1
|
Embaby E, Khalil AA, Mansour A, Hamdy HA. The relationship between myofascial trigger points sensitivity, cervical postural abnormality, and clinical tension-type headache parameters. J Man Manip Ther 2024; 32:390-399. [PMID: 38163855 PMCID: PMC11257008 DOI: 10.1080/10669817.2023.2299186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Myofascial Trigger Points (MTrPs) play a significant role in the pathogenesis of Tension Type Headache (TTH). Abnormal cranio-cervical posture has been linked to various types of headaches. However, the correlation between MTrPs sensitivity, cervical postural alignment, and clinical measures of headache has not been extensively studied in patients with TTH. OBJECTIVES To investigate the relationship between MTrPs sensitivity in cervical and pericranial muscles, cervical postural abnormality, and clinical headache parameters in patients with TTH. Furthermore, to investigate the effect of sex on the examined variables and their association with headache type (episodic vs chronic TTH). METHODS A total of 72 patients with TTH of both sexes were enrolled in this study. Headache frequency and disability as clinical measures of headache, pressure pain threshold (PPT) of bilateral upper trapezius (UT) and suboccipital (SUB) muscles, cervical lordosis angle (CA), and anterior head translation (AHT) were measured. RESULTS Pericranial MTrPs sensitivity did not demonstrate any correlation with clinical headache parameters or cervical postural abnormality. However, there was a significant correlation between the frequency of headaches and the level of disability (r = 0.32, P < 0.05). In addition, episodic TTH was more prevalent in females who exhibited greater AHT and MTrPs sensitivity of both bilateral UT and right SUB muscles than males. CONCLUSIONS There was no correlation found between the frequency of headaches and the level of disability with measures of cervical posture alignment or MTrPs sensitivity in individuals with TTH.. Based on findings, Clinicians should consider sex differences when assessing patients with TTH.
Collapse
Affiliation(s)
- Eman Embaby
- Basic science department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Aya A Khalil
- Biomechanics Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Abdallah Mansour
- 5 year undergraduate student, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Hend A Hamdy
- Basic science department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| |
Collapse
|
2
|
Son JY, Goo K, Kim NY, Yang SG, Lee DH, Im YR, Kwon OB, Cho HW, Kim SD, Kim D, Ha IH. Effectiveness and Safety of Pharmacopuncture on Inpatients with Tension Headache Caused by Traffic Accidents: A Pragmatic Randomized Controlled Trial. J Clin Med 2024; 13:4457. [PMID: 39124723 PMCID: PMC11312919 DOI: 10.3390/jcm13154457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/04/2024] [Accepted: 07/18/2024] [Indexed: 08/12/2024] Open
Abstract
Background: This study investigated the effectiveness and safety of pharmacopuncture for pain relief and functional improvement in patients with traffic accident (TA)-induced acute tension headaches. Methods: The study employed a parallel, single-centered, pragmatic, randomized controlled trial design. Eighty patients complaining of acute tension headaches were randomized into the integrative Korean medicine treatment (IKM treatment) group and the pharmacopuncture group on suboccipital muscles (suboccipital muscles pharmacopuncture + IKM treatment), with 40 participants assigned to each group. The patients in the pharmacopuncture group underwent pharmacopuncture as an add-on therapy, consisting of three sessions. Both groups were reassessed 2 months post-intervention. To assess the outcomes, the Numeric Rating Scale (NRS) for Headache, NRS for Neck Pain, Headache Disability Index, Headache Impact Test-6, EuroQol 5-Dimension, and Patient Global Impression of Change were used. Results: The improvement in the outcomes of the pharmacopuncture group was significantly greater than that of the comparison group on day 4 of hospitalization in terms of pain (difference in NRS of headache -2.59, 95% CI -3.06 to -2.12; NRS of Neck pain -1.05, 95% CI -1.50 to -0.59) and function (difference in HDI -24.78, 95% CI, -31.79 to -17.76; HIT-6 -6.13, 95% CI, -9.47 to -2.78). Additionally, in 2 months of follow-up, the recovery rate of headache was significantly higher in the pharmacopuncture group than in the comparison group. Conclusions: The pharmacopuncture group demonstrated superior outcomes in symptom improvement than the comparison group did, providing insights into novel and useful applications of pharmacopuncture in the clinical practice of Korean medicine.
