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Hussein M, Hassan A, Nada MAF, Mohammed Z, Abdel Ghaffar NF, Kedah H, Fathy W, Magdy R. Reliability, validity, and responsiveness of the Arabic version of HIT-6 questionnaire in patients with migraine indicated for preventive therapy: A multi-center study. Headache 2024; 64:500-508. [PMID: 38651363 DOI: 10.1111/head.14719] [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: 10/14/2023] [Revised: 02/16/2024] [Accepted: 02/22/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND The Headache Impact Test (HIT-6) is an important patient-reported outcome measure (PROM) in migraine prevention trials. OBJECTIVES This study aimed to (i) assess the reliability and validity of the Arabic version of HIT-6 in Arabic-speaking patients experiencing migraine, and (ii) evaluate the responsiveness of HIT-6 following migraine preventive therapy. METHODS In this prospective study, patients with migraine (n = 145) were requested to fill out a headache diary, the Arabic version of HIT-6, and Migraine Disability Assessment Scale (MIDAS) at two time points (baseline and 3 months after initiation of prophylactic treatment). Some respondents (n = 73) were requested to fill out HIT-6 again 1 week from the baseline for test-retest reliability. The intensity of migraine headache attacks was evaluated using the Visual Analogue Scale (VAS). An anchor-based method was used to establish the minimal important change (MIC) value and responsiveness of HIT-6. RESULTS The total scores of HIT-6 were significantly correlated to a fair degree with MIDAS (r = 0.41), as well as VAS (r = 0.53), and monthly migraine days (r = 0.38) at the baseline while at the follow-up (after 3 months), the correlations were of moderate degree with MIDAS scores (r = 0.62) and monthly migraine days (r = 0.60; convergent validity). Reliability estimates of the Arabic HIT-6 were excellent (Cronbach's α = 0.91 at baseline and 0.89 at follow-up). The average measure interclass correlation coefficient (ICC) value for the test-retest reliability was 0.96 (95% confidence interval = 0.94-0.98, p < 0.001). The HIT-6 total score is sensitive to change, being significantly reduced after prophylactic treatment compared to before (effect size = 1.5, standardized response mean = 1.3). A reduction from baseline of 4.5 on HIT-6 showed the highest responsiveness to predict improvement with an area under the curve equal to 0.66, sensitivity of 80%, specificity of 45%, and significance at 0.021. Changes in the HIT-6 total score were positively correlated with changes in monthly migraine days (r = 0.40) and VAS scores (r = 0.69) but not with changes in the score of MIDAS (r = 0.07). CONCLUSION The Arabic version of HIT-6 is valid, reliable, and sensitive to detect clinical changes following migraine prophylactic treatment with a MIC of 4.5 points.
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Affiliation(s)
- Mona Hussein
- Department of Neurology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Amr Hassan
- Department of Neurology, Cairo University, Cairo, Egypt
| | - Mona A F Nada
- Department of Neurology, Cairo University, Cairo, Egypt
| | - Zeinab Mohammed
- Department of Public Health and Community Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Nawal F Abdel Ghaffar
- Department of Neurology, Cairo University, Cairo, Egypt
- Aseer Central Hospital, Abha, Saudi Arabia
| | | | - Wael Fathy
- Department of Anesthesiology, Surgical ICU and Pain Management, Beni-Suef University, Beni-Suef, Egypt
| | - Rehab Magdy
- Department of Neurology, Cairo University, Cairo, Egypt
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Onan D, Arıkan H, Martelletti P. The Effect of OnabotulinumtoxinA on Headache Intensity and Number of Monthly Headache Days in Individuals with Chronic Migraine with Different Levels of Neck Disability. Toxins (Basel) 2023; 15:685. [PMID: 38133189 PMCID: PMC10747931 DOI: 10.3390/toxins15120685] [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: 11/05/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
One of the treatment methods used in chronic migraine is OnabotulinumtoxinA. The effects of OnabotulinumtoxinA on headache intensity (HI) and number of monthly headache days (NMHD) in chronic migraine (CM) patients classified according to neck disability levels are unknown. Our aim was to investigate the effect of OnabotulinumtoxinA on the HI and the NMHD in individuals with CM with different levels of neck disability. One hundred sixteen patients were enrolled in the study. The OnabotulinumtoxinA protocol was administered as per Follow-the-Pain PREEMPT. The Neck Disability Index was used to evaluate neck disability. Primary outcome measures were headache intensity, assessed with the Visual Analogue Scale, and the number of monthly headache days recorded from patients' diaries. Secondary outcome measures were migraine disability, assessed with the Migraine Disability Assessment Test, and quality-of-life, assessed with the Headache Impact Test-6. All assessments were made at baseline and end of the treatment. The OnabotulinumtoxinA treatment showed a greater improvement effect in the number of monthly headache days (p = 0.000) and migraine disability (p = 0.000) parameters in the severe and complete disability groups. CM patients with complete and severe neck disability received the most benefit in reducing the NMHD at 3 months after OnabotulinumtoxinA treatment, but the HI decreased at a similar level in all neck disability groups.
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Affiliation(s)
- Dilara Onan
- Department of Physiotherapy and Rehabilitation, Faculty of Heath Sciences, Yozgat Bozok University, Yozgat 66100, Turkey;
| | - Halime Arıkan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tokat Gaziosmanpasa University, Tokat 60000, Turkey;
| | - Paolo Martelletti
- School of Health Sciences, Unitelma Sapienza University, 00161 Rome, Italy
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Jiang G, Ma S, Zhao J, Zhang M, Li Y, Chen W, Cui L, Jia L. Assessing the efficacy and safety of Craniosacral therapy for migraine: A single center randomized controlled trial. Medicine (Baltimore) 2023; 102:e35431. [PMID: 37960717 PMCID: PMC10637508 DOI: 10.1097/md.0000000000035431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/29/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVE Design a feasible study to assess the efficacy and safety of Craniosacral therapy (CST) in the treatment of migraine, using a rigorous and innovative randomized controlled study design involving complementary light-touch sham treatments (CLST) as an attention control intervention. METHODS This was a single-center, randomized, cross-over placebo-controlled experimental design. A total of 87 participants who suffered migraine attacks from 4 to 9 per month were randomly assigned into either 2 weekly units of CST or CLST for 4 weeks. And then the 2 groups were crossed and continued treatment for 4 weeks plus a follow-up observation for 4 weeks. As the primary outcome measures, Headache Impact Test-6 (HIT-6) and headache frequency were assessed every 4 weeks (at baseline, week 4, week 8 and week 12). The secondary outcome was the scores of Headache Disability inventory (HDI) and the Hamilton Anxiety Scale (HAMA) as well as the adverse events. RESULTS All 87 individuals had been screened for eligibility, of which 60 were licensed for the study. The difference of HIT-6 and headache frequency between the 2 groups was not significant at the baseline. But the headache frequency and HIT-6 of 2 groups were all declined respectively after the CST at week 4 (group A) and week 8 (group B) than before (P☆= 0.01 < 0.05, 95% CI, -3.06 to -1.87; P※= 0.01 < 0.05, 95% CI, -3.52 to -2.53; P1A = 0.01 < 0.05, 95% CI, 4.55-11.7; P2B = 0.01 < 0.05, 95% CI, -11.78 to -6.01) while the changes were not obvious after CLST with previous treatment. The scores and frequency of fourth evaluation showed that there was no significant increase or decrease in both the 2 groups. Besides, we found that the mean scores of HIT-6 for all participants, compared with the baseline, were decreased significantly after the 3 round treatments (P3A = 0.01 < 0.05, 95% CI, -13.12 to -6.4; P3B = 0.01 < 0.05, CI, -12.73 to -6.69). We also showed the similar result in the scores of HDI and HAMA. CONCLUSION The results indicated that standardized CST was both effective and safe in alleviating the migraine intensity and frequency as well as the headache-related disability. Further larger research is needed.
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Affiliation(s)
- Guangya Jiang
- Department of Neurology, Yellow River Central Hospital of Yellow River Conservancy Commission, Zhengzhou, China
| | - Saichao Ma
- Department of Rehabilitation, Yellow River Central Hospital of Yellow River Conservancy Commission, Zhengzhou, China
| | - Jinfeng Zhao
- The Department of Gerontology, Zhengzhou University Province People’s Hospital, Zhengzhou, China
| | - Ming Zhang
- Department of Health Management Center, Yellow River Central Hospital of Yellow River Conservancy Commission, Zhengzhou, China
| | - Yan Li
- Department of Health Management Center, Yellow River Central Hospital of Yellow River Conservancy Commission, Zhengzhou, China
| | - Wenli Chen
- Department of Rehabilitation, Yellow River Central Hospital of Yellow River Conservancy Commission, Zhengzhou, China
| | - Lin Cui
- Department of Neurological Intensive Medicine, Yellow River Central Hospital of Yellow River Conservancy Commission, Zhengzhou, China
| | - Liuyun Jia
- Department of Neurological Intensive Medicine, Yellow River Central Hospital of Yellow River Conservancy Commission, Zhengzhou, China
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Empl M, Löser S, Spille P, Rozwadowska A, Ruscheweyh R, Straube A. Effects of Introvision, a self-regulation method with a mindfulness-based perception technique in migraine prevention: a monocentric randomized waiting-list controlled study (IntroMig Study). J Headache Pain 2023; 24:146. [PMID: 37924063 PMCID: PMC10623798 DOI: 10.1186/s10194-023-01684-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Migraine is a brain disorder with recurrent headache attacks and altered sensory processing. Introvision is a self-regulation method based on mindfulness-like perception techniques, developed at the University of Hamburg. Here, we examined the effect of Introvision in migraine prevention. METHODS Migraineurs with at least five headache days per month were block-randomized to the experimental group (EG) or waiting list group (WL), the latter starting Introvision training six weeks after the EG. Participants learned Introvision in six weekly on-site group sessions with video-conference support followed by three individual video-conference sessions. Headache diaries and questionnaires were obtained before Introvision training and three months after the last individual Introvision session. RESULTS Fifty-one patients completed the study. The primary outcome, headache days of the EG after Introvision training compared to those of the WL before the training, showed no significant effect (10.6 ± 7.7, n = 22; vs. 10.9 ± 6.3, n = 29, p = 0.63; Mann-Whitney-U-Test). The secondary outcome, comparing pooled EG and WL data before and after Introvision training, revealed a significant reduction of headache days (from 11.7 ± 6.5 to 9.8 ± 7.0; p = 0.003; Wilcoxon-paired-Test) as well as of acute medication intake and Headache-Impact-Test 6 (HIT-6) scores and increased self-efficacy as quantified by increased FKMS-scores (FKMS: german short form of the Headache Management Self-Efficacy Scale (HMSE)). CONCLUSION Although the study did not reach its primary endpoint, several secondary outcome parameters in the pooled (non-controlled) pre-post analysis showed an improvement with a decrease in monthly headache days by 1.9 days/ month. A larger randomized controlled trial has to corroborate these preliminary findings. TRIAL REGISTRATION NCT03507400, Registration date 09.03.2018.
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Affiliation(s)
- Monika Empl
- Department of Neurology, Ludwig-Maximilians-University Munich, Munich, Germany.
