolescents. METHODS PubMed, Index to Chiropractic Literature, Embase, CINAHL and Cochrane Library were searched up to December 2017. Controlled studies, describing primary SMT treatment in infants (<1 year) and children/adolescents (1-18 years), were included to determine effectiveness. Controlled and observational studies and case reports were included to examine harms. One author screened titles and abstracts and two authors independently screened the full text of potentially eligible studies for inclusion. Two authors assessed risk of bias of included studies and quality of the body of evidence using the GRADE methodology. Data were described according to PRISMA guidelines and CONSORT and TIDieR checklists. If appropriate, random-effects meta-analysis was performed. RESULTS Of the 1,236 identified studies, 26 studies were eligible. Infants and children/adolescents were treated for various (non-)musculoskeletal indications, hypothesized to be related to spinal joint dysfunction. Studies examining the same population, indication and treatment comparison were scarce. Due to very low quality evidence, it is uncertain whether gentle, low-velocity mobilizations reduce complaints in infants with colic or torticollis, and whether high-velocity, low-amplitude manipulations reduce complaints in children/adolescents with autism, asthma, nocturnal enuresis, headache or idiopathic scoliosis. Five case reports described severe harms after HVLA manipulations in four infants and one child. Mild, transient harms were reported after gentle spinal mobilizations in infants and children, and could be interpreted as side effect of treatment. CONCLUSIONS Based on GRADE methodology, we found the evidence was of very low quality; this prevented us from drawing conclusions about the effectiveness of specific SMT techniques in infants, children and adolescents. Outcomes in the included studies were mostly parent or patient-reported; studies did not report on intermediate outcomes to assess the effectiveness of SMT techniques in relation to the hypothesized spinal dysfunction. Severe harms were relatively scarce, poorly described and likely to be associated with underlying missed pathology. Gentle, low-velocity spinal mobilizations seem to be a safe treatment technique in infants, children and adolescents. We encourage future research to describe effectiveness and safety of specific SMT techniques instead of SMT as a general treatment approach.
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Affiliation(s)
- Femke Driehuis
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Thomas J. Hoogeboom
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Rob A. de Bie
- Caphri Research School, Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - J. Bart Staal
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, the Netherlands
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Davidson I, Crooks K, Newington L, Pilling M, Todd C. Assessing the feasibility of mobilisation of C0–C3 cervical segments to reduce headache in migraineurs. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.8.382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Ian Davidson
- Senior lecturer in physiotherapy, Manchester Metropolitan University
| | - Kathryn Crooks
- Research assistant, School of Nursing, Midwifery and Social Work, University of Manchester
| | - Lisa Newington
- Senior physiotherapist, Chelsea and Westminster Hospital NHS Foundation Trust, London
| | - Mark Pilling
- Senior research associate in statistics, Institute of Public Health, University of Cambridge
| | - Christopher Todd
- Professor of primary care and community health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre and Manchester University NHS Foundation Trust
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Dutch Translation and Validation of the Headache-Specific Locus of Control Scale (HSLC-DV). Pain Res Manag 2018; 2018:3046235. [PMID: 29854036 PMCID: PMC5954918 DOI: 10.1155/2018/3046235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/30/2017] [Accepted: 04/03/2018] [Indexed: 11/17/2022]
Abstract
Background and Objective The assessment of locus of control forms an important part of headache treatment, and there is need to adapting them to the Dutch population. Methods Forward-backward translation was used to obtain the Headache-Specific Locus of Control Scale-Dutch Version (HSLC-DV). The response of 87 participants with migraine, tension-type headache, and cervicogenic headache, aged between 18 and 55 years (75% female), is used. Test-retest reliability was measured by intraclass correlations. Construct validity was assessed by correlations with corresponding domains of the Pain Coping and Cognition List (PCCL) and by confirmation of known groups hypotheses. Structural validity was evaluated by factor analysis (principal axis factoring). Results The intraclass correlations for the External, Internal, and Chance domains were 0.79, 0.89, and 0.73, respectively. Internal consistencies for domains exceeded 0.73 and were similar to those observed in the original study. Convergent correlations were as expected and three of the seven known groups hypotheses were confirmed. Structural validity was supported by results of the factor analysis that matched the proposed structure of the original instrument. Conclusions The HSLC-DV is a valid and reliable questionnaire for measuring the locus of control.
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Chiropraktische Behandlung von Kopfschmerzen. MANUELLE MEDIZIN 2017. [DOI: 10.1007/s00337-017-0327-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Objectives To systematically collate and evaluate the evidence from recent systematic reviews of clinical trials of spinal manipulation. Design Literature searches were carried out in four electronic databases for all systematic reviews of the effectiveness of spinal manipulation in any indication, published between 2000 and May 2005. Reviews were defined as systematic if they included an explicit and repeatable inclusion and exclusion criteria for studies. Results Sixteen papers were included relating to the following conditions: back pain (n=3), neck pain (n=2), lower back pain and neck pain (n=1), headache (n=3), non-spinal pain (n=1), primary and secondary dysmenorrhoea (n=1), infantile colic (n=1), asthma (n=1), allergy (n=1), cervicogenic dizziness (n=1), and any medical problem (n=1). The conclusions of these reviews were largely negative, except for back pain where spinal manipulation was considered superior to sham manipulation but not better than conventional treatments. Conclusions Collectively these data do not demonstrate that spinal manipulation is an effective intervention for any condition. Given the possibility of adverse effects, this review does not suggest that spinal manipulation is a recommendable treatment.
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Affiliation(s)
- E Ernst
- Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, 25 Victoria Park Road, Exeter EX2 4NT, UK.