Collapse
Affiliation(s)
- Ja-Yean Son
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea (S.-G.Y.); (H.-W.C.); (S.D.K.)
| | - Kangmoo Goo
- Department of Korean Medicine Neuropsychiatry, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea
| | - Na-young Kim
- Department of Korean Internal Medicine, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea;
| | - Seok-Gyu Yang
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea (S.-G.Y.); (H.-W.C.); (S.D.K.)
| | - Dong Hwan Lee
- Department of Korean Acupuncture & Moxibustion Medicine, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea; (D.H.L.); (O.B.K.)
| | - Yu-Ra Im
- Department of Korean Medicine Ophthalmology & Otolaryngology & Dermatology, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea;
| | - Oh Bin Kwon
- Department of Korean Acupuncture & Moxibustion Medicine, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea; (D.H.L.); (O.B.K.)
| | - Hyun-Woo Cho
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea (S.-G.Y.); (H.-W.C.); (S.D.K.)
| | - Sang Don Kim
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea (S.-G.Y.); (H.-W.C.); (S.D.K.)
| | - Doori Kim
- Clinical Research Center, Jaseng Hospital of Korean Medicine, 536, Gangnam-daero, Gangnam-gu, Seoul 06110, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 2F 540 Gangnam-daero, Gangnam-gu, Seoul 06110, Republic of Korea
| |
Collapse
|
3
|
Lu Z, Zou H, Zhao P, Wang J, Wang R. Myofascial Release for the Treatment of Tension-Type, Cervicogenic Headache or Migraine: A Systematic Review and Meta-Analysis. Pain Res Manag 2024; 2024:2042069. [PMID: 38585645 PMCID: PMC10999287 DOI: 10.1155/2024/2042069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/07/2024] [Accepted: 03/12/2024] [Indexed: 04/09/2024]
Abstract
Objective To assess the effectiveness of myofascial release (MFR) techniques on the intensity of headache pain and associated disability in patients with tension-type headache (TTH), cervicogenic headache (CGH), or migraine. Design A systematic review and meta-analysis. Methods Eight databases were searched on September 15, 2023, including PubMed, Scopus, Web of Science, CINAHL, Cochrane Library, Embase, CNKI, and Wanfang Database. The risk of bias was evaluated utilizing the Cochrane Risk of Bias 2 (RoB 2) tool. Results Pooled results showed that MFR intervention significantly reduces pain intensity [SMD = -2.01, 95% CI (-2.98, -1.03), I2 = 90%, P < 0.001] and improves disability [SMD = -1.3, 95% CI (-1.82, -0.79), I2 = 74%, P < 0.001]. Subgroup analysis based on the type of headache revealed significant reductions in pain intensity for CGH [SMD = -2.01, 95% CI (-2.73, -1.29), I2 = 63%, P < 0.001], TTH [SMD = -0.86, 95% CI (-1.52, -0.20), I2 = 50%, P=0.01] and migraine [SMD = -6.52, 95% CI (-8.15, -4.89), P < 0.001] and in disability for CGH [SMD = -1.45, 95% CI (-2.07, -0.83), I2 = 0%, P < 0.001]; TTH [SMD = -0.98, 95% CI (-1.32, -0.65), I2 = 0%, P < 0.001] but not migraine [SMD = -2.44, 95% CI (-6.04, 1.16), I2 = 97%, P=0.18]. Conclusion The meta-analysis results indicate that MFR intervention can significantly alleviate pain and disability in TTH and CGH. For migraine, however, the results were inconsistent, and there was only moderate quality evidence of disability improvement for TTH and CGH. In contrast, the quality of other evidence was low or very low.