- Practice Munich, Munich, Germany.
| | | | | | - Agnieszka Rozwadowska
- Department of Neurology, Ludwig-Maximilians-University Munich, Munich, Germany
- Department of Neurology, Kbo Hospital, Haar, Germany
| | - Ruth Ruscheweyh
- Department of Neurology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Andreas Straube
- Department of Neurology, Ludwig-Maximilians-University Munich, Munich, Germany
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Onan D, Bentivegna E, Martelletti P. OnabotulinumtoxinA Treatment in Chronic Migraine: Investigation of Its Effects on Disability, Headache and Neck Pain Intensity. Toxins (Basel) 2022; 15:29. [PMID: 36668849 PMCID: PMC9862733 DOI: 10.3390/toxins15010029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/12/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Neck disability and pain are frequently encountered problems in patients with chronic migraine (CM). The long-term stimuli of neurons in the trigeminocervical junction may explain this situation. OnabotulinumtoxinA (ONA) treatment is one of the proven treatments for CM; however, there is no study data on the efficacy of ONA treatment on neck disability and pain in CM patients. Therefore, we aimed to investigate the effect of ONA treatment on disability, neck pain and headache intensity in CM patients. One hundred thirty-four patients who met the inclusion criteria were included in the study. ONA treatment was administered at a dose of 195 U to 39 sites in total as per Follow-the-Pain PREEMPT protocol. The disability was evaluated with the Neck Disability Index and the Migraine Disability Assessment; pain intensity was evaluated with the Visual Analogue Scale; the monthly number of headache days were recorded; quality of life was evaluated with the Headache Impact Test. All assessments were recorded at baseline and 3 months after treatment. After the treatment, neck−migraine disabilities decreased from severe to mild for neck and moderate for migraine (p < 0.001). Neck pain and headache intensities decreased by almost half (p < 0.001). The median number of monthly headache days decreased from 20 days to 6 days (p < 0.000). The quality-of-life level decreased significantly from severe to substantial level (p < 0.001). According to our results, ONA treatment was effective in reducing neck-related problems in CM patients. Long-term follow-up results may provide researchers with more comprehensive results in terms of the treatment of chronic migraine−neck-related problems.
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Affiliation(s)
- Dilara Onan
- Spine Health Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara 06230, Türkiye
- Department of Clinical and Molecular Medicine, Sapienza University, 000189 Rome, Italy
| | - Enrico Bentivegna
- Department of Clinical and Molecular Medicine, Sapienza University, 000189 Rome, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, 000189 Rome, Italy
- Regional Referral Headache Centre, Sant’Andrea Hospital, 000189 Rome, Italy
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SOUSA MELO E, PEDROSA RP, CARRILHO AGUIAR F, VALENTE LM, SAMPAIO ROCHA-FILHO PA. Dialysis headache: characteristics, impact and cerebrovascular evaluation. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:129-136. [DOI: 10.1590/0004-282x-anp-2021-0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/14/2021] [Indexed: 11/21/2022]
Abstract
ABSTRACT Background: Headache is one of the most frequent symptoms that occur during hemodialysis sessions. Despite the high prevalence of dialysis headache, it has been little studied. Objective: To evaluate the characteristics, impact and factors associated with dialysis headache. The behavior of the cerebral vasculature was also compared between patients with and without dialysis headache. Methods: This was a cross-sectional study. Consecutive patients who underwent hemodialysis were assessed through a semi-structured questionnaire, the Headache Impact Test (HIT-6), the Hospital Anxiety and Depression Scale and the Short Form-36 Health Survey (SF-36). Transcranial Doppler ultrasonography was performed in the first and fourth hours of hemodialysis. Results: A total of 100 patients were included; 49 of them had dialysis headache. Women (OR=5.04; 95%CI 1.95-13.04), younger individuals (OR=1.05; 95%CI 1.01-1.08), individuals with higher schooling levels (OR=3.86; 95%CI 1.4-10.7) and individuals who had spent longer times on dialysis programs (OR=0.99; 95%CI 0.98-1) had more dialysis headache (logistic regression). Individuals with dialysis headache had worse quality of life in the domains of pain and general state of health (56.9 versus 76.4, p=0.01; 49.7 versus 60.2, p=0.03, respectively). Dialysis headache was associated with significantly greater impact on life (OR=24.4; 95%CI 2.6-226.6; logistic regression). The pulsatility index (transcranial Doppler ultrasonography) was lower among patients with dialysis headache than among those without them. Conclusions: Dialysis headaches occur frequently and are associated with worse quality of life and patterns of cerebral vasodilatation.
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Corrêa Rangel T, Falcão Raposo MC, Sampaio Rocha-Filho PA. Internet addiction, headache, and insomnia in university students: a cross-sectional study. Neurol Sci 2022; 43:1035-1041. [PMID: 34106366 DOI: 10.1007/s10072-021-05377-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE There is controversy about whether there is an association between headache and internet addiction. Therefore, the objective was to assess whether there is an association between the headache, insomnia, and internet addiction. METHODS This was a cross-sectional study with 420 university students. We used a semi-structured questionnaire, Headache Impact Test, Hospital Anxiety Depression Scale, Insomnia Severity Index, and Internet Addiction Test. RESULTS 51.4% were men, the median age was 21 (19, 23), 399 (95.0%) suffered from headaches in the last year, 265 (63.1%) had migraine, 182 (43.3%) had migraine with aura, 119 (28.3%) had episodic tension-type headache, 84 (20%) had internet addiction, and 95 (22.6%) had insomnia. Internet addiction was associated with anxiety (OR = 2.3; 95% CI: 1.3, 4.0; p = 0.003), insomnia (OR = 3.0; 95% CI: 2.0, 4.6; p < 0.001), and migraine with aura (OR = 1.8; 95% CI: 1.1, 2.9; p = 0.066) (logistic regression). The severity of internet dependence is associated with the impact of headache (p = 0.047) and with the severity of insomnia (p < 0.001) (multiple linear regression). CONCLUSIONS Internet addiction was associated with anxiety, migraine with aura, and insomnia. The severity of internet addiction is associated with the severity of the headache and with the severity of insomnia.
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Affiliation(s)
- Tathiana Corrêa Rangel
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Rua General Joaquim Inacio, 830, Sala 1412 - Edf The Plaza Business Center, Recife, CEP: 50070-495, Pernambuco, Brazil.,Department of Physiotherapy, University of Pernambuco (UPE), Petrolina, Brazil
| | | | - Pedro Augusto Sampaio Rocha-Filho
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Rua General Joaquim Inacio, 830, Sala 1412 - Edf The Plaza Business Center, Recife, CEP: 50070-495, Pernambuco, Brazil. .,Division of Neuropsychiatry, Centro de Ciências Médicas, Federal University of Pernambuco (UFPE), Recife, Brazil. .,Headache Clinic, Oswaldo Cruz University Hospital, University of Pernambuco (UPE), Recife, Brazil.
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Corrêa Rangel T, Falcão Raposo MC, Sampaio Rocha-Filho PA. The prevalence and severity of insomnia in university students and their associations with migraine, tension-type headache, anxiety and depression disorders: a cross-sectional study. Sleep Med 2021; 88:241-246. [PMID: 34798440 DOI: 10.1016/j.sleep.2021.10.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/05/2021] [Accepted: 10/22/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND There is possibly an association between migraine, tension-type headache, anxiety, depression and insomnia. These conditions are prevalent among university students. Our primary objective was to verify whether students with primary headaches (migraine and tension-type headache) have a higher prevalence of insomnia. Our secondary objective was to assess whether the impact of headaches was associated with greater severity of insomnia. METHODS Cross-sectional study. 440 students out of 3030 were randomly selected. A semi-structured questionnaire containing information about the characteristics of the headaches, including their frequencies in the last 3 months; the Headache Impact Test (HIT-6); the Hospital Anxiety Depression Scale; and the Insomnia Severity Index were used. RESULTS 420 students (95.5%) agreed to participate; 51.4% men; median age of 21 (19, 23); 95 (22.6%) had insomnia; 265 (63.1%), migraine; 152 (36.2%), tension-type headache; 201 (47.9%) suffered from anxiety and 108 (25.7%), from depression. The severe impact of headache (HIT-6>55 points; OR = 3.9; p = 0.003) and anxiety (OR = 3.6; p = 0.003) were associated with insomnia (logistic regression). The severity of insomnia was positively and significantly correlated with the impact (HIT-6 score), with frequency of headache, and with having anxiety (multiple linear regression). CONCLUSIONS The diagnoses of migraine and tension-type headache are not associated with the presence of insomnia. The severity of insomnia is associated with the impact and the frequency of the headaches.
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Affiliation(s)
- Tathiana Corrêa Rangel
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Recife, Brazil; Department of Physiotherapy, University of Pernambuco (UPE), Petrolina, Brazil
| | | | - Pedro Augusto Sampaio Rocha-Filho
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Recife, Brazil; Division of Neuropsychiatry, Centro de Ciências Médicas, Federal University of Pernambuco (UFPE), Recife, Brazil; Headache Clinic, Oswaldo Cruz University Hospital, University of Pernambuco (UPE), Recife, Brazil.
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Patient-Reported Outcome Measurements in Temporomandibular Disorders and Headaches: Summary of Measurement Properties and Applicability. J Clin Med 2021; 10:jcm10173823. [PMID: 34501273 PMCID: PMC8432093 DOI: 10.3390/jcm10173823] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/13/2021] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Several patient-reported outcome measurements (PROMs) are available in the literature to support the evaluation and diagnosis of temporomandibular disorders and headaches. However, clinicians and researchers usually complain that they had no education on PROMs and low overall knowledge about PROMs. OBJECTIVE This study aimed to summarize, describing the measurement properties and clinical applicability of the main condition-specific PROMs available in the literature to the assessment of patients with Temporomandibular Disorders and Headaches. METHODS The current manuscript reviewed 10 PROMs commonly used in the field. Four instruments about functioning and disability: 1. Mandibular Function Impairment Questionnaire (MFIQ), 2. Craniofacial Pain and Disability Inventory (CF-PDI), 3. 8-item and 20-item Jaw Functional Limitation Scale (JFLS), and 4. Manchester Orofacial Pain Disability Scale (MOPDS). Two instruments about headache-related disability: 5. Headache-Related Disability Index (HDI) and 6. Headache Impact Test-6 (HIT-6). Three instruments focused on TMD and headache screening: 7. 3Q/TMD, 8. Short-Form Anamnestic Fonseca Index (SFAI), 9. Headache Screening Questionnaire. In addition, one instrument about maladaptive beliefs regarding pain and injury: 10. Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD). CONCLUSIONS The knowledge about the limitations and applicability of the PROMs commonly used to assess TMDs and Headaches can help clinicians and researchers to obtain reliable and valid outcomes to support the decision-making process. The current review recognizes the importance of using patient-reported outcome measures in research and clinical practice. However, our findings call the attention that further studies on the measurement properties of such instruments are imperative.
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Validity and Reliability of the Caregiving Difficulty Scale in Mothers of Children with Cerebral Palsy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115689. [PMID: 34073272 PMCID: PMC8198070 DOI: 10.3390/ijerph18115689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 11/16/2022]
Abstract
This study was conducted to determine the construct validity and reliability of the Caregiving Difficulty Scale, a tool developed to measure difficulties experienced by parents of children with cerebral palsy. To this end, a survey was conducted with 215 mothers of children with cerebral palsy, and the resultant data were analyzed. A confirmatory factor analysis was performed to verify the construct validity of this scale, and the intra-item fit value was calculated for reliability analysis. Validity analysis confirmed that a bi-factor model comprising four sub-factors, Concern for the Child, Impact on Self, Support for Caregiving, and Social and Economic Strain, was suitable for the Caregiving Difficulty Scale. In addition, the reliability analysis results showed that the reliability coefficients of three of these areas, excluding Social and Economic Strain, and the reliability of the entire scale were acceptable. Therefore, the Caregiving Difficulty Scale is an appropriate tool to measure the burden of caregiving for children with cerebral palsy, and the findings emphasize the need to improve its reliability by comparing sub-factors’ reliability.