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Clearfield M. A Path to Osteopathic Distinction: The Touro California GROUPIE Program. J Osteopath Med 2017; 117:488-494. [DOI: 10.7556/jaoa.2017.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Zhang Y, Dennis JA, Leach MJ, Bishop FL, Cramer H, Chung VCH, Moore C, Lauche R, Cook R, Sibbritt D, Adams J. Complementary and Alternative Medicine Use Among US Adults With Headache or Migraine: Results from the 2012 National Health Interview Survey. Headache 2017; 57:1228-1242. [PMID: 28742215 DOI: 10.1111/head.13148] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 06/05/2017] [Accepted: 06/05/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Given the safety concerns regarding pharmacological agents, and the considerable impact of headache and migraine on the sufferer's quality of life, many people seek other treatment options beyond conventional medication and care to address their symptoms; this includes complementary and alternative medicine (CAM). Some CAM interventions have shown promising results in clinical trials of headache and migraine management. Nonetheless, there has been little research exploring the reasons for using CAM, and the types of CAM used, among this population. OBJECTIVE The study aimed to answer the following questions: (1) Which CAM modalities are used most frequently among migraine/headache sufferers? and (2) What are the self-reported reasons for CAM use among migraine/headache sufferers? METHODS This secondary analysis of data from the 2012 U.S. NHIS (a national cross-sectional survey) examined the use of CAM among migraine/headache sufferers, including the main reasons related to CAM use. Data were weighted and analyzed using STATA 14.0. RESULTS The sample of 34,525 adults included 6558 (18.7%) headache/migraine sufferers. Of the headache/migraine sufferers, a substantial proportion (37.6%, n = 2427) used CAM for various conditions; however, CAM use specifically for headache/migraine was much less prevalent (3.3%, n = 216). Of those who used CAM for headache/migraine, about half used CAM in conjunction with prescription (47.8%, n = 100) or over-the-counter medication (55.1%, n = 113). As severity of headache/migraine increased so did the likelihood of using CAM (severe migraine odds ratio [OR] = 2.32; 95% confidence interval [CI]: 1.41, 3.82; both recurring headache/severe migraine OR = 3.36; 95% CI: 2.08, 5.43; when compared to those with recurring headache only). The most frequently used CAM modality among all headache/migraine sufferers (N = 6558) was manipulative therapy (22.0%, n = 1317), herbal supplementation (21.7%, n = 1389) and mind-body therapy (17.9%, n = 1100). The top 3 reasons for using CAM for headache were general wellness (28.7%, n = 60/209), improving overall health (26.8%, n = 56/209), and reducing stress (16.7%, n = 35/209). CONCLUSIONS Although CAM is used by many sufferers of headache/migraine, the use of CAM specifically for the treatment of headache/migraine is relatively low in the United States. The study also assesses the key differences of CAM use among headache/migraine sufferers in NHIS 2012 compared with those in NHIS 2007, and identifies shortfalls in the evidence-base of several CAM modalities used by U.S. adults for headache/migraine. This information may assist health providers and consumers in making informed decisions about the safest and most appropriate approach to managing headache/migraine.
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Affiliation(s)
- Yan Zhang
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jeff A Dennis
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Matthew J Leach
- Department of Rural Health, University of South Australia, Adelaide, Australia.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Felicity L Bishop
- Faculty of Social Human and Mathematical Sciences, University of Southampton, Southampton, UK.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Vincent C H Chung
- JC School of Public Health and Primary Care, Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Hong Kong.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Craig Moore
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Ron Cook
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
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Sahai-Srivastava S, Sigman E, Uyeshiro Simon A, Cleary L, Ginoza L. Multidisciplinary Team Treatment Approaches to Chronic Daily Headaches. Headache 2017; 57:1482-1491. [DOI: 10.1111/head.13118] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 04/30/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | - Erica Sigman
- Division of Biokinesiology and Physical Therapy; Ostrow School of Dentistry, USC; Los Angeles CA USA
| | - Ashley Uyeshiro Simon
- Division of Occupational Science and Occupational Therapy; Ostrow School of Dentistry, USC; Los Angeles CA USA
| | - Lyssa Cleary
- USC Physical Therapy Associates; Los Angeles CA USA
| | - Lori Ginoza
- Division of Biokinesiology and Physical Therapy; Ostrow School of Dentistry, USC; Los Angeles CA USA
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Nielsen SM, Tarp S, Christensen R, Bliddal H, Klokker L, Henriksen M. The risk associated with spinal manipulation: an overview of reviews. Syst Rev 2017; 6:64. [PMID: 28340595 PMCID: PMC5366149 DOI: 10.1186/s13643-017-0458-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/15/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Spinal manipulative therapy (SMT) is a widely used manual treatment, but many reviews exist with conflicting conclusions about the safety of SMT. We performed an overview of reviews to elucidate and quantify the risk of serious adverse events (SAEs) associated with SMT. METHODS We searched five electronic databases from inception to December 8, 2015. We included reviews on any type of studies, patients, and SMT technique. Our primary outcome was SAEs. Quality of the included reviews was assessed using a measurement tool to assess systematic reviews (AMSTAR). Since there were insufficient data for calculating incidence rates of SAEs, we used an alternative approach; the conclusions regarding safety of SMT were extracted for each review, and the communicated opinion were judged by two reviewers independently as safe, harmful, or neutral/unclear. Risk ratios (RRs) of a review communicating that SMT is safe and meeting the requirements for each AMSTAR item, were calculated. RESULTS We identified 283 eligible reviews, but only 118 provided data for synthesis. The most frequently described adverse events (AEs) were stroke, headache, and vertebral artery dissection. Fifty-four reviews (46%) expressed that SMT is safe, 15 (13%) expressed that SMT is harmful, and 49 reviews (42%) were neutral or unclear. Thirteen reviews reported incidence estimates for SAEs, roughly ranging from 1 in 20,000 to 1 in 250,000,000 manipulations. Low methodological quality was present, with a median of 4 of 11 AMSTAR items met (interquartile range, 3 to 6). Reviews meeting the requirements for each of the AMSTAR items (i.e. good internal validity) had a higher chance of expressing that SMT is safe. CONCLUSIONS It is currently not possible to provide an overall conclusion about the safety of SMT; however, the types of SAEs reported can indeed be significant, sustaining that some risk is present. High quality research and consistent reporting of AEs and SAEs are needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015030068 .