Collapse
Affiliation(s)
- Zhoupeng Lu
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
- College of Sports Medicine and Physical Therapy, Beijing Sport University, Beijing, China
| | - Hui Zou
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
- College of Sports Medicine and Physical Therapy, Beijing Sport University, Beijing, China
| | - Peng Zhao
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
| | - Jialin Wang
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
| | - Ruirui Wang
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
- College of Sports Medicine and Physical Therapy, Beijing Sport University, Beijing, China
| |
Collapse
|
4
|
Martín-Vera D, Sánchez-Sierra A, González-de-la-Flor Á, García-Pérez-de-Sevilla G, Domínguez-Balmaseda D, del-Blanco-Muñiz JÁ. Efficacy of a strength-based exercise program in patients with chronic tension type headache: a randomized controlled trial. Front Neurol 2023; 14:1256303. [PMID: 37789886 PMCID: PMC10543698 DOI: 10.3389/fneur.2023.1256303] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/07/2023] [Indexed: 10/05/2023] Open
Abstract
Background Strength-based exercise is widely used to treat tension-type headache, but the evidence of its benefit is unclear. This study aims to analyze the efficacy of a strength-based exercise program in patients with chronic tension-type headaches. Methods A randomized controlled trial with a 12-week strength-based exercise program, with chronic tension-type headache. The headache characteristics (which were the primary outcomes: frequency, duration, and intensity), cervical muscle thickness at rest or contraction of multifidus and longus-colli muscle, cervical range of motion, pain pressure threshold of temporalis, upper trapezius, masseter, tibialis muscle and median nerve, and cervical craniocervical flexion test were assessed at baseline and 12-weeks of follow-up in the intervention group (n = 20) and the control group (n = 20) was performed on 40 patients (85% women, aged 37.0 ± 13.3 years). Results Between baseline and week-12 of follow-up the intervention group showed statistically significant differences compared to control group in the following primary outcomes: duration and intensity of headaches. In addition, the intervention group improved the thickness of deep cervical muscles, reduced the peripheral sensitization, and improved the strength of deep cervical flexors. Conclusion A 12-week strength training of neck and shoulder region induced changes in pain intensity and duration, and physical-related factors in patients with TTH. Future interventions are needed to investigate if normalization of pain characteristics and physical factors can lead to an increase of headache-related impact.
Collapse
Affiliation(s)
- Daniel Martín-Vera
- Department of Physiotherapy, Faculty of Sports Sciences, Universidad Europea de Madrid, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Villaviciosa de Odón, Madrid, Spain
| | - Alberto Sánchez-Sierra
- Department of Physiotherapy, Faculty of Sports Sciences, Universidad Europea de Madrid, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Villaviciosa de Odón, Madrid, Spain
| | - Ángel González-de-la-Flor
- Department of Physiotherapy, Faculty of Sports Sciences, Universidad Europea de Madrid, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Villaviciosa de Odón, Madrid, Spain
| | - Guillermo García-Pérez-de-Sevilla
- Department of Physiotherapy, Faculty of Sports Sciences, Universidad Europea de Madrid, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Villaviciosa de Odón, Madrid, Spain
| | - Diego Domínguez-Balmaseda
- Department of Physiotherapy, Faculty of Sports Sciences, Universidad Europea de Madrid, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Villaviciosa de Odón, Madrid, Spain
- Faculty of Biomedical Sciences and Health, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Jose Ángel del-Blanco-Muñiz
- Department of Physiotherapy, Faculty of Sports Sciences, Universidad Europea de Madrid, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Villaviciosa de Odón, Madrid, Spain
| |
Collapse
|
5
|
Muacevic A, Adler JR, Khatib M, Knafo J, Karas M, Krupa K, Rivera B, Macia A, Madhu B, McMillan M, Burtch J, Quinonez J, Albert T, Khanna D. Osteopathic Manipulative Treatment and the Management of Headaches: A Scoping Review. Cureus 2022; 14:e27830. [PMID: 36110479 PMCID: PMC9462953 DOI: 10.7759/cureus.27830] [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] [Received: 07/11/2022] [Accepted: 08/08/2022] [Indexed: 02/05/2023] Open
Abstract
Headaches have been studied and treated since nearly 7,000 BC because of their significant global impact. Current headache treatment modalities are various and have a wide variety of targets, but medications are the most common. Since conventional medical treatments have several side effects, alternative remedies such as osteopathic manipulative treatment (OMT) should be considered. OMT can assist in the management of various health conditions, such as low back pain, neck pain, and headaches. The purpose of this scoping review is to evaluate recent findings regarding the efficacy of OMT modalities in the management of headaches such as tension-type headaches (TTH) and migraines. This study was designed as a scoping review to gather evidence on the efficacy of OMT modalities in the management of headaches. Following PRISMA guidelines, four databases were used to search for articles published between 2010 and 2022 that reported the use of OMT and manual therapy for TTH and migraines. Databases used include Embase, PubMed, Medline, and Web of Science. The following keywords were used: treatment, therapy, Headache, migraine, craniosacral, muscle energy, myofascial release, trigger point, osteopathic, and manipulation. The initial search yielded 473 unique articles after removing duplicates. After screening based on the inclusion and exclusion criteria, and after further analysis, 15 articles were selected. Data reports of OMT and manual therapy efficacy and/or effectiveness in treating TTH and migraine were analyzed. Articles included were randomized control studies (13 of 15, 86.6%), one pilot study (one of 15, 6.7%), and one case series (one of 15, 6.7%), which were divided into TTH (nine of 15, 60%) and Migraine Headaches (six of 15, 40%). All articles reported significant headache improvement in at least one measurement. Of all treatments analyzed, single technique interventions (seven of 15, 47%) and multiple technique interventions (eight of 15, 53%) were identified. Among the techniques used, Myofascial Release was the most common (nine of 15, 60%). The articles presented provide evidence of the significant benefits of manual therapy. Because of the limitations of traditional medicine, OMT can be used either as an alternative or adjuvant therapy for headaches. Evidence suggests the positive impact it can provide on headache management, but the number of randomized control trials and population samples should be increased to support its recommendation. This demonstrates how different osteopathic techniques can provide therapeutic effects on TTH, MH, and potentially other types of headaches. A preference for myofascial release was observed, which can be due to the fast relief from the physiologic effect on tissue movement. This review study demonstrates the benefits OMT has on decreasing headache frequency, intensity, and duration in TTH and migraines. OMT has shown to be beneficial, especially for patients seeking alternative non-pharmaceutical and non-invasive treatments. Further studies are needed to evaluate the effects of different OMT techniques, and different combinations of treatments, on other types of headaches.