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Devoogdt N, Partsch H, Heroes AK, De Vrieze T, De Groef A, Geraerts I, Damstra RJ, Hafner J, Keeley V, Becker A, Mosti G, Brouwer E, Thomis S. The ICC Compression Questionnaire: A Comprehensive Tool to Evaluate Compression Materials or Devices Applied in Subjects with Lymphedema or Chronic Venous Disease. Lymphat Res Biol 2021; 20:191-202. [PMID: 33781091 PMCID: PMC9081015 DOI: 10.1089/lrb.2020.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Compression therapy is an important part of the treatment of patients with lymphedema or chronic venous disease. However, there is no validated questionnaire evaluating the effect of compression and its acceptance by the patient. Therefore, the aims of this study were to construct a questionnaire evaluating the effect of compression and its acceptance by the patient, that is, the Dutch ICC Compression Questionnaire (ICC-CQ), to investigate its reliability and validity, and to translate it into English. Methods and Results: Eleven experts in applying compression and 51 Dutch patients with experience of using compression were involved in the construction process. One part of the ICC-CQ has to be completed by the patient and evaluates seven domains. The other part has to be completed by the health care provider and comprises three domains. Reliability and validity of the final version was investigated in a new group of 79 Dutch-speaking patients with lymphedema or chronic venous disease, wearing compression garments (N = 52) or bandages (N = 27). Except for one domain, the Intraclass Correlation Coefficients for test–rest/interrater reliability ranged from 0.55 to 0.93. Cronbach's alpha for internal consistency ranged from 0.71 to 0.97. Eighty-nine percent of the patients fully understood the questionnaire indicating good face validity, and 87% found it complete indicating good content validity. Construct validity was considered good since 10 out of 11 hypotheses were accepted. Conclusion: The ICC-CQ is the first reliable and valid questionnaire evaluating different kinds of compression and the experience by patients with lymphedema or chronic venous disease.
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Affiliation(s)
- Nele Devoogdt
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.,Department of Vascular Surgery, Centre for Lymphoedema, University Hospitals of Leuven, Leuven, Belgium
| | - Hugo Partsch
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - An-Kathleen Heroes
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.,Department of Vascular Surgery, Centre for Lymphoedema, University Hospitals of Leuven, Leuven, Belgium
| | - Tessa De Vrieze
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - An De Groef
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Inge Geraerts
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Robert J Damstra
- Department of Dermatology, Phlebology and Lympho-vascular Medicine, Expert Center for Lympho-Vascular Medicine, Nij Smellinghe Hospital, Drachten, the Netherlands
| | - Juerg Hafner
- Division of In-patient Dermatology, Dermatosurgery and Phlebology, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - Vaughan Keeley
- Department of Palliative Medicine, Lymphoedema Clinic, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom.,Medical School, University of Nottingham, Nottingham, United Kingdom
| | | | - Giovanni Mosti
- Department of Angiology, Barbantini Clinic, Lucca, Italy
| | - Els Brouwer
- Department of Sales Phlebology/Lymphology, Medi International, Bayreuth, Germany
| | - Sarah Thomis
- Department of Vascular Surgery, Centre for Lymphoedema, University Hospitals of Leuven, Leuven, Belgium
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12
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Pradela J, Bevilaqua-Grossi D, Chaves TC, Dach F, Carvalho GF. Measurement properties of the Headache Impact Test (HIT-6™ Brazil) in primary and secondary headaches. Headache 2021; 61:527-535. [PMID: 33432581 DOI: 10.1111/head.14049] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND The Headache Impact Test-6™ is a widely recommended questionnaire to evaluate the impact of headaches. However, its measurement properties were never evaluated in both primary and secondary headaches, and the Brazilian Portuguese version of the questionnaire was never assessed at all. OBJECTIVE To assess the reliability, and structural and construct validity of the Headache Impact Test-Brazil™ in patients with primary and secondary headaches. METHODS In total, 132 patients with primary and secondary headaches were included, screened from a headache tertiary clinic. They completed the Headache Impact Test-Brazil™ questionnaire, the 12-Item Short-Form Survey (SF-12), and the Headache Disability Inventory-Brazil. Pearson's correlation analysis was performed among the three questionnaires for validity assessment. One to three weeks after the first application, the Headache Impact Test-Brazil™ was answered again by 67 patients for reliability assessment. RESULTS The validity sample consisted of 86/132 (65.1%) patients with primary and 46/132 (34.9%) secondary headaches, with mean age of 39.6 (SD: 12.7) years. The reliability sample consisted of 39/67 (58.2%) patients with primary and 28/67 (41.8%) secondary headaches, with mean age of 36.8 (12.5) years. According to the confirmatory factor analysis, the Headache Impact Test-Brazil™ consists of single factor. Its internal consistency was α = 0.97 and the question number 3 had the lowest factor loading (0.31). The Headache Impact Test-Brazil™ exhibited a moderate correlation with both the SF-12 questionnaire (r = -0.64, 95%CI: -0.72 to -0.52, p = 0.001) and the Headache Disability Inventory-Brazil (r = 0.67, 95%CI: 0.56 to 0.75, p = 0.001). The correlation between the Headache Impact Test-Brazil™ and the headache frequency was weak (r = 0.22, 95%CI: 0.04 to 0.39, p = 0.001), and with the headache intensity, moderate (r = 0.44, 95%CI: 0.23 to 0.62, p = 0.001). The Headache Impact Test-Brazil™ test-retest reliability was excellent (ICC = 0.95) with a standard error of 1.58 and a smallest detectable change of 4.38 points. CONCLUSION The Headache Impact Test-6-Brazil™ can be considered as a valid and reliable tool to assess the impact of several headache types. Future studies may revise the questionnaire items to confirm its redundancy.
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Affiliation(s)
- Juliana Pradela
- Department of Health Sciences - Ribeirão Preto Medical School, University de São Paulo, Ribeirão Preto, Brazil
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences - Ribeirão Preto Medical School, University de São Paulo, Ribeirão Preto, Brazil
| | - Thais C Chaves
- Department of Health Sciences - Ribeirão Preto Medical School, University de São Paulo, Ribeirão Preto, Brazil
| | - Fabiola Dach
- Department of Neurosciences and Behavioral Sciences - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Gabriela F Carvalho
- Department of Health Sciences - Ribeirão Preto Medical School, University de São Paulo, Ribeirão Preto, Brazil.,Institute of Health Sciences, Academic Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), University of Luebeck, Luebeck, Germany
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13
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De Vrieze T, Frippiat J, Deltombe T, Gebruers N, Tjalma WAA, Nevelsteen I, Thomis S, Vandermeeren L, Belgrado JP, De Groef A, Devoogdt N. Cross-cultural validation of the French version of the Lymphedema Functioning, Disability and Health Questionnaire for Upper Limb Lymphedema (Lymph-ICF-UL). Disabil Rehabil 2020; 43:2797-2804. [PMID: 31990592 DOI: 10.1080/09638288.2020.1716271] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE Upper limb lymphedema is a vexing morbidity that can occur after the treatment for breast cancer. The Lymphedema Functioning, Disability and Health Questionnaire for Upper Limb Lymphedema (Lymph-ICF-UL) is a valid and reliable tool assessing problems in functioning in patients with breast cancer-related lymphedema. Until now, a French-language version was lacking. The aim of this study was to perform a cross-cultural validation of the French version of the Lymph-ICF-UL questionnaire. METHODS A forward-backward translation process between the original language (Dutch) and the target language (French) was performed. Psychometric properties of this final French version were examined in 50 participants. RESULTS Intraclass correlation coefficients for test-retest reliability ranged from 0.66 to 0.95. Cronbach's alpha coefficients for internal consistency were higher than 0.77. Face and content validity were very good because the scoring system was clear for all participants (100%), questions were understandable (100%), and all complaints due to BCRL were mentioned by 78% of the participants. Construct validity was moderate. Convergent validity was established since 3 out of 5 expected domains of the Lymph-ICF-UL showed a moderate correlation with expected domains of the 36-item Short-Form Health Survey. There was satisfactory divergent validity as 6 out of 9 hypotheses assessing divergent validity were accepted. CONCLUSION The French version of the Lymph-ICF-UL is a reliable and valid questionnaire and ready for use in clinical as well as in scientific practice.Implications for rehabilitationSince the introduction of more effective treatment modalities increasing the number of breast cancer survivors, the amount of patients dealing with lymphedema is rising likewise up to a pooled incidence rate of more than 16% of the women treated for breast cancer.The French version of the Lymph-ICF-UL is a reliable and valid questionnaire for assessing problems in functioning of patients with breast cancer-related lymphedema of the arm and/or hand.As the questionnaire provides patient information in the different domains of the International Classification of Functioning, Disability and Health, it facilitates evaluating the impact of breast cancer-related lymphedema on daily functioning.Based on the outcomes of the Lymph-ICF-UL treatment goals can be set, where after the questionnaire can be used to monitor long-term results of this treatment and self-care.