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Affiliation(s)
- Sabrina Mai Nielsen
- The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Simon Tarp
- The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Robin Christensen
- The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Henning Bliddal
- Clinical Research Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Louise Klokker
- The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Marius Henriksen
- Physiotherapy and Biomechanics Research Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark.
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Analysis of the upper cervical spine stiffness during axial rotation: A comparative study among patients with tension-type headache or migraine and asymptomatic subjects. Clin Biomech (Bristol, Avon) 2017; 42:128-133. [PMID: 28157621 DOI: 10.1016/j.clinbiomech.2017.01.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 10/19/2016] [Accepted: 01/26/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Many studies reported the implication of the cervical musculoskeletal system in patients with tension type headache and migraine. The objective of this study is to investigate the upper cervical spine stiffness features in axial rotation among headache patients in comparison with a healthy population. METHODS 48 subjects including 30 migraine patients with/without aura and 18 patients with tension-type headache, aged between 18 and 60years (mean 36, SD 11years) have been evaluated. Stiffness measurements were carried out for passive axial rotation using a torque meter device. The flexion-rotation test was used to emphasize assessment of the upper cervical spine. FINDINGS Neither the stiffness nor the neutral zone varies between different populations studied. Passive range of motion in axial rotation is unilaterally reduced in symptomatic subjects (p=0.001). Considering the elastic zone, right and left motion magnitude was significantly lower for clinical groups compared to the control group. INTERPRETATION Stiffness seems not to be altered among tension type headache and migraine patients. However, patients seem prone to display a larger right-left asymmetry of axial rotation and a reduction in the motion range tolerance, emphasizing the likely link between the cervical discomfort and these pathologies. Any difference is observed in the elastic behavior of the upper cervical spine between the two primary headache populations. However, further investigations are needed to confirm these previous results taking various specific clinical characteristics into consideration.
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Ng JY, Liang L, Gagliardi AR. The quantity and quality of complementary and alternative medicine clinical practice guidelines on herbal medicines, acupuncture and spinal manipulation: systematic review and assessment using AGREE II. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:425. [PMID: 27793133 PMCID: PMC5086054 DOI: 10.1186/s12906-016-1410-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 10/20/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Complementary and alternative medicine (CAM) use is often not disclosed by patients, and can be unfamiliar to health care professionals. This may lead to underuse of beneficial CAM therapies, and overuse of other CAM therapies with little proven benefit or known contraindications. No prior research has thoroughly evaluated the credibility of knowledge-based resources. The purpose of this research was to assess the quantity and quality of CAM guidelines. METHODS A systematic review was conducted to identify CAM guidelines. MEDLINE, EMBASE and CINAHL were searched in January 2016 from 2003 to 2015. The National Guideline Clearinghouse, National Center for Complementary and Integrative Health web site, and two CAM journals were also searched. Eligible guidelines published in English language by non-profit agencies on herbal medicine, acupuncture, or spinal manipulation for adults with any condition were assessed with the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. RESULTS From 3,126 unique search results, 17 guidelines (two herbal medicine, three acupuncture, four spinal manipulation, eight mixed CAM therapies) published in 2003 or later and relevant to several clinical conditions were eligible. Scaled domain percentages from highest to lowest were clarity of presentation (85.3 %), scope and purpose (83.3 %), rigour of development (61.2 %), editorial independence (60.1 %), stakeholder involvement (52.0 %) and applicability (20.7 %). Quality varied within and across guidelines. None of the 17 guidelines were recommended by both appraisers; 14 were recommended as Yes or Yes with modifications. CONCLUSIONS Guidelines that scored well could be used by patients and health care professionals as the basis for discussion about the use of these CAM therapies. In future updates, guidelines that achieved variable or lower scores could be improved according to specifications in the AGREE II instrument, and with insight from a large number of resources that are available to support guideline development and implementation. Future research should identify CAM therapies other than those reviewed here for which guidelines are available. Research is also needed on the safety and effectiveness of CAM therapies.
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Affiliation(s)
- Jeremy Y. Ng
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario Canada
| | - Laurel Liang
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario Canada
| | - Anna R. Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario Canada
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Efficacy of manual therapy in the treatment of tension-type headache. A systematic review from 2000 to 2013. NEUROLOGÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.nrleng.2016.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Hanson L, Haas M, Bronfort G, Vavrek D, Schulz C, Leininger B, Evans R, Takaki L, Neradilek M. Dose-response of spinal manipulation for cervicogenic headache: study protocol for a randomized controlled trial. Chiropr Man Therap 2016; 24:23. [PMID: 27280016 PMCID: PMC4898300 DOI: 10.1186/s12998-016-0105-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/31/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Cervicogenic headache is a prevalent and costly pain condition commonly treated by chiropractors. There is evidence to support the effectiveness for spinal manipulation, but the dose of treatment required to achieve maximal relief remains unknown. The purpose of this paper is to describe the methodology for a randomized controlled trial evaluating the dose-response of spinal manipulation for chronic cervicogenic headache in an adult population. METHODS/DESIGN This is a mixed-methods, two-site, prospective, parallel groups, observer-blind, randomized controlled trial conducted at university-affiliated research clinics in the Portland, OR and Minneapolis, MN areas. The primary outcome is patient reported headache frequency. Other outcomes include self-reported headache intensity, disability, quality of life, improvement, neck pain intensity and frequency, satisfaction, medication use, outside care, cervical motion, pain pressure thresholds, health care utilization, health care costs, and lost productivity. Qualitative interviews are also conducted to evaluate patients' expectations of treatment. DISCUSSION With growing concerns regarding the costs and side effects of commonly used conventional treatments, greater numbers of headache sufferers are seeking other approaches to care. This is the first full-scale randomized controlled trial assessing the dose-response of spinal manipulation therapy on outcomes for cervicogenic headache. The results of this study will provide important evidence for the management of cervicogenic headache in adults. TRIAL REGISTRATION ClinicalTrials.gov (Identifier: NCT01530321).