Collapse
|
6
|
Santos TS, Oliveira KKB, Martins LV, Vidal APC. Effects of manual therapy on body posture: Systematic review and meta-analysis. Gait Posture 2022; 96:280-294. [PMID: 35738063 DOI: 10.1016/j.gaitpost.2022.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/11/2022] [Accepted: 06/16/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Several clinical trials investigated the effectiveness of MT on body posture, but a systematic review grouping the results of these studies was not found in the literature. RESEARCH QUESTION Does manual therapy (MT) cause postural changes? METHODS Inclusion criteria were: randomized controlled trials in any population; studies in which the primary intervention was the use of any MT technique; studies that evaluated the immediate, short, medium, or long-term effects of interventions on body posture; and studies published in peer-reviewed scientific journals in any year and language. In March 2022, we conducted a search in the PUBMED, Cinahl, Embase, PEDro, and Cochrane Central databases that yielded 6627 articles, of which 38 including 1597 participants were eligible; of these, 35 could be grouped into 12 meta-analyses. The risk of bias was assessed using the PEDro scale and the certainty in the scientific evidence rated through the GRADE system. RESULTS The results allowed us to conclude with moderate certainty in the evidence that, when compared to no intervention or sham, in the short and medium term, MT reduced the forward head posture (14 studies, 584 individuals, 95%CI 0.38, 1.06), reduced thoracic kyphosis (5 studies, 217 individuals, 95%CI 0.37, 0.94), improved lateral pelvic tilt (5 studies, 211 individuals, 95%CI 0.11, 0.67) and pelvic torsion (2 studies, 120 individuals, 95%CI 0.44, 1.19) and increased plantar area (3 studies, 134 individuals, 95%CI 0.04, 0.74). With moderate certainty, there was no significant effect on shoulder protrusion (5 studies, 176 individuals, 95%CI -0.11, 0.61), shoulder alignment in the frontal plane (3 studies, 160 individuals, 95%CI -0.15, 0.52), scoliosis (2 studies, 26 individuals, 95%CI -1.57, 2.19), and pelvic anteversion (5 studies, 233 individuals, 95%CI -0.02, 0.51). With low certainty, MT had no effect on scapular upward rotation (2 studies, 74 individuals, 95%CI -0.76, 2.17). With low to very low certainty, it is possible to conclude that MT was not superior to other interventions in the short or medium term regarding the improvement of forward head posture (5 studies, 170 individuals, 95%CI -1.39, 0.67) and shoulder protrusion (3 studies, 94 individuals, 95%CI -4.04, 0.97). SIGNIFICANCE MT can be recommended to improve forward head posture, thoracic kyphosis and pelvic alignment in the short and medium term, but not shoulder posture and scoliosis. MT reduces the height of the plantar arch and this must be taken into account in physical therapy planning. PROSPERO registration number: CRD42021244423.
Collapse
Affiliation(s)
- T S Santos
- Federal University of Espírito Santo, Brazil
| | | | - L V Martins
- Federal University of Espírito Santo, Brazil
| | - A P C Vidal
- Federal University of Espírito Santo, Brazil.
| |
Collapse
|