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Affiliation(s)
- Tessa De Vrieze
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.,Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, Antwerp, Belgium
| | - Jacqueline Frippiat
- Department of Physical Medicine and Rehabilitation, Centre de Référence du Lymphoedème, CHU UCL Namur - Site Godinne, Yvoir, Belgium
| | - Thierry Deltombe
- Department of Physical Medicine and Rehabilitation, Centre de Référence du Lymphoedème, CHU UCL Namur - Site Godinne, Yvoir, Belgium
| | - Nick Gebruers
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, Antwerp, Belgium.,Multidisciplinary Oedema Clinic, University of Antwerp & Antwerp University Hospital, Antwerp, Belgium
| | - Wiebren A A Tjalma
- Multidisciplinary Oedema Clinic, University of Antwerp & Antwerp University Hospital, Antwerp, Belgium.,Department of Medicine, University of Antwerp, MIPRO, Antwerp, Belgium.,Multidisciplinary Breast Clinic, Antwerp University Hospital, Edegem, Belgium
| | - Ines Nevelsteen
- Multidisciplinary Breast Centre, UZ Leuven - University Hospitals Leuven, Leuven, Belgium
| | - Sarah Thomis
- Department of Vascular Surgery and Department of Physical Medicine and Rehabilitation, Centre for Lymphedema, UZ Leuven - University Hospitals Leuven, Leuven, Belgium
| | - Liesbeth Vandermeeren
- Lymphology Research Unit, BLLC - Centre for Lymphedema and Lipedema Brussels & Université libre de Bruxelles, Brussels, Belgium
| | - Jean-Paul Belgrado
- Lymphology Research Unit, Saint-Pierre University Hospital, Lymphology Clinic of Brussels & Université libre de Bruxelles, Brussels, Belgium
| | - An De Groef
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Nele Devoogdt
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.,Department of Vascular Surgery and Department of Physical Medicine and Rehabilitation, Centre for Lymphedema, UZ Leuven - University Hospitals Leuven, Leuven, Belgium
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14
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De Vrieze T, Vos L, Gebruers N, De Groef A, Dams L, Van der Gucht E, Nevelsteen I, Devoogdt N. Revision of the Lymphedema Functioning, Disability and Health Questionnaire for Upper Limb Lymphedema (Lymph-ICF-UL): Reliability and Validity. Lymphat Res Biol 2019; 17:347-355. [DOI: 10.1089/lrb.2018.0025] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Tessa De Vrieze
- Department of Rehabilitation Sciences, KU Leuven—University of Leuven, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, Antwerp, Belgium
| | - Lore Vos
- Department of Rehabilitation Sciences, KU Leuven—University of Leuven, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, Antwerp, Belgium
| | - Nick Gebruers
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, Antwerp, Belgium
- Multidisciplinary Oedema Clinic, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - An De Groef
- Department of Rehabilitation Sciences, KU Leuven—University of Leuven, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium
| | - Lore Dams
- Department of Rehabilitation Sciences, KU Leuven—University of Leuven, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, Antwerp, Belgium
| | - Elien Van der Gucht
- Department of Rehabilitation Sciences, KU Leuven—University of Leuven, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, Antwerp, Belgium
| | - Ines Nevelsteen
- Multidisciplinary Breast Centre, UZ Leuven—University Hospitals Leuven, Leuven, Belgium
| | - Nele Devoogdt
- Department of Rehabilitation Sciences, KU Leuven—University of Leuven, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium
- Departments of Vascular Surgery and Physical Medicine and Rehabilitation, Lymphovenous Centre, UZ Leuven—University Hospitals Leuven, Leuven, Belgium
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15
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Malmberg-Ceder K, Haanpää M, Korhonen PE, Kautiainen H, Veromaa V, Soinila S. The role of psychosocial risk factors in the burden of headache. J Pain Res 2019; 12:1733-1741. [PMID: 31213885 PMCID: PMC6548994 DOI: 10.2147/jpr.s165263] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 04/01/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose: Psychosocial risk factors are common in headache patients and affect the impact of headache in multiple ways. The aim of our study was to assess how psychosocial risk factors correlate with the headache impact test-6 (HIT-6). To our knowledge this is the first study to evaluate the impact of several psychosocial factors on the HIT-6 score. Patients and methods: Our study population consisted of 469 Finnish female employees reporting headache during the past year. Psychosocial risk factors were assessed using validated, self-administered questionnaires: the generalized anxiety disorder 7-item scale (GAD-7) for anxiety, the major depression inventory (MDI) for depressive symptoms, the ENRICHD short social support instrument (ESSI) for social isolation, the cynical distrust scale for hostility and the Bergen burnout indicator (BBI-15) for work stress. Results: Exploratory factor analysis of the HIT-6 scores revealed two factors, one describing psychological and quality of life aspects affected by headache and the other describing severity of pain and functional decline. Internal consistency of the HIT-6 was 0.87 (95%CI: 0.85–0.89). Correlations between the total HIT-6 score and all measured psychosocial risk factors except for hostility were weak, but statistically significant. Conclusion: The HIT-6 questionnaire has good construct validity and it describes reliably and independently the impact of headache without interference of psychosocial factors in general working-aged female population.
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Affiliation(s)
- Kirsi Malmberg-Ceder
- Department of Neurology, Satakunta Central Hospital, Pori, Finland.,Department of Neurology, University of Turku, Turku, Finland
| | - Maija Haanpää
- Mutual Insurance Company Ilmarinen, Helsinki, Finland.,Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Päivi E Korhonen
- Department of General Practice, Turku University Hospital, Turku University, Turku, Finland
| | - Hannu Kautiainen
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.,Folkhälsan Research Centre, Helsinki, University of Helsinki, Helsinki, Finland
| | - Veera Veromaa
- Department of General Practice, Turku University Hospital, Turku University, Turku, Finland.,Central Satakunta Heath Federation of Municipalities, Harjavalta, Finland
| | - Seppo Soinila
- Department of Neurology, University of Turku, Turku, Finland.,Division of Clinical Neurosciences/General Neurology, Turku University Hospital, Turku, Finland
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16
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Garrigós-Pedrón M, La Touche R, Navarro- Desentre P, Gracia-Naya M, Segura-Ortí E. Widespread mechanical pain hypersensitivity in patients with chronic migraine and temporomandibular disorders: relationship and correlation between psychological and sensorimotor variables. Acta Odontol Scand 2019; 77:224-231. [PMID: 30626243 DOI: 10.1080/00016357.2018.1538533] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study aimed to assess mechanical hyperalgesia in the trigeminal and extra-trigeminal regions in patients with chronic migraine (CM) and temporomandibular disorders (TMD) in comparison to asymptomatic subjects and to determine the association between sensorimotor variables and psychological and disability variables and evaluate the prediction of a sensorimotor variables though psychological and disability variables in patients with CM and TMD. MATERIAL AND METHODS A total of 52 subjects with concomitant CM and TMD and 30 asymptomatic subjects were included in the study. The pressure pain threshold (PPT), maximal mouth opening (MMO) and a series of self-reported factors were compared. RESULTS There were 52 CM and TMD (92.3% women and 7.7% men; age = 46.2 ± 9.5) and 30 asymptomatic subjects (80% women and 20% men; age = 47.4 ± 10). Differences were found between patients with CM and TMD and asymptomatic participants (p < .01) when comparing the PPTs in the trigeminal and extra-trigeminal regions. The PPT for the trigeminal region was predicted by depressive symptoms (variance of 18%) as well as disability and craniofacial pain (variance of 20%). The extra-trigeminal region PPT was predicted by depressive symptoms (variance of 10%), and pain-free MMO was predicted by disability and craniofacial pain (variance of 24%). CONCLUSIONS This study suggests that patients with CM and TMD present with generalized mechanical hyperalgesia. In addition, an association between sensorimotor, psychological and disability variables was observed.
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Affiliation(s)
- Miriam Garrigós-Pedrón
- Departamento de Fisioterapia, Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | | | - Manuel Gracia-Naya
- Doctor in Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Eva Segura-Ortí
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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17
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Sohail S, Nakigozi G, Anok A, Batte J, Kisakye A, Mayanja R, Nakasujja N, Robertson KR, Gray RH, Wawer MJ, Sacktor N, Saylor D. Headache prevalence and its functional impact among HIV-infected adults in rural Rakai District, Uganda. J Neurovirol 2019; 25:248-253. [PMID: 30607892 DOI: 10.1007/s13365-018-0710-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/08/2018] [Accepted: 12/03/2018] [Indexed: 02/07/2023]
Abstract
Headache is common, but its prevalence and impact in sub-Saharan Africa and especially in HIV+ individuals is relatively unknown. We sought to determine the prevalence and functional impact of headache among HIV-infected (HIV+) adults in a cross-sectional observational cohort study in rural Rakai District, Uganda. Participants completed a sociodemographic survey, depression screen, functional status assessments, and answered the headache screening question, "Do you have headaches?" Participants responding affirmatively were assessed with the ID Migraine tool for diagnosis of migraine and Headache Impact Test-6 to determine functional impact of headache. Characteristics of participants with and without headaches and with and without functional impairment were compared using t tests for continuous variables, chi-square tests for categorical variables, and multivariate logistic regression. Of 333 participants, 51% were males, mean age was 37 (SD 9) years, 94% were on antiretroviral therapy (ART) and mean CD4 count was 403 (SD 198) cells/μL. Headache prevalence was 28%. Among those reporting headache, 19% met criteria for migraine, 55% reported functional impairment, and 37% reported substantial or severe impact of headache. In multivariate analyses, female sex (odds ratio (OR) 2.58) and depression (OR 2.49) were associated with increased odds and ART (OR 0.33) with decreased odds of headache. Participants with substantial/severe functional impact were more likely to meet criteria for depression (32% vs 9%). In conclusion, headache prevalence in HIV+ rural Ugandans was lower than global averages but still affected more than one quarter of participants and was associated with significant functional impairment.
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Affiliation(s)
| | | | - Aggrey Anok
- Rakai Health Sciences Program, Kalisizo, Uganda
| | - James Batte
- Rakai Health Sciences Program, Kalisizo, Uganda
| | | | | | | | - Kevin R Robertson
- Department of Neurology, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Ronald H Gray
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maria J Wawer
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ned Sacktor
- Department of Neurology, Johns Hopkins University School of Medicine, Meyer 6-113, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
| | - Deanna Saylor
- Department of Neurology, Johns Hopkins University School of Medicine, Meyer 6-113, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia.
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18
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Sahai-Srivastava S, Wang SL, Ugurlu C, Amezcua L. Headaches in multiple sclerosis: Cross-sectional study of a multiethnic population. Clin Neurol Neurosurg 2016; 143:71-5. [PMID: 26896785 DOI: 10.1016/j.clineuro.2016.01.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 10/26/2015] [Accepted: 01/09/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Headaches in MS are common, but there is little data on the influence of race, comorbidities, MS disability and socioeconomic issues on headaches, especially migraine. We aimed at looking at prevalence and type of headache across a multiethnic MS population, and relationship between MS related clinical factors and migraine. PATIENTS AND METHODS This is a cross-sectional study of 233 MS patients at two clinical sites, one at a county hospital, and the other a private academic center clinic. We collected demographic data, MS characteristics, and headache histories using validated survey instruments including Headache Impact Test (HIT-6) and Patient Health Questionnaire-9 (PHQ-9). The relationship between MS and migraine was examined using logistic regression. RESULTS Majority of our patients were female (N=156, 67%), average age 44 years, with relapsing remitting MS (N=214, 92%). Our cohort was multi-ethnic predominantly Whites (N=106, 46%) and Hispanics (N=87, 37%). Public sector patients were significantly disadvantaged in socioeconomic measures (p<0.0001) and younger (40 vs 47 yrs, p<0.0001), compared to the private sector patients who had a higher MS burden. Headaches were common, regardless of sector (N=115, 49.4%), the most common type being migraine (N=83, 36%). Chronic migraine was more common among Hispanics (82%) than Whites (18.2%) (p=0.012). Headache impact on daily life, measured by HIT-6 score (p=0.006) and PHQ-9 score (p=0.004) were significantly higher in the public sector. After controlling for income and education, female gender (OR 2.59, 95% CIs 1.312-5.127) and ambulatory disability were found to be more likely to suffer from migraines. CONCLUSION Headache, especially migraine is common among MS patients regardless of socio-economic status and treatment setting. Female MS patients with walking disability and longer disease duration tend to get migraines. Hispanic MS patients have a higher likelihood of suffering from chronic migraines. Thorough headache evaluation and headache treatment are essential to comprehensive MS care.
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Affiliation(s)
| | - Shirley L Wang
- Department of Neurology, USC Keck School of Medicine, Los Angeles, USA
| | - Ceren Ugurlu
- Department of Neurology, USC Keck School of Medicine, Los Angeles, USA
| | - Lilyana Amezcua
- Department of Neurology, USC Keck School of Medicine, Los Angeles, USA
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19
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Beltran-Alacreu H, Lopez-de-Uralde-Villanueva I, La Touche R. Multimodal Physiotherapy Based on a Biobehavioral Approach as a Treatment for Chronic Tension-Type Headache: A Case Report. Anesth Pain Med 2015; 5:e32697. [PMID: 26705532 PMCID: PMC4688818 DOI: 10.5812/aapm.32697] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 09/20/2015] [Accepted: 10/11/2015] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Tension-type headache (TTH) is the most common primary headache affecting the general population, which is characterized by bilateral headache and mild to moderate pain. This disorder causes high levels of disability and recent scientific evidence suggests that manual therapy (MT) and therapeutic exercise are effective in reducing medication intake and decreasing the frequency and intensity of headaches in patients with TTH. CASE PRESENTATION A 34-year-old woman was known to have chronic TTH. Initially, the patient presented moderate headaches 5 days per week, mechanical neck pain and no positive response to analgesics. A battery of self-reports was given to the patient to assess disability (using the Spanish versions of the Headache Impact Test-6 and the neck disability index), pain (visual analogue scale) and psychosocial issues (Spanish version of the pain catastrophizing scale) involved in the headaches. All measurements were taken four times during 161 days. Eleven sessions of treatment including MT, motor control therapeutic exercise (MCTE) and therapeutic patient education (TPE) were applied. CONCLUSIONS This biobehavioral-based multimodal physical rehabilitation treatment combining MT, TPE and MCTE produced a substantial reduction in pain intensity, pain catastrophizing, disability and the impact of headaches on patient's life.