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Affiliation(s)
- Linda Hanson
- />Center for Spirituality and Healing, The University of Minnesota, 420 Delaware St SE C592, Minneapolis, MN 55455 USA
| | - Mitchell Haas
- />Center for Outcome Studies, The University of Western States, 2900 NE 132nd Ave, Portland, OR 97230 USA
| | - Gert Bronfort
- />Center for Spirituality and Healing, The University of Minnesota, 420 Delaware St SE C592, Minneapolis, MN 55455 USA
| | - Darcy Vavrek
- />Biostatistics, Clinical and Regulatory Affairs, Illumina, 5200 Illumina Way, San Diego, CA 92122 USA
| | - Craig Schulz
- />Center for Spirituality and Healing, The University of Minnesota, 420 Delaware St SE C592, Minneapolis, MN 55455 USA
- />Children’s Hospitals and Clinics of Minnesota, Pain, Palliative Care, and Integrative Medicine, 2525 Chicago Ave, Minneapolis, MN 55404 USA
| | - Brent Leininger
- />Center for Spirituality and Healing, The University of Minnesota, 420 Delaware St SE C592, Minneapolis, MN 55455 USA
| | - Roni Evans
- />Center for Spirituality and Healing, The University of Minnesota, 420 Delaware St SE C592, Minneapolis, MN 55455 USA
| | - Leslie Takaki
- />Center for Outcome Studies, The University of Western States, 2900 NE 132nd Ave, Portland, OR 97230 USA
| | - Moni Neradilek
- />The Mountain-Whisper-Light Statistics, 1827 23rd Ave East, Seattle, WA 98112 USA
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A Randomized Pragmatic Clinical Trial of Chiropractic Care for Headaches With and Without a Self-Acupressure Pillow. J Manipulative Physiol Ther 2015; 38:637-643. [DOI: 10.1016/j.jmpt.2015.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 10/13/2015] [Accepted: 10/13/2015] [Indexed: 01/03/2023]
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Puentedura EJ, O'Grady WH. Safety of thrust joint manipulation in the thoracic spine: a systematic review. J Man Manip Ther 2015; 23:154-61. [PMID: 26309386 DOI: 10.1179/2042618615y.0000000012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There appears to be very little in the research literature on the safety of thrust joint manipulation (TJM) when applied to the thoracic spine. PURPOSE To retrospectively analyze all available documented case reports in the literature describing patients who had experienced severe adverse events (AE) after receiving TJM to their thoracic spine. DATA SOURCES Case reports published in peer reviewed journals were searched in Medline (using Ovid Technologies, Inc.), Science Direct, Web of Science, PEDro (Physiotherapy Evidence Database), Index of Chiropractic literature, AMED (Allied and Alternative Medicine Database), PubMed and the Cumulative Index to Nursing and Allied Health (CINHAL) from January 1950 to February 2015. STUDY SELECTION Case reports were included if they: (1) were peer-reviewed; (2) were published between 1950 and 2015; (3) provided case reports or case series; and (4) had TJM as an intervention. Articles were excluded if: (1) the AE occurred without TJM (e.g. spontaneous); (2) the article was a systematic or literature review; or (3) it was written in a language other than English or Spanish. DATA EXTRACTION Data extracted from each case report included: gender; age; who performed the TJM and why; presence of contraindications; the number of manipulation interventions performed; initial symptoms experienced after the TJM; as well as type of severe AE that resulted. RESULTS Ten cases, reported in 7 case reports, were reviewed. Cases involved females (8) more than males (2), with mean age being 43.5 years (SD=18.73, Range = 17 -71). The most frequent AE reported was injury (mechanical or vascular) to the spinal cord (7/10), with pneumothorax and hematothorax (2/10) and CSF leak secondary to dural sleeve injury (1/10). LIMITATIONS There were only a small number of case reports published in the literature and there may have been discrepancies between what was reported and what actually occurred, since physicians dealing with the effects of the AE, rather than the clinician performing the TJM, published the cases. CONCLUSIONS Serious AE do occur in the thoracic spine, most commonly, trauma to the spinal cord, followed by pneumothorax. This suggests that excessive peak forces may have been applied to thoracic spine, and it should serve as a cautionary note for clinicians to decrease these peak forces.
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Affiliation(s)
- Emilio J Puentedura
- University of Nevada Las Vegas, School of Allied Health Sciences, Department of Physical Therapy, Las Vegas, NV, USA
| | - William H O'Grady
- University of Nevada Las Vegas, School of Allied Health Sciences, Department of Physical Therapy, Las Vegas, NV, USA
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Kosloff TM, Elton D, Tao J, Bannister WM. Chiropractic care and the risk of vertebrobasilar stroke: results of a case-control study in U.S. commercial and Medicare Advantage populations. Chiropr Man Therap 2015; 23:19. [PMID: 26085925 PMCID: PMC4470078 DOI: 10.1186/s12998-015-0063-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 04/28/2015] [Indexed: 12/19/2022] Open
Abstract
Background There is controversy surrounding the risk of manipulation, which is often used by chiropractors, with respect to its association with vertebrobasilar artery system (VBA) stroke. The objective of this study was to compare the associations between chiropractic care and VBA stroke with recent primary care physician (PCP) care and VBA stroke. Methods The study design was a case–control study of commercially insured and Medicare Advantage (MA) health plan members in the U.S. population between January 1, 2011 and December 31, 2013. Administrative data were used to identify exposures to chiropractic and PCP care. Separate analyses using conditional logistic regression were conducted for the commercially insured and the MA populations. The analysis of the commercial population was further stratified by age (<45 years; ≥45 years). Odds ratios were calculated to measure associations for different hazard periods. A secondary descriptive analysis was conducted to determine the relevance of using chiropractic visits as a proxy for exposure to manipulative treatment. Results There were a total of 1,829 VBA stroke cases (1,159 – commercial; 670 – MA). The findings showed no significant association between chiropractic visits and VBA stroke for either population or for samples stratified by age. In both commercial and MA populations, there was a significant association between PCP visits and VBA stroke incidence regardless of length of hazard period. The results were similar for age-stratified samples. The findings of the secondary analysis showed that chiropractic visits did not report the inclusion of manipulation in almost one third of stroke cases in the commercial population and in only 1 of 2 cases of the MA cohort. Conclusions We found no significant association between exposure to chiropractic care and the risk of VBA stroke. We conclude that manipulation is an unlikely cause of VBA stroke. The positive association between PCP visits and VBA stroke is most likely due to patient decisions to seek care for the symptoms (headache and neck pain) of arterial dissection. We further conclude that using chiropractic visits as a measure of exposure to manipulation may result in unreliable estimates of the strength of association with the occurrence of VBA stroke.
