Manual therapy for chronic migraine: a pragmatic randomised controlled trial study protocol

Exploring Adherence to Pelvic Floor Muscle Training in Women Using Mobile Apps: Scoping Review

BACKGROUND

Pelvic floor dysfunction is a public health issue, with 1 in 3 women experiencing symptoms at some point in their lifetime. The gold standard of treatment for pelvic floor dysfunction is supervised pelvic floor muscle training (PFMT); however, adherence to PFMT in women is poor. Mobile apps are increasingly being used in the National Health Service to enable equity in the distribution of health care and increase accessibility to services. However, it is unclear how PFMT mobile apps influence PFMT adherence in women.

OBJECTIVE

We aimed to identify which behavior change techniques (BCTs) have been used in PFMT mobile apps, to distinguish the core "capability, opportunity, and motivation" (COM) behaviors targeted by the BCTs used in PFMT mobile apps, and to compare the levels of PFMT adherence in women between those using PFMT mobile apps and those receiving usual care.

METHODS

We conducted a scoping review of the literature. Published quantitative literature that compared the use of a PFMT mobile app to a control group was included to address the objectives of the study. The electronic bibliographic databases searched included MEDLINE, CINAHL, Scopus, Web of Science, and PEDro, along with CENTRAL. Studies were also identified from reference searching of systematic reviews. Original articles written in English from 2006 onward were included. Nonexperimental quantitative studies, qualitative studies, studies that use male participants, case studies, web-based interventions, and interventions that use vaginal probes were excluded. Narrative synthesis was conducted on eligible articles based on the aims of the study.

RESULTS

Of the 114 records retrieved from the search, a total of 6 articles met the eligibility and inclusion criteria. The total number of participants in the studies was 471. All PFMT mobile apps used the BCT "prompts and cues." Opportunity was the core COM behavior targeted by the PFMT mobile apps. Higher levels of adherence to PFMT were observed among women using PFMT mobile apps.

CONCLUSIONS

Digital "prompts and cues" are a BCT commonly used in PFMT mobile apps, and further research is required to practically assess whether a future randomized controlled trial that investigates the effectiveness of digital "prompts and cues" on PFMT adherence in women can be conducted.

Primary headache management in a multidisciplinary team - a pilot study

Tension-type headaches and migraines are bidirectionally related to dysfunctions of the cervical and masticatory muscles and some psychosocial factors. Our pilot study aimed to investigate the connections between primary headaches, bruxism, and psychosocial issues. In addition, we aimed to assess the effectiveness of a multidisciplinary approach in decreasing the intensity and frequency of headache episodes and bruxism. Sixty-seven patients previously diagnosed with primary headache and bruxism were divided into two similar groups. One group benefited from manual therapy alone, while the other received manual therapy and counseling sessions for three months. Statistical data analysis was conducted using SPSS, Version 24, using the paired Student's t-tests and McNemar's tests. After the three-month intervention period, we observed substantial improvements across various parameters. Some demonstrated statistically significant differences, while others did not reach statistical significance. When comparing the outcomes, the combined therapy proved more effective than manual therapy alone.

Successful management of chronic migraine through manual therapy. A case report

Migraine is the second most debilitating condition affecting a significant portion of the general population, particularly young adults under 50. Despite extensive research, the etiology of migraine remains diverse and often multifactorial, with limited clarity on the specific underlying pathogenic processes. Consequently, the treatment of migraine lacks a mechanism-based approach. We present the case of a young female patient suffering for 8 years of chronic migraine and tension-type headaches. The manual therapy techniques successfully released the muscular tensions, considerably improving her quality of life in terms of pain and emotional well-being.

Levels and determinants of knowledge about chronic migraine diagnosis and management among primary health-care physicians in ministry of health, Jeddah 2019

Background:

Chronic migraine (CM) poses a significant burden for patients, and it has multiple diagnostic and managemental challenges, particularly among primary health-care physicians (PCPs).

Objectives:

The objective of this study is to assess the levels of knowledge regarding CM diagnosis and management among PCPs and to explore the factors associated with poor knowledge.

Methods:

A cross-sectional study was conducted among PCPs working at primary health-care centers in Jeddah, Saudi Arabia. A semi-structured questionnaire comprising 20 items related to CM diagnosis and treatment was used.

Results:

A total of 136 PCPs responded (aged 36.4 ± 8.1, 68.4% were females). The overall median (P75) knowledge score was 13.0 (15.0), and 45.6% of the participants had adequate knowledge (score > median). The majority of respondents (>50%) could not identify the lower limits of CM duration, the necessity of identifying at least eight migraine attacks in a month, the importance of managing medication overuse, and the indication of topiramate as the most efficacious agent in CM. Young physicians (23–35 years), bachelor graduates, general practitioners (GPs), and those having ≤5 years of experience scored lower than their peers. Physicians with 6–10 years of clinical experience were independently more knowledgeable than less-experienced PCPs (odds ratio = 5.09, P = 0.006).

Conclusion:

Knowledge regarding CM diagnosis and treatment was inadequate among PCPs, which could detrimentally influence the patterns of referral to secondary health-care facilities. Given these observations, it is recommended to amend the academic curricula for medical students/GPs and adopt continuing medical education programs for PHPs to support their levels of knowledge.