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Affiliation(s)
- Hector Beltran-Alacreu
- Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Autonomous University of Madrid, Madrid, Spain
- Research Group on Movement and Behavioural Science and Study of Pain, The Center for Advanced Studies University La Salle, Autonomous University of Madrid, Madrid, Spain
- Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain
| | - Ibai Lopez-de-Uralde-Villanueva
- Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Autonomous University of Madrid, Madrid, Spain
- Research Group on Movement and Behavioural Science and Study of Pain, The Center for Advanced Studies University La Salle, Autonomous University of Madrid, Madrid, Spain
- Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain
- La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain
| | - Roy La Touche
- Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Autonomous University of Madrid, Madrid, Spain
- Research Group on Movement and Behavioural Science and Study of Pain, The Center for Advanced Studies University La Salle, Autonomous University of Madrid, Madrid, Spain
- Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain
- La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain
- Corresponding author: Roy La Touche, The Center for Advanced Studies University La Salle, Autonomous University of Madrid, Madrid, Spain. Tel: +34-917401980, Fax: +34-913571730, E-mail:
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20
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La Touche R, Paris-Alemany A, Gil-Martínez A, Pardo-Montero J, Angulo-Díaz-Parreño S, Fernández-Carnero J. Masticatory sensory-motor changes after an experimental chewing test influenced by pain catastrophizing and neck-pain-related disability in patients with headache attributed to temporomandibular disorders. J Headache Pain 2015; 16:20. [PMID: 25902781 PMCID: PMC4385233 DOI: 10.1186/s10194-015-0500-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 02/04/2015] [Indexed: 01/03/2023] Open
Abstract
Background Recent research has shown a relationship of craniomandibular disability with neck-pain-related disability has been shown. However, there is still insufficient information demonstrating the influence of neck pain and disability in the sensory-motor activity in patients with headache attributed to temporomandibular disorders (TMD). The purpose of this study was to investigate the influence of neck-pain-related disability on masticatory sensory-motor variables. Methods An experimental case–control study investigated 83 patients with headache attributed to TMD and 39 healthy controls. Patients were grouped according to their scores on the neck disability index (NDI) (mild and moderate neck disability). Initial assessment included the pain catastrophizing scale and the Headache Impact Test-6. The protocol consisted of baseline measurements of pressure pain thresholds (PPT) and pain-free maximum mouth opening (MMO). Individuals were asked to perform the provocation chewing test, and measurements were taken immediately after and 24 hours later. During the test, patients were assessed for subjective feelings of fatigue (VAFS) and pain intensity. Results VAFS was higher at 6 minutes (mean 51.7; 95% CI: 50.15-53.26) and 24 hours after (21.08; 95% CI: 18.6-23.5) for the group showing moderate neck disability compared with the mild neck disability group (6 minutes, 44.16; 95% CI 42.65-45.67/ 24 hours after, 14.3; 95% CI: 11.9-16.7) and the control group. The analysis shows a decrease in the pain-free MMO only in the group of moderate disability 24 hours after the test. PPTs of the trigeminal region decreased immediately in all groups, whereas at 24 hours, a decrease was observed in only the groups of patients. PPTs of the cervical region decreased in only the group with moderate neck disability 24 hours after the test. The strongest negative correlation was found between pain-free MMO immediately after the test and NDI in both the mild (r = −0.49) and moderate (r = −0.54) neck disability groups. VAFS was predicted by catastrophizing, explaining 17% of the variance in the moderate neck disability group and 12% in the mild neck disability group. Conclusion Neck-pain-related disability and pain catastrophizing have an influence on the sensory-motor variables evaluated in patients with headache attributed to TMD.
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Affiliation(s)
- Roy La Touche
- Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain. .,Motion in Brains Research Group, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madird, Aravaca, Madrid, Spain. .,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain. .,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.
| | - Alba Paris-Alemany
- Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain. .,Motion in Brains Research Group, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madird, Aravaca, Madrid, Spain. .,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain. .,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.
| | - Alfonso Gil-Martínez
- Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain. .,Motion in Brains Research Group, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madird, Aravaca, Madrid, Spain. .,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain. .,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.
| | - Joaquín Pardo-Montero
- Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain. .,Motion in Brains Research Group, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madird, Aravaca, Madrid, Spain. .,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain. .,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.
| | - Santiago Angulo-Díaz-Parreño
- Motion in Brains Research Group, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madird, Aravaca, Madrid, Spain. .,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain. .,Faculty of Medicine, Universidad San Pablo CEU, Madrid, Spain.
| | - Josué Fernández-Carnero
- Motion in Brains Research Group, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madird, Aravaca, Madrid, Spain. .,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain. .,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
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Knutsen KV, Madar AA, Brekke M, Meyer HE, Natvig B, Mdala I, Lagerlv P. Effect of vitamin D on musculoskeletal pain and headache: A randomized, double-blind, placebo-controlled trial among adult ethnic minorities in Norway. Pain 2014; 155:2591-2598. [PMID: 25261164 DOI: 10.1016/j.pain.2014.09.024] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/04/2014] [Accepted: 09/16/2014] [Indexed: 11/17/2022]
Abstract
Immigrants from South Asia, the Middle East, and Africa living in Northern Europe frequently have low vitamin D levels and more pain compared to the native Western population. The aim of this study was to examine whether daily vitamin D3 (25 μg/d or 10 μg/d) supplementation for 16 weeks would improve musculoskeletal pain or headache compared to placebo. This randomized, double-blind, placebo-controlled, parallel-group trial recruited 251 participants aged 18 to 50 years, and 215 (86%) attended the follow-up visit. The pain measures were occurrence, anatomical localization, and degree of musculoskeletal pain, as measured by visual analogue scale (VAS) score during the past 2 weeks. Headache was measured with VAS and the Headache Impact Test (HIT-6) questionnaire. At baseline, females reported more pain sites (4.7) than males (3.4), and only 7% reported no pain in the past 2 weeks. During the past 4 weeks, 63% reported headache with a high mean HIT-6 score of 60 (SD 7). At follow-up, vitamin D level, measured as serum 25(OH)D3, increased from 27 nmol/L to 52 nmol/L and from 27 nmol/L to 43 nmol/L in the 25-μg and 10-μg supplementation groups, respectively, whereas serum 25(OH)D3 did not change in the placebo group. Pain scores and headache scores were improved at follow-up compared with baseline. The use of vitamin D supplements, however, showed no significant effect on the occurrence, anatomical localization, and degree of pain or headache compared to placebo.
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Affiliation(s)
- Kirsten V Knutsen
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway Department of Community Medicine, Institute of Health and Society, University of Oslo, Norway Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
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Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL): reliability and validity. Phys Ther 2014; 94:705-21. [PMID: 24415775 DOI: 10.2522/ptj.20130285] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Patients may develop primary (congenital) or secondary (acquired) lymphedema, causing significant physical and psychosocial problems. To plan treatment for lymphedema and monitor a patient's progress, swelling, and problems in functioning associated with lymphedema development should be assessed at baseline and follow-up. OBJECTIVE The purpose of this study was to investigate the reliability (test-retest, internal consistency, and measurement variability) and validity (content and construct) of data obtained with the Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL). DESIGN This was a multicenter, cross-sectional study. METHODS The Lymph-ICF-LL is a descriptive, evaluative tool containing 28 questions about impairments in function, activity limitations, and participation restrictions in patients with lower limb lymphedema. The questionnaire has 5 domains: physical function, mental function, general tasks/household activities, mobility activities, and life domains/social life. The reliability and validity of the Lymph-ICF-LL were examined in 30 participants with objective lower limb lymphedema. RESULTS Intraclass correlation coefficients for test-retest reliability ranged from .69 to .94, and Cronbach alpha coefficients for internal consistency ranged from .82 to .97. Measurement variability was acceptable (standard error of measurement=5.9-12.6). Content validity was good because all questions were understandable for 93% of participants, the scoring system (visual analog scale) was clear, and the questionnaire was comprehensive for 90% of participants. Construct validity was good. All hypotheses for assessing convergent validity and divergent validity were accepted. LIMITATIONS The known-groups validity and responsiveness of the Dutch Lymph-ICF-LL and the cross-cultural validity of the English version of the Lymph-ICF-LL were not investigated. CONCLUSIONS The Lymph-ICF-LL is a Dutch questionnaire with evidence of reliability and validity for assessing impairments in function, activity limitations, and participation restrictions in people with primary or secondary lower limb lymphedema.
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Zandifar A, Banihashemi M, Haghdoost F, Masjedi SS, Manouchehri N, Asgari F, Najafi MR, Ghorbani A, Zandifar S, Saadatnia M, White MK. Reliability and Validity of the Persian HIT-6 Questionnaire in Migraine and Tension-type Headache. Pain Pract 2013; 14:625-31. [PMID: 24237583 DOI: 10.1111/papr.12120] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 08/15/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Headache Impact Test (HIT-6) measures the impact headaches in a 1-month period. We validated the Persian translation of HIT-6, compared the HIT-6 psychometric analysis between migraine and tension-type headache (TTH) patients, and evaluated the capability of HIT-6 to differentiate between TTH, chronic migraine, and episodic migraine. METHODS Qualified participants, including 274 patients diagnosed with migraine or TTH, were required to complete HIT-6, SF-36v2, and a symptoms questionnaire on their first visit. At 3 and 8 weeks from first visit, participants completed HIT-6. Internal consistency (Cronbach's α) and test-retest reproducibility (Pearson's correlation coefficient) were used to assess reliability. Convergent validity was also assessed. RESULTS Tension-type headache, episodic, and chronic migraines included 24.5%, 61.9%, and 13.6% of the participants, respectively. Internal consistency among all patients, TTH, and migraine in the first visit were 0.74, 0.77, and 0.73, respectively. Test-retest reliability for HIT-6 between visit 1 and 2 showed a moderate level of correlation (r = 0.50). Convergent validity and also item total correlation were acceptable. There was no significant difference in HIT-6 total score between TTH and migraine. CONCLUSION Persian HIT-6 is a valid and reliable questionnaire for the evaluation of headache. However, it cannot differentiate between chronic migraine, episodic migraine, and TTH in Iranian population.