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Affiliation(s)
- Thomas M Kosloff
- Optum Health - Clinical Programs at United Health Group, 11000 Optum Circle, Eden Prairie, MN 55344 USA
| | - David Elton
- Optum Health - Clinical Programs at United Health Group, 11000 Optum Circle, Eden Prairie, MN 55344 USA
| | - Jiang Tao
- Optum Health - Clinical Analytics at United Health Group, 11000 Optum Circle, Eden Prairie, MN 55344 USA
| | - Wade M Bannister
- Optum Health - Clinical Analytics at United Health Group, 11000 Optum Circle, Eden Prairie, MN 55344 USA
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Rolle G, Tremolizzo L, Somalvico F, Ferrarese C, Bressan LC. Pilot Trial of Osteopathic Manipulative Therapy for Patients With Frequent Episodic Tension-Type Headache. J Osteopath Med 2014; 114:678-85. [DOI: 10.7556/jaoa.2014.136] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Context: Osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) may be used for managing headache pain and related disability, but there is a need for high-quality randomized controlled trials to assess the effectiveness of this intervention.
Objective: To explore the efficacy of OMTh for pain management in frequent episodic tension-type headache (TTH).
Design: Single-blind randomized placebo-controlled pilot study.
Setting: Patients were recruited from 5 primary care settings.
Patients: Forty-four patients who were affected by frequent episodic TTH and not taking any drugs for prophylactic management of episodic TTH were recruited.
Interventions: Patients were randomly allocated to an experimental or control group. The experimental group received corrective OMTh techniques, tailored for each patient; the control group received assessment of the cranial rhythmic impulse (sham therapy). The study included a 1-month baseline period, a 1-month treatment period, and a 3-month follow-up period.
Main Outcome Measures: The primary outcome was the change in patient-reported headache frequency, and secondary outcomes included changes in headache pain intensity (discrete score, 1 [lowest perceived pain] to 5 [worst perceived pain]), over-the-counter medication use, and Headache Disability Inventory score.
Results: Forty patients completed the study (OMTh, n=21; control, n=19). The OMTh group had a significant reduction in headache frequency over time that persisted 1 month (approximate reduction, 40%; P<.001) and 3 months (approximate reduction, 50%; P<.001) after the end of treatment. Moreover, there was an absolute difference between the 2 treatment groups at the end of the study, with a 33% lower frequency of headache in the OMTh group (P<.001).
Conclusion: This feasibility study demonstrated the efficacy of OMTh in the management of frequent episodic TTH, compared with sham therapy in a control group. Osteopathic manipulative therapy may be preferred over other treatment modalities and may benefit patients who have adverse effects to medications or who have difficulty complying with pharmacologic regimens. This protocol may serve as a model for future studies.
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Brønfort G, Haas M, Evans RL, Goldsmith CH, Assendelft WJJ, Bouter LM. WITHDRAWN: Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database Syst Rev 2014; 2014:CD001878. [PMID: 25157618 PMCID: PMC6483320 DOI: 10.1002/14651858.cd001878.pub3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This review is out of date, but is correct at the date of publication. The review has been withdrawn from The Cochrane Library, but readers can still access previous versions in the 'Other versions' tab. The original author team is preparing three new protocols which will serve to update and replace this review: Manual treatment and spinal rehabilitative exercise for the prevention of migraine attacks in adults, Manual treatment and spinal rehabilitative exercise for the prevention of TTH in adults, and Manual treatment and spinal rehabilitative exercise for the prevention of cervicogenic headaches in adults. For further information, please contact the PaPaS CRG (details here ). July 2017 At July 2017, the series of three new reviews intended to replace this review were withdrawn as they were not able to be completed within the available editorial resource. The editorial group responsible for this previously published document have withdrawn it from publication.
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Affiliation(s)
- Gert Brønfort
- University of MinnesotaIntegrative Health & Wellbeing Research Program, Center for Spirituality & Healing420 Delaware Street SE, MMC505MinneapolisMNUSA55455
| | | | - Roni L Evans
- University of MinnesotaIntegrative Health & Wellbeing Research Program, Center for Spirituality & Healing420 Delaware Street SE, MMC505MinneapolisMNUSA55455
| | - Charles H Goldsmith
- Simon Fraser UniversityFaculty of Health SciencesBlossom Hall, Room 95108888 University DriveBurnabyBCCanadaV5A 1S6
| | - Willem JJ Assendelft
- Radboud University Nijmegen Medical CenterDepartment of Primary and Community Care, 117 ELGPO Box 9101route 117NijmegenNetherlands6500 HB
| | - Lex M Bouter
- VU UniversityDe Boelelaan 1105AmsterdamNetherlands1081 HV
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Cost-Effectiveness of Manual Therapy for the Management of Musculoskeletal Conditions: A Systematic Review and Narrative Synthesis of Evidence From Randomized Controlled Trials. J Manipulative Physiol Ther 2014; 37:343-62. [DOI: 10.1016/j.jmpt.2014.05.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 04/30/2014] [Accepted: 05/01/2014] [Indexed: 11/20/2022]
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Lozano López C, Mesa Jiménez J, de la Hoz Aizpurúa JL, Pareja Grande J, Fernández de Las Peñas C. Efficacy of manual therapy in the treatment of tension-type headache. A systematic review from 2000-2013. Neurologia 2014; 31:357-69. [PMID: 24856370 DOI: 10.1016/j.nrl.2014.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 12/27/2013] [Accepted: 01/03/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To study the efficacy of manual therapy in the treatment of tension-type headache (TTH) by assessing the quality of randomized control trials (RCTs) published from the year 2000 to April 2013. METHODS A search was performed in the following databases: MEDLINE, EBSCO, CINAHL, SCOPUS, PEDRO and OVID. An analysis was made of RCT including patients with TTH receiving any manual therapy, and assessing outcome measures including the intensity, and frequency or duration of the headache. Two independent referees reviewed the methodological quality of RCTs using the Jadad scale. Data from the studies were extracted by two different reviewers. RESULTS A total of fourteen RCTs were selected. Twelve studies showed acceptable quality (Jadad scale ≥3), and the remaining 2 had low quality (Jadad=2). The studies showed positive results, including reduction in headache intensity and/or frequency, reduction of medication consumption, and improvement in quality of life. CONCLUSIONS The effectiveness of manual therapy for TTH cannot be completely assessed due to the heterogeneity in study design, outcome measures, and different treatments. Nevertheless, the results suggest patients with TTH receiving manual therapies showed better progress than those receiving conventional treatment or placebo. Further studies of high quality using manual therapy protocols, and also including standardized outcome measures, are now needed to clarify the efficacy of manual therapy in the management of TTH.