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Affiliation(s)
- Alireza Zandifar
- Department of Physiology, Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Medical Student Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboobeh Banihashemi
- Department of Physiology, Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Faraidoon Haghdoost
- Department of Physiology, Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samaneh S Masjedi
- Department of Physiology, Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Navid Manouchehri
- Department of Physiology, Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Asgari
- Department of Physiology, Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad R Najafi
- Department of Neurology, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Ghorbani
- Department of Neurology, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samaneh Zandifar
- Medical Student Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Saadatnia
- Medical Student Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Neurology, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Smelt AFH, Assendelft WJJ, Terwee CB, Ferrari MD, Blom JW. What is a clinically relevant change on the HIT-6 questionnaire? An estimation in a primary-care population of migraine patients. Cephalalgia 2013; 34:29-36. [PMID: 23843470 DOI: 10.1177/0333102413497599] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To interpret questionnaire scores, clinicians and researchers need to know what change in score reflects a meaningful change in the condition of an individual patient, and what difference reflects a meaningful difference between groups. These values differ between different populations. We determined the within-person minimally important change (MIC) and the between-group minimally important difference (MID) of the Headache Impact Test-6 (HIT-6) questionnaire in a primary-care population of migraine patients. METHODS We included 490 patients who participated in a clinical trial on the treatment of migraine in primary care. We compared their change scores on the HIT-6 questionnaire between baseline and at three-months follow-up with the answers to two anchor questions according to the 'mean change approach' and the 'ROC curve approach'. RESULTS The within-person MIC was estimated to be between -2.5 points (mean change approach) and -6 points (ROC curve approach). The choice for the within-person MIC value depends on the consequences of false positives and false negatives in a particular setting. The between-group MID was estimated at -1.5 points. CONCLUSIONS We determined the within-person MIC and between-group MID for the HIT-6 in a primary-care population of migraine patients. We recommend the use of these values for clinical care and for research.
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Magalhães JE, Azevedo-Filho HRC, Rocha-Filho PAS. The Risk of Headache Attributed to Surgical Treatment of Intracranial Aneurysms: A Cohort Study. Headache 2013; 53:1613-23. [DOI: 10.1111/head.12165] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2013] [Indexed: 11/29/2022]
Affiliation(s)
- João E. Magalhães
- Division of Neurology; Hospital Universitário Oswaldo Cruz; Universidade de Pernambuco; Recife PE Brazil
| | | | - Pedro A. S. Rocha-Filho
- Division of Neurology; Hospital Universitário Oswaldo Cruz; Universidade de Pernambuco; Recife PE Brazil
- Department of Neuropsychiatry; Universidade Federal de Pernambuco; Recife PE Brazil
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Kristoffersen ES, Straand J, Benth JS, Russell MB, Lundqvist C. Study protocol: brief intervention for medication overuse headache--a double-blinded cluster randomised parallel controlled trial in primary care. BMC Neurol 2012; 12:70. [PMID: 22883540 PMCID: PMC3488483 DOI: 10.1186/1471-2377-12-70] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Accepted: 07/17/2012] [Indexed: 11/10/2022] Open
Abstract
Background Chronic headache (headache ≥ 15 days/month for at least 3 months) affects 2–5% of the general population. Medication overuse contributes to the problem. Medication-overuse headache (MOH) can be identified by using the Severity of Dependence Scale (SDS). A “brief intervention” scheme (BI) has previously been used for detoxification from drug and alcohol overuse in other settings. Short, unstructured, individualised simple information may also be enough to detoxify a large portion of those with MOH. We have adapted the structured (BI) scheme to be used for MOH in primary care. Methods/Design A double-blinded cluster randomised parallel controlled trial (RCT) of BI vs. business as usual. Intervention will be performed in primary care by GPs trained in BI. Patients with MOH will be identified through a simple screening questionnaire sent to patients on the GPs lists. The BI method involves an approach for identifying patients with high likelihood of MOH using simple questions about headache frequency and the SDS score. Feedback is given to the individual patient on his/her score and consequences this might have regarding the individual risk of medication overuse contributing to their headache. Finally, advice is given regarding measures to be taken, how the patient should proceed and the possible gains for the patient. The participating patients complete a headache diary and receive a clinical interview and neurological examination by a GP experienced in headache diagnostics three months after the intervention. Primary outcomes are number of headache days and number of medication days per month at 3 months. Secondary outcomes include proportions with 25 and 50% improvement at 3 months and maintenance of improvement and quality of life after 12 months. Discussion There is a need for evidence-based and cost-effective strategies for treatment of MOH but so far no consensus has been reached regarding an optimal medication withdrawal method. To our knowledge this is the first RCT of structured non-pharmacological MOH treatment in primary care. Results may hold the potential of offering an instrument for treating MOH patients in the general population by GPs. Trial registration ClinicalTrials.gov identifier: NCT01314768
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Freitas TDS, Ferreira IC, Pereira Neto A, Neto ORM, Gomes GDV, da Mota LACR, Naves LA, Azevedo MF. Treatment of severe trigeminal headache in patients with pituitary adenomas. Neurosurgery 2012; 68:1300-8; discussion 1308. [PMID: 21307794 DOI: 10.1227/neu.0b013e31820c6c9e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The incidence of headache in patients with pituitary adenomas is high, and the underlying pathological mechanisms are not completely understood. OBJECTIVE We tested the efficacy of percutaneous ganglion block and trigeminal rhizotomy in the treatment of severe trigeminal/autonomic headache associated with pituitary tumors. METHODS Eleven patients treated surgically for pituitary adenomas in whom intractable trigeminal headaches developed were enrolled in the study and underwent ictal cerebral single-photon emission computed tomography before starting treatment. Initially, all patients underwent a 6-month medical treatment trial. Patients who did not experience improvement in headache severity, addressed by the Headache Impact Test-6 scale, underwent trigeminal percutaneous ganglion blockade. Two patients subsequently underwent trigeminal balloon rhizotomy. RESULTS Among the 11 patients, 6 did not have improved Headache Impact Test-6 scale scores after 6 months of treatment with medications and underwent trigeminal ganglion blockade. Significant improvement in headache severity was noted in 3 of them. Long-term response was obtained in 1 patient, and the other 2, in whom the response was transient, were then successfully treated with trigeminal rhizotomy. Cerebral single-photon emission computed tomography showed increased uptake in the thalamus/hypothalamus region in patients who responded well to manipulation of the trigeminal-hypothalamic system. CONCLUSION Percutaneous ganglion blockade and trigeminal rhizotomy may be promising alternative options for the treatment of severe headache in selected patients with pituitary adenomas.
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Smelt AFH, Blom JW, Dekker F, van den Akker ME, Knuistingh Neven A, Zitman FG, Ferrari MD, Assendelft P. A proactive approach to migraine in primary care: a pragmatic randomized controlled trial. CMAJ 2012; 184:E224-31. [PMID: 22231680 DOI: 10.1503/cmaj.110908] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Migraine is a common, disabling headache disorder that leads to lost quality of life and productivity. We investigated whether a proactive approach to patients with migraine, including an educational intervention for general practitioners, led to a decrease in headache and associated costs. METHODS We conducted a pragmatic randomized controlled trial. Participants were randomized to one of two groups: practices receiving the intervention and control practices. Participants were prescribed two or more doses of triptan per month. General practitioners in the intervention group received training on treating migraine and invited participating patients for a consultation and evaluation of the therapy they were receiving. Physicians in the control group continued with usual care. Our primary outcome was patients' scores on the Headache Impact Test (HIT-6) at six months. We considered a reduction in score of 2.3 points to be clinically relevant. We used the Kessler Psychological Distress Scale (K10) questionnaire to determine if such distress was a possible effect modifier. We also examined the interventions' cost-effectiveness. RESULTS We enrolled 490 patients in the trial (233 to the intervention group and 257 to the control group). Of the 233 patients in the intervention group, 192 (82.4%) attended the consultation to evaluate the treatment of their migraines. Of these patients, 43 (22.3%) started prophylaxis. The difference in change in score on the HIT-6 between the intervention and control groups was 0.81 (p = 0.07, calculated from modelling using generalized estimating equations). For patients with low levels of psychological distress (baseline score on the K10 ≤ 20) this change was -1.51 (p = 0.008), compared with a change of 0.16 (p = 0.494) for patients with greater psychological distress. For patients who were not using prophylaxis at baseline and had two or more migraines per month, the mean HIT-6 score improved by 1.37 points compared with controls (p = 0.04). We did not find the intervention to be cost-effective. INTERPRETATION An educational intervention for general practitioners and a proactive approach to patients with migraine did not result in a clinically relevant improvement of symptoms. Psychological distress was an important confounder of success. (Current Controlled Trials registration no. ISRCTN72421511.).
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Affiliation(s)
- Antonia F H Smelt
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands.
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Juyal R, Verma R, Garg RK, Shukla R, Agarwal A, Singh MK. Reliability and validity of Hindi translation of the migraine disability assessment and headache impact test-6 questionnaires. Ann Indian Acad Neurol 2011; 13:276-83. [PMID: 21264136 PMCID: PMC3021931 DOI: 10.4103/0972-2327.74201] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Revised: 04/27/2010] [Accepted: 06/04/2010] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The objective of the study was to assess the reliability and validity of the Hindi translation of the Migraine Disability Assessment (MIDAS) and Headache Impact Test-6 (HIT-6) questionnaires. MATERIALS AND METHODS The study was conducted on the migraine patients. For test-retest reliability, the respondents filled the MIDAS and HIT-6 questionnaires twice, at an interval of three weeks. For validity, the same population of patients filled the headache diary for three months. After three months they filled the MIDAS and HIT-6 questionnaires again. The patients were subgrouped according to their occupation and level of education. The test-retest reliability and validity were calculated by the Pearson correlation coefficient. Internal consistency was calculated using the Cronbach alpha. RESULTS A total of 236 migraine patients were screened. Seventy-nine patients fulfilled the inclusion criteria. A total of 69 patients completed the study. The HIT-6 questionnaire was applicable to all the subgroups of patients and had better comprehensibility than the MIDAS. Housewives missed out on the first two questions of the MIDAS and had lower mean MIDAS scores than HIT-6. The test-retest correlation coefficients for the total MIDAS and HIT-6 scores were 0.94 and 0.81, respectively. The correlation coefficients between the total score in the headache diary equivalent and the MIDAS and HIT-6 total score were 0.91 and 0.77, respectively. Cronbach alpha, a measure of internal consistency for the MIDAS questionnaire was > 0.90 at all the compilations. For the HIT-6 questionnaire, it ranged from 0.67 to 0.79. CONCLUSION The Hindi versions of MIDAS and HIT-6 questionnaires were reliable and valid, but could not be interchanged. HIT-6 had better comprehensibility.
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Affiliation(s)
- Ratish Juyal
- Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, Uttar Pradesh, Lucknow, India
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Abstract
BACKGROUND Lymphedema occurs frequently after axillary dissection for breast cancer and causes significant physical and psychosocial problems. To plan the treatment for lymphedema and monitor the patient's progress, arm swelling and arm function need to be assessed. OBJECTIVE The purpose of this study was to investigate the reliability (test-retest, internal consistency, measurement variability) and validity (content and construct) of data obtained with the Lymphoedema Functioning, Disability and Health questionnaire (Lymph-ICF). METHODS The Lymph-ICF is a descriptive and evaluative tool and consists of 29 questions about impairments in function, activity limitations, and participation restrictions of patients with breast cancer and arm lymphedema. The questionnaire is divided into 5 domains: physical function, mental function, household activities, mobility activities, and life and social activities. Reliability and validity were examined on 60 patients with lymphedema and 30 patients without lymphedema. RESULTS Intraclass correlation coefficients for test-retest reliability ranged from .65 to .93. Cronbach alpha coefficients for internal consistency were higher than .70. There were no systematic changes from the first test to the second test, and measurement variability was acceptable (standard errors of measurement=4.8-12.5). Content validity was good because all questions were understandable for all participants, the scoring system (visual analog scale) was clear for 88% of the participants, and all complaints due to arm lymphedema were mentioned by 85% of the participants. Construct validity was good. There was good convergent validity because 5 expected domains of the Lymph-ICF had the strongest correlation with 5 expected domains of the 36-Item Short-Form Health Survey questionnaire (SF-36). Thus, the 5 hypotheses assessing convergent validity were accepted. There was acceptable divergent validity because 3 of 5 hypotheses assessing divergent validity were accepted. There was good known-groups validity because patients with lymphedema had a higher total score on the Lymph-ICF and had a higher score on each domain and on each question (except one) compared with patients without lymphedema. CONCLUSION The Lymph-ICF is a reliable and valid questionnaire to assess impairments in function, activity limitations, and participation restrictions of patients with arm lymphedema after axillary dissection for breast cancer.
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Radat F, Lantéri-Minet M, Nachit-Ouinekh F, Massiou H, Lucas C, Pradalier A, Mercier F, El Hasnaoui A. The GRIM2005 Study of Migraine Consultation in France. III: Psychological Features of Subjects With Migraine. Cephalalgia 2009; 29:338-50. [DOI: 10.1111/j.1468-2982.2008.01718.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The objective of this analysis was to describe psychological and cognitive variables in subjects with migraine and to identify those associated with chronicity. Data were collected from 10 000 subjects during face-to-face interview. Subjects with episodic migraine ( n = 1127) or chronic daily headache ( n = 407) with migrainous features were identified using an algorithm based on the International Classification of Headache Disorders, 2nd edn classification. Data on headache impact was obtained with the Headache Impact Test-6, on psychological distress with the Hospital Anxiety and Depression Scale, on coping with the Coping Strategy Questionnaire catastrophizing score and the Brief COPE inventory, on illness perception with the Brief Illness Perception Questionnaire and on locus of control. Psychological variables associated with chronicity include perceived headache impact, psychological distress, the use of catastrophizing and avoidance coping strategies and an externalized locus of control. In conclusion, maladaptive coping strategies should be taken into account in the management of patients with migraine. Longitudinal studies will be necessary to address the causality of the relationship observed.
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Affiliation(s)
| | | | | | | | - C Lucas
- Hôpital Roger Salengro, Lille
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Abstract
A series of 22 patients was consecutively diagnosed with hypnic headache (HH) from June 2007 to June 2008 in two headache specialty centres participating in the French Observatory of Migraine and Headaches. Patients and headache characteristics were compared with the 2004 International Classification of Headache Disorders, 2nd edn (ICHD-II) criteria for HH and published series of HH patients. One-third of HH patients reported migraine-like headaches (pulsating/unilateral/stabbing) and > 20% were aged < 50 years at symptom onset. Of note, HH patients displayed typical motor activities during the headache (getting up, eating/drinking especially a cup of coffee, reading/watching television) that differentiate HH from migraine and suggest relationships between HH and trigeminal autonomic cephalalgias. The functional and emotional impact of HH appears low and similar to that of migraine in patients consulting in primary care practice. Improvements in ICHD-II criteria are suggested, especially to introduce the typical motor behaviour acted out by HH patients.
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Affiliation(s)
- A Donnet
- Department of Neurology, Clinical Neuroscience Federation, La Timone Hospital, Marseille, France.
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Innamorati M, Pompili M, De Filippis S, Gentili F, Erbuto D, Lester D, Tamburello A, Iacorossi G, Cuomo I, Dominici G, Tatarelli R, Martelletti P. The validation of the Italian Perceived Disability Scale (IPDS) in chronic daily headache sufferers. J Headache Pain 2008; 10:21-6. [PMID: 18854920 PMCID: PMC3451762 DOI: 10.1007/s10194-008-0076-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Accepted: 09/16/2008] [Indexed: 12/13/2022] Open
Abstract
The goals of this study were to assess the validity and usefulness of a new scale and to assess disability in a sample of patients with chronic daily headache. Participants were a convenience sample of 61 adult outpatients admitted to the Department of Medical Sciences of the Sant’Andrea Hospital in Rome, between September 2007 and May 2008. Inclusion criteria were, a diagnosis of chronic daily headache (illness duration >5 years). Patients were administered the Beck Hopelessness Scale (BHS), a specific section of the Mini-International Neuropsychiatric Interview (MINI) assessing suicidal intent, the Gotland Male Depression Scale (GMDS), and a scale devised to measure the degree of disability caused by the headache [Italian Perceived Disability Scale (IPDS)]. Analyses indicated that the IPDS had good internal consistency (Cronbach alpha = 0.93; average inter-item correlation = 0.40), and good convergent validity, with moderate to strong associations with measures assessing emotional distress (BHS, r = 0.47; P < 0.0001; GMDS, r = 0.72; P < 0.001). A single-item, logistic regression analysis indicated that the IPDS is able to predict suicide intent (Wald χ2 = 5.04; P < 0.05) in chronic daily headache patients. The IPDS is a brief instrument that is useful for comparisons with other chronic illnesses, and it may be used both for basic research and clinical applications when screening for comorbidity with emotional distress and disorders.
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Vas J, Rebollo Á, Perea-Milla E, Méndez C, Font CR, Gómez-Río M, Martín-Ávila M, Carbrera-Iboleón J, Caballero MD, Olmos MÁ, Aguilar I, Faus V, Martos F. Study protocol for a pragmatic randomised controlled trial in general practice investigating the effectiveness of acupuncture against migraine. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2008; 8:12. [PMID: 18410686 PMCID: PMC2377233 DOI: 10.1186/1472-6882-8-12] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Accepted: 04/14/2008] [Indexed: 11/27/2022]
Abstract
Background Migraine is a chronic neurologic disease that can severely affect the patient's quality of life. Although in recent years many randomised studies have been carried out to investigate the effectiveness of acupuncture as a treatment for migraine, it remains a controversial issue. Our aim is to determine whether acupuncture, applied under real conditions of clinical practice in the area of primary healthcare, is more effective than conventional treatment. Methods/Design The design consists of a pragmatic multi-centre, three-armed randomised controlled trial, complemented with an economic evaluation of the results achieved, comparing the effectiveness of verum acupuncture with sham acupuncture, and with a control group receiving normal care only. Patients eligible for inclusion will be those presenting in general practice with migraine and for whom their General Practitioner (GP) is considering referral for acupuncture. Sampling will be by consecutive selection, and by randomised allocation to the three branches of the study, in a centralised way following a 1:1:1 distribution (verum acupuncture; sham acupuncture; conventional treatment). Secondly, one patient in three will be randomly selected from each of the acupuncture (verum or sham) groups for a brain perfusion study (by single photon emission tomography). The treatment with verum acupuncture will consist of 8 treatment sessions, once a week, at points selected individually by the acupuncturist. The sham acupuncture group will receive 8 sessions, one per week, with treatment being applied at non-acupuncture points in the dorsal and lumbar regions, using the minimal puncture technique. The control group will be given conventional treatment, as will the other two groups. Discussion This trial will contribute to available evidence on acupuncture for the treatment of migraine. The primary endpoint is the difference in the number of days with migraine among the three groups, between the baseline period (the 4 weeks prior to the start of treatment) and the period from weeks 9 to 12. As a secondary aspect, we shall record the index of laterality and the percentage of change in the mean count per pixel in each region of interest measured by the brain perfusion tomography, performed on a subsample of the patients within the real and sham acupuncture groups. Trial registration Current Controlled Trials ISRCTN98703707.
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Magnoux E, Freeman MA, Zlotnik G. MIDAS and HIT-6 French Translation: Reliability and Correlation Between Tests. Cephalalgia 2007; 28:26-34. [DOI: 10.1111/j.1468-2982.2007.01461.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim was to evaluate the test-retest reliability of the French translation of the Migraine Disability Assessment (MIDAS) and Headache Impact Test (HIT)-6 questionnaires as applied to episodic and chronic headaches and to assess the correlation between these two questionnaires. The MIDAS and HIT-6 questionnaires, which assess the degree of migraine-related functional disability, are widely used in headache treatment clinics. The French translation has not been checked for test-retest reliability. MIDAS involves recall, over the previous 3 months, of the number of days with functional disability with regard to work and to home and social life. HIT-6 involves a more subjective and general assessment of headache-related disability over the previous 4 weeks. We expect that there may be greater impact recall bias for chronic headaches than for episodic headaches and considered it important to be able to determine if the reliability of these questionnaires is equally good for these two patient populations. Given that both questionnaires have the same objective, that of assessing headache impact, it was thought useful to determine if their results might show a correlation and if they could thus be used interchangeably. The study was approved by an external ethics committee. The subjects were patients who regularly visit the Clinique de la Migraine de Montréal, which specializes in the treatment of headaches. The MIDAS and HIT-6 questionnaires were completed by the patients during their regular visit. Twelve days later, the same questionnaires were mailed with a prepaid return envelope. Sixty-five patients were required in both the episodic and chronic headache groups, assuming an 80± questionnaire return rate. One hundred and eighty-five patients were enrolled, and 143 completed the study, 75 with episodic headaches and 68 with chronic headaches. The questionnaire return rate was 78.9±. On average, questionnaires were completed a second time 21 days after the first, with a median of 19 days. The Shrout-Fleiss intraclass correlation coefficients for MIDAS and HIT-6 were, respectively, 0.76 and 0.77 for episodic headaches and 0.83 and 0.80 for chronic headaches. The Pearson correlation coefficient between the MIDAS and HIT-6 questionnaires was 0.48 for episodic headaches and 0.58 for chronic headaches at the first compilation and 0.42 and 0.59 at the second compilation. The test-retest intraclass correlation of the French versions for both MIDAS and HIT-6 questionnaires indicates moderate reliability for episodic headache and substantial reliability for chronic headache. The correlation between the MIDAS and HIT-6 questionnaires is weak for episodic headaches, but approaches a level of ‘good’ for chronic headaches.
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Affiliation(s)
| | - MA Freeman
- GlaxoSmithKline, Medical Affairs, Montreal, Canada
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Lucas C, Lantéri-Minet M, Massiou H, Nachit-Ouinekh F, Pradalier A, Mercier F, El Hasnaoui A, Radat F. The GRIM2005 study of migraine consultation in France II. Psychological factors associated with treatment response to acute headache therapy and satisfaction in migraine. Cephalalgia 2007; 27:1398-407. [PMID: 17941879 DOI: 10.1111/j.1468-2982.2007.01446.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The objective of this analysis was to identify variables associated with treatment response in subjects with migraine. Data were collected from a sample of 10,000 subjects. A battery of questionnaires assessing clinical and psychological variables was completed. Migraine diagnosis was attributed using an algorithm based on the IHS criteria and treatment response using the ANAES criteria. We identified 1534 subjects, of whom 1443 were treated. For 54.2%, at least one ANAES criterion for treatment response was unfulfilled. Non-response was associated with female gender, high HIT-6 impact scores and high HAD psychological distress scores. The strongest associations with non-response were identified for four psychological variables: elevated scores on the CSQ catastrophization subscale and the 'Consequences' and 'Acceptance' dimensions of the Brief COPE, and low scores on the 'Positive Reinterpretation' Brief COPE dimension. In conclusion, many individuals with migraine respond inadequately to treatment. Behavioural interventions aimed at modifying coping strategies may improve outcome.