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Affiliation(s)
- C Lozano López
- Máster en Dolor Orofacial y Disfunción Craneomandibular, Facultad de Medicina, Departamento de Fisioterapia, Universidad CEU San Pablo, Madrid, España
| | - J Mesa Jiménez
- Máster en Dolor Orofacial y Disfunción Craneomandibular, Facultad de Medicina, Departamento de Fisioterapia, Universidad CEU San Pablo, Madrid, España.
| | - J L de la Hoz Aizpurúa
- Máster en Dolor Orofacial y Disfunción Craneomandibular, Facultad de Medicina, Departamento de Fisioterapia, Universidad CEU San Pablo, Madrid, España
| | - J Pareja Grande
- Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - C Fernández de Las Peñas
- Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
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Abstract
BACKGROUND Intracranial hypotension (IH) is caused by a leakage of cerebrospinal fluid (often from a tear in the dura) which commonly produces an orthostatic headache. It has been reported to occur after trivial cervical spine trauma including spinal manipulation. Some authors have recommended specifically questioning patients regarding any chiropractic spinal manipulation therapy (CSMT). Therefore, it is important to review the literature regarding chiropractic and IH. OBJECTIVE To identify key factors that may increase the possibility of IH after CSMT. METHOD A systematic search of the Medline, Embase, Mantis and PubMed databases (from 1991 to 2011) was conducted for studies using the keywords chiropractic and IH. Each paper was reviewed to examine any description of the key factors for IH, the relationship or characteristics of treatment, and the significance of CSMT to IH. In addition, other items that were assessed included the presence of any risk factors, neck pain and headache. RESULTS The search of the databases identified 39 papers that fulfilled initial search criteria, from which only eight case reports were relevant for review (after removal of duplicate papers or papers excluded after the abstract was reviewed). The key factors for IH (identified from the existing literature) were recent trauma, connective tissue disorders, or otherwise cases were reported as spontaneous. A detailed critique of these cases demonstrated that five of eight cases (63%) had non-chiropractic SMT (i.e. SMT technique typically used by medical practitioners). In addition, most cases (88%) had minimal or no discussion of the onset of the presenting symptoms prior to SMT and whether the onset may have indicated any contraindications to SMT. No case reports included information on recent trauma, changes in headache patterns or connective tissue disorders. DISCUSSION Even though type of SMT often indicates that a chiropractor was not the practitioner that delivered the treatment, chiropractic is specifically cited as either the cause of IH or an important factor. There are so much missing data in the case reports that one cannot determine whether the practitioner was negligent (in clinical history taking) or whether the SMT procedure itself was poorly administered. CONCLUSIONS This systematic review revealed that case reports on IH and SMT have very limited clinical details and therefore cannot exclude other theories or plausible alternatives to explain the IH. To date, the evidence that CSMT is not a cause of IH is inconclusive. Further research is required before making any conclusions that CSMT is a cause of IH. Chiropractors and other health practitioners should be vigilant in recording established risk factors for IH in all cases. It is possible that the published cases of CSMT and IH may have missed important confounding risk factors (e.g. a new headache, or minor neck trauma in young or middle-aged adults).
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Affiliation(s)
- P Tuchin
- Department of Chiropractic, Macquarie University, NorthRyde, NSW, Australia
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Abstract
Primary headache disorders are often accompanied by neck pain or other symptoms referable to neck muscles. Therefore, physical therapy and other physical treatments are commonly prescribed for headache management. A medical literature review was completed in order to gather information regarding the efficacy of selected physical modalities in the treatment of primary and cervicogenic headache disorders. After analyzing the collected data, expert opinions were developed regarding the utility and efficacy of selected physical modalities in the management of primary and cervicogenic headaches. Based on this review, the following four expert opinions are presented: physical therapy is more effective than massage therapy or acupuncture for the treatment of tension-type headache and appears to be most beneficial for patients with a high frequency of headache attacks. Physical therapy is most effective for the treatment of migraine when combined with other treatments such as thermal biofeedback, relaxation training and exercise. Chiropractic manipulation demonstrated a trend towards benefit in the treatment of tension-type headache, but evidence is weak. Chiropractic manipulation is probably more effective in the treatment of tension-type headache than it is in the treatment of migraine. In general, strong evidence is lacking regarding the efficacy of these treatments in reducing headache frequency, intensity, duration and disability in many commonly encountered clinical situations. Many of the published case series and controlled studies are of low quality. Physical treatments are unlikely to pose a significant risk, with the exception of high velocity chiropractic manipulation of the neck. Consideration must be given to financial costs and lost treatment opportunity by prescribing potentially ineffective treatment. In the absence of clear evidence regarding their role in treatment, physicians and patients are advised to make cautious and individualized judgments about the utility of physical treatments for headache management. In most cases, the use of physical modalities should complement rather than replace better validated forms of therapy. The evidence base to determine the safety and efficacy of physical treatments in the management of headache disorders would be substantially improved by using standard scientific rigor in the development and conduct of future clinical studies.