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Affiliation(s)
- C Lucas
- Hôpital Roger Salengro, Lille, France
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Lantéri-Minet M, Massiou H, Nachit-Ouinekh F, Lucas C, Pradalier A, Radat F, Mercier F, El Hasnaoui A. The GRIM2005 study of migraine consultation in France I. Determinants of consultation for migraine headache in France. Cephalalgia 2007; 27:1386-97. [PMID: 17888013 DOI: 10.1111/j.1468-2982.2007.01426.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of this study was to evaluate determinants of consultation for migraine in a representative sample of the French general adult population. We interviewed 10,032 subjects, of whom 1534 fulfilled the International Headache Society diagnostic criteria for migraine. These were categorized into migraine, probable migraine and chronic migraine. Information was collected on consultation experience; 436 subjects (28.4%) had never consulted for headache, 473 (30.8%) were in active consultation and 625 (40.7%) had previously consulted but lapsed. Subjects with chronic migraine showed the highest active consultation rates (51.8%). All subjects completed rating instruments for headache [Headache Impact Test (HIT)-6], psychiatric (Hospital Anxiety and Depression Scale scale) and psychological [Brief Illness Perception Questionnaire (BIPQ), Brief COPE Inventory and Coping Strategy Questionnaire] variables. The strongest determinants of active consultation were BIPQ scores, HIT-6 scores and migraine type. Consultation was associated with maladaptive coping strategies (social support, emotional expression and acceptance). Determinants of remaining in consultation were catastrophizing coping scores and previous consultation experience.
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Abstract
OBJECTIVE To describe translation methods, to outline current recommendations for translation and to give an overview of translation procedures used in headache. BACKGROUND In health-care research, particularly in the domain of health-related quality of life, an increasing number of questionnaires are translated for cross- cultural comparison. A number of headache-related questionnaires have also been translated. To ensure true cross-cultural comparison, it is important to use rigorous translation methods to ensure a high quality translated version of the instruments. METHODS Literature relevant to cross-cultural translations was reviewed, as well as literature concerning translation of headache-related instruments. CONCLUSION More information on the translation process for headache-related instruments is essential to carry out high quality cross-cultural research. Recommendation are given to encourage good translation practices.
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Affiliation(s)
- Michele Peters
- Department of Medical Psychology, Erasmus MC, Rotterdam, The Netherlands
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Fabre N, Nachit-Ouinekh F, Becq JP, Chastan G, Sénard JM, El Hasnaoui A. Prise en charge de la migraine en médecine générale. Rev Neurol (Paris) 2005; 161:949-56. [PMID: 16365624 DOI: 10.1016/s0035-3787(05)85158-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION A national survey has been conducted with 349 general practitioners in order to analyze the management of concerned episodic headache in general practice. METHOD This survey enabled collection of data from 2537 headache patients. The main data concered IHS diagnosis, severity of headache using the MIGSEV scale, management, practices and the impact on daily living (QVM and HIT-6 scales). RESULTS Out of the 2537 included patients, 52 percent were migraine sufferers according to IHS criteria (code 1.1/1.2), 34 percent presented with migrainous disorders (code 1.7), and 14 percent were non-migraine headache patients. The distribution of management practices showed that 71 percent of them were given non-specific treatments, 46 percent of them specific treatments and 27 percent of them prophylactic treatments. Analysis of the impact of headache using the QVM or the HIT-6 demonstrated a relationship between diagnosis, migraine severity and disability. Analysis of the correlation between the severity of the last migraine attack as evaluated by the patient and that estimated by the doctor showed that the practitioner tended to underestimate the patient's pain. These results highlight the importance of communication between practitioners and migraine sufferers. CONCLUSION Training of general practitioners in the use of simple tools such as the HIT-6 scale, should be helpful for a better evaluation of the impact of headache on daily living, and hence should lead to more optimal therapeutic management of headache patients.
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Affiliation(s)
- N Fabre
- Service de Neurologie, Hôpital Rangueil, Toulouse
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Nachit-Ouinekh F, Dartigues JF, Henry P, Becg JP, Chastan G, Lemaire N, El Hasnaoui A. Use of the headache impact test (HIT-6) in general practice: relationship with quality of life and severity. Eur J Neurol 2005; 12:189-93. [PMID: 15693807 DOI: 10.1111/j.1468-1331.2004.00934.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To assess the global impact of episodic headaches in patients consulting general practitioners (GPs) using the Headache Impact Test (HIT-6) questionnaire, and to compare this with measures of headache severity and quality of life. A total of 2802 patients consulting 349 GPs participated to this cross-sectional study. Data were collected on headache severity using the Migraine Severity (MIGSEV) scale, headache impact with the HIT-6 and quality of life with the Qualité de Vie et Migraine (QVM) questionnaire. Diagnosis was assigned retrospectively according to the International Headache Society criteria. The association between the HIT-6 scale and the other scales was determined from a Pearson's chi-square test, an analysis of variance and Spearman correlation coefficients. Patients (2537) provided exploitable data. Six percent of the sample had little impact, 14% moderate, 14% substantial and 66% severe impact. The HIT-6 scores were significantly different between diagnostic groups, being highest in the migraine group. The HIT-6 score were well correlated with headache severity and QVM score. The HIT-6 scale correlates, across different diagnostic groups of headache, with both headache severity and with quality of life.
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Affiliation(s)
- F Nachit-Ouinekh
- Public Health Department, University Victor Segalen, INSERM U593, Bordeaux, France.
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Martin M, Blaisdell B, Kwong JW, Bjorner JB. The Short-Form Headache Impact Test (HIT-6) was psychometrically equivalent in nine languages. J Clin Epidemiol 2005; 57:1271-8. [PMID: 15617953 DOI: 10.1016/j.jclinepi.2004.05.004] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2004] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVE This study examined the psychometric properties and equivalence of the six-item Headache Impact Test (HIT-6) across 11 languages in 14 countries. METHODS A multicenter, international cross-sectional study conducted in a primary care setting. Data obtained from 1,171 adults from 14 countries who consulted their primary care physician for headache completed the HIT-6 questionnaire and a headache survey were included in this analysis. Item-level statistics (e.g., range of response choices used by participants), item-scale statistics (e.g., item-total correlations), scale level statistics (e.g., internal consistency reliability), and tests of differential item functioning were conducted to examine the psychometric properties of all HIT-6 translations and their comparability across translations. RESULTS Across languages, missing data were low, item-scale correlations were high, reliability was adequate, and item-level statistics were generally comparable. We found only minor differential item functioning, suggesting that the HIT-6 translations are equivalent to the U.S. English form. CONCLUSIONS Psychometric analyses indicate that most HIT-6 translations (Canadian English, French, Greek, Hungarian, UK English, Hebrew, Portuguese, German, Spanish, and Dutch) are comparable to U.S. English. Improvements may be needed in the Finnish and Slovakian translations and the appropriateness of using the HIT-6 in South Africa should be explored further.
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Affiliation(s)
- Marie Martin
- QualityMetric Incorporated, 640 George Washington Highway, Lincoln, RI 02865, USA.
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Géraud G, Lantéri-Minet M, Lucas C, Valade D. French guidelines for the diagnosis and management of migraine in adults and children. Clin Ther 2004; 26:1305-18. [PMID: 15476911 DOI: 10.1016/s0149-2918(04)80161-9] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2004] [Indexed: 11/23/2022]
Abstract
BACKGROUND The French Recommendations for Clinical Practice: Diagnosis and Therapy of Migraine are guidelines concerning the overall management of patients with migraine, including diagnostic and therapeutic strategies and assessment of disability. OBJECTIVE This article summarizes the guidelines as they apply to adults and children, and proposes future direction for steps toward optimal treatment of migraine in patients in France. METHODS The recommendations were categorized into 3 levels of proof (A-C) according to the National Agency for Accreditation and Evaluation in Health (ANAES) methodology and were based on a professional consensus reached among members of the Working Group and the Guidelines Review Group of the ANAES. RESULTS The International Headache Society diagnostic criteria for migraine should be used in routine clinical practice. Recommended agents for the treatment of migraine in adults include nonsteroidal anti-inflammatory drugs, acetylsalicylic acid (ASA) monotherapy or in combination with metoclopramide, acetaminophen monotherapy, triptans, ergotamine tartrate, and dihydroergotamine mesylate. Patients should use the medication as early as possible after the onset of migraine headache. For migraine prophylaxis in adults, the following can be used: propranolol, metoprolol, oxetorone, or amitriptyline as first-line treatment, and pizotifen, flunarizine, valproate sodium, or topiramate as second-line treatment. Migraine in children can be distinguished from that in adults by shorter duration (2-48 hours in children aged <15 years), more frequent bilateral localization, frequent predominant gastrointestinal disturbances, and frequent pallor hailing the onset of the attack. The following drugs are recommended in children and adolescents: ibuprofen in children aged >6 months, diclofenac in children weighing >16 kg, naproxen in children aged >6 years or weighing >25 kg, ASA alone or in combination with metoclopramide, acetaminophen alone or in combination with metoclopramide, and ergotamine tartrate in children aged >10 years. CONCLUSIONS These guidelines are intended to help general practitioners to manage migraine patients according to the rules of evidence-based medicine.
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Affiliation(s)
- Gilles Géraud
- Department of Neurology, Rangueil Hospital, Toulouse, France.
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Kosinski M, Bayliss MS, Bjorner JB, Ware JE, Garber WH, Batenhorst A, Cady R, Dahlöf CGH, Dowson A, Tepper S. A six-item short-form survey for measuring headache impact: the HIT-6. Qual Life Res 2003; 12:963-74. [PMID: 14651415 DOI: 10.1023/a:1026119331193] [Citation(s) in RCA: 843] [Impact Index Per Article: 40.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Migraine and other severe headaches can cause suffering and reduce functioning and productivity. Patients are the best source of information about such impact. OBJECTIVE To develop a new short form (HIT-6) for assessing the impact of headaches that has broad content coverage but is brief as well as reliable and valid enough to use in screening and monitoring patients in clinical research and practice. METHODS HIT-6 items were selected from an existing item pool of 54 items and from 35 items suggested by clinicians. Items were selected and modified based on content validity, item response theory (IRT) information functions, item internal consistency, distributions of scores, clinical validity, and linguistic analyses. The HIT-6 was evaluated in an Internet-based survey of headache sufferers (n = 1103) who were members of America Online (AOL). After 14 days, 540 participated in a follow-up survey. RESULTS HIT-6 covers six content categories represented in widely used surveys of headache impact. Internal consistency, alternate forms, and test-retest reliability estimates of HIT-6 were 0.89, 0.90, and 0.80, respectively. Individual patient score confidence intervals (95%) of app. +/-5 were observed for 88% of all respondents. In tests of validity in discriminating across diagnostic and headache severity groups, relative validity (RV) coefficients of 0.82 and 1.00 were observed for HIT-6, in comparison with the Total Score. Patient-level classifications based in HIT-6 were accurate 88.7% of the time at the recommended cut-off score for a probability of migraine diagnosis. HIT-6 was responsive to self-reported changes in headache impact. CONCLUSIONS The IRT model estimated for a 'pool' of items from widely used measures of headache impact was useful in constructing an efficient, reliable, and valid 'static' short form (HIT-6) for use in screening and monitoring patient outcomes.
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Affiliation(s)
- M Kosinski
- QualityMetric Incorporated Lincoln, RI 02865, USA.
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