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Affiliation(s)
- David M Biondi
- Spaulding Rehabilitation Hospital, Headache Management Program, 125 Nashua Street, Boston, MA 02114, USA.
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Fernández-de-las-Peñas C, Cuadrado ML. Therapeutic options for cervicogenic headache. Expert Rev Neurother 2013; 14:39-49. [PMID: 24308280 DOI: 10.1586/14737175.2014.863710] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The term cervicogenic headache (CeH) describes a syndrome originating from the cervical spine. There are a variety of therapeutic approaches used for the management of CeH, but scientific evidence of their effectiveness is scarce. No medication drug has proven to be effective. The evidence for greater occipital nerve blocks, cervical nerve blockades, facet joint injections and surgical procedures is limited. Several physical therapy interventions are proposed for CeH, with spinal manipulation and soft tissue interventions being the most commonly used. However, the lack of solid evidence of positive effects and risks of serious complications for spinal manipulation should be considered in favor of other physical therapy interventions associated with less risk. The inconsistent results in the literature can be related to the fact that maybe not all therapeutic interventions are appropriate for all patients with CeH or maybe not all patients with CeH will benefit from particular interventions.
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Affiliation(s)
- César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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Vaughn DW, Kenyon LK, Sobeck CM, Smith RE. Spinal manual therapy interventions for pediatric patients: a systematic review. J Man Manip Ther 2013; 20:153-9. [PMID: 23904755 DOI: 10.1179/2042618612y.0000000007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE Although much has been written about the efficacy of manual therapy interventions for adults with headaches or spinal pain, little research has focused on the use of these interventions in pediatric patients. The purpose of this systematic review was to evaluate the evidence for spinal manual therapy (SMT) interventions in patients 4-17 years old with headaches and/or mechanical spinal pain. METHODS A search for relevant studies published in the past 15 years was conducted on MEDLINE, CINAHL, Cochrane Central Register of Randomized Control Trials, PEDro, PubMed, and Sports Discus. Only English language articles were reviewed. Studies had to include at least one outcome measure for pain, function, or quality of life. Studies evaluating post-operative interventions, or those in which the interventions were directed at influencing excessive spinal curvatures, were excluded. Case reports and studies that did not limit analysis of the results to the pediatric population were also excluded. RESULTS Two randomized control trials and two studies offering lower levels of evidence were identified in the literature search. The latter studies were prospective cohort studies. The four studies were evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. DISCUSSION There are very little data in the literature to support or refute the use of SMT interventions in pediatric patients. Further research is required to establish a strong evidence-based foundation for use of these interventions in children.
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Gadotti IC, Olivo SA, Magee DJ. Cervical musculoskeletal impairments in cervicogenic headache: a systematic review and a meta-analysis. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/174328808x252082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Rathier LA, Buse DC, Nicholson RA, Andrasik F. Multidisciplinary Approach to Patients with Migraine. Headache 2013. [DOI: 10.1002/9781118678961.ch7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Fernández-de-las-Peñas C, Arendt-Nielsen L, Simons DG. Contributions of Myofascial Trigger Points to Chronic Tension Type Headache. J Man Manip Ther 2013. [DOI: 10.1179/106698106790820016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Hanten WP, Olson SL, Lindsay WA, Lounsberry KA, Stewart JK. The Effect of Manual Therapy and a Home Exercise Program on Cervicogenic Headaches: A Case Report. J Man Manip Ther 2013. [DOI: 10.1179/106698105790835859] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Issa TS, Huijbregts PA. Physical Therapy Diagnosis and Management of a Patient with Chronic Daily Headache: A Case Report. J Man Manip Ther 2013. [DOI: 10.1179/jmt.2006.14.4.88e] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Herzog W, Tang C, Leonard T. Internal Carotid Artery Strains During High-Speed, Low-Amplitude Spinal Manipulations of the Neck. J Manipulative Physiol Ther 2012; 38:664-671. [PMID: 23140796 DOI: 10.1016/j.jmpt.2012.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 08/28/2012] [Accepted: 09/17/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The primary objective of this study was to quantify the strains applied to the internal carotid artery (ICA) during neck spinal manipulative treatments and range of motion (ROM)/diagnostic testing of the head and neck. METHODS Strains of the ICA (n = 12) were measured in 6 fresh, unembalmed cadaveric specimens using sonomicrometry. Peak and average strains of the ICA obtained during cervical spinal manipulations given by experienced doctors of chiropractic were compared with the corresponding strains obtained during ROM and diagnostic testing of the head and neck. RESULTS Peak and average strains of the ICA for cervical spinal manipulative treatments were significantly smaller (P < .001) than the corresponding strains obtained for the ROM and diagnostic testing. All strains during ROM and treatment testing were dramatically smaller than the initial failure strains of the ICA. CONCLUSIONS This study showed that maximal ICA strains imparted by cervical spinal manipulative treatments were well within the normal ROM. Chiropractic manipulation of the neck did not cause strains to the ICA in excess of those experienced during normal everyday movements. Therefore, cervical spinal manipulative therapy as performed by the trained clinicians in this study, did not appear to place undue strain on the ICA and thus does not seem to be a factor in ICA injuries.
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Affiliation(s)
- Walter Herzog
- Killam Memorial Chair, Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; Canada Research Chair (Tier 1) in Molecular and Cellular Biomechanics, Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; Professor in Kinesiology, Medicine, Engineering and Veterinary Medicine, Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
| | - Conrad Tang
- Chiropractor, Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Tim Leonard
- Research Associate, Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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Affiliation(s)
- Edzard Ernst
- Peninsula Medical School; University of Exeter; Veysey Building, Salmon Pool Lane; Exeter; EX2 4SG; UK
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Abstract
STUDY DESIGN Retrospective cross-sectional analysis of administrative data. OBJECTIVE To examine the relationship between regional chiropractic supply and both use and utilization intensity of chiropractic services among Medicare beneficiaries. SUMMARY OF BACKGROUND DATA Numerous studies have documented trends and patterns in the utilization of chiropractic services in the United States, but little is known about geographic variation in the relationship between chiropractic supply and utilization. METHODS We analyzed Medicare claims data for services provided by chiropractic physicians in 2008. We aggregated the data to the hospital referral region level and used small area analysis techniques to generate descriptive statistics. We mapped geographic variations in chiropractic supply, use and utilization intensity (treatments per user), and quantified the variation by coefficient of variation and extremal ratio. We used Spearman rank correlation coefficient to correlate use with supply. We used a logistic regression model for chiropractic use and a multiple linear regression model for chiropractic utilization intensity. RESULTS The average regional supply of chiropractic physicians was 21.5 per 100,000 adult capita. The average percentage of beneficiaries who used chiropractic was approximately 7.6 (SD, 3.9). The average utilization intensity was 10.6 (SD, 1.8). Regional chiropractic supply varied more than 14-fold, and chiropractic use varied more than 17-fold. Chiropractic supply and use were positively correlated (Spearman ρ, 0.68; P < 0.001). A low back or cervical spine problem was strongly associated with chiropractic use (odds ratios, 21.6 and 14.3, respectively). Increased chiropractic supply was associated with increased chiropractic use (odds ratio, 1.04) but not with increased chiropractic utilization intensity. CONCLUSION Both the supply of chiropractors and the utilization of chiropractic by older US adults varied widely by region. Increased chiropractic supply was associated with increased chiropractic use but not with increased chiropractic utilization intensity. Utilization of chiropractic care is likely sensitive to both supply and patient preference.
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Complementary and Alternative Approaches to the Treatment of Tension-Type Headache. Curr Pain Headache Rep 2012; 16:539-44. [DOI: 10.1007/s11916-012-0295-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mintken PE, Derosa C, Little T, Smith B. A model for standardizing manipulation terminology in physical therapy practice. J Man Manip Ther 2011; 16:50-6. [PMID: 19119385 DOI: 10.1179/106698108790818567] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Paul E Mintken
- Chair of the Task Force; Assistant Professor, University of Colorado Denver, School of Medicine, Physical Therapy Program, Denver, CO; Fellow, Regis University Manual Therapy Fellowship, Regis University, School of Physical Therapy, Denver, CO
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Chaibi A, Tuchin PJ. Chiropractic spinal manipulative treatment of migraine headache of 40-year duration using Gonstead method: a case study. J Chiropr Med 2011; 10:189-93. [PMID: 22014909 PMCID: PMC3259914 DOI: 10.1016/j.jcm.2011.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 02/06/2011] [Accepted: 02/18/2011] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE The purpose of this article is to present a case study of chiropractic spinal manipulative treatment (CSMT) using the Gonstead method for a patient with migraines. CLINICAL FEATURES The patient was a 52-year-old married woman with a long-term history of chronic migraines, which included nausea, vomiting, and photophobia. The patient had endometriosis, but did not relate the migraines to her menstrual cycles. She also reported not using medication for her migraines due to previous drug-related issues. The average frequency of episodes before treatment was 1 per month, and her migraines often included an aura. The pain was moderate, was located on the right side, was pulsating, and lasted for approximately 15 hours. The numeric pain scale for an average episode was 8 out of a possible 10. The aura involved nausea, photophobia, and visual disturbances including black dots in the visual field lasting for approximately 10 minutes. INTERVENTION AND OUTCOME The patient reported all episodes being eliminated following CSMT. At 6-month follow-up, the patient had not had a single migraine episode in this period. The patient was certain that there had been no other lifestyle changes that could have contributed to her improvement. CONCLUSION This case adds to previous research suggesting that some migraine patients may respond favorably to CSMT. The case also provides information on the Gonstead method. A case study does not represent significant scientific evidence in context with other studies conducted; this study suggests that a trial of CSMT using the Gonstead methods could be considered for chronic, nonresponsive migraines.
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Affiliation(s)
- Aleksander Chaibi
- Chiropractor and Physiotherapist, Atlasklinikken, Fridtjof Nansens plass 8, 0160 Oslo, Norway
| | - Peter J. Tuchin
- Senior Lecturer, Department of Chiropractic, Macquarie University, NSW 2109, Australia
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Evidence-based medicine: revisiting the pyramid of priorities. J Bodyw Mov Ther 2011; 16:42-9. [PMID: 22196426 DOI: 10.1016/j.jbmt.2011.05.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2011] [Revised: 05/07/2011] [Accepted: 05/10/2011] [Indexed: 12/27/2022]
Abstract
Evidence-based medicine (EBM) is beset with numerous problems. In addition to the fact that varied audiences have each customarily sought differing types of evidence, EBM traditionally incorporated a hierarchy of clinical research designs, placing systematic reviews and meta-analyses at the pinnacle. Yet the canonical pyramid of EBM excludes numerous sources of research information, such as basic research, epidemiology, and health services research. Models of EBM commonly used by third party payers have ignored clinical judgment and patient values and expectations, which together form a tripartite and more realistic guideline to effective clinical care. Added to this is the problem in which enhanced placebo treatments in experimentation may obscure verum effects seen commonly in practice. Compounding the issue is that poor systematic reviews which comprise a significant portion of EBM are prone to subjective bias in their inclusion criteria and methodological scoring, shown to skew outcomes. Finally, the blinding concept of randomized controlled trials is particularly problematic in applications of physical medicine. Examples from the research literature in physical medicine highlight conclusions which are open to debate. More progressive components of EBM are recommended, together with greater recognition of the varying audiences employing EBM.
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Posadzki P, Ernst E. Spinal Manipulations for Cervicogenic Headaches: A Systematic Review of Randomized Clinical Trials. Headache 2011; 51:1132-9. [DOI: 10.1111/j.1526-4610.2011.01932.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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