Manual therapies for primary chronic headaches: a systematic review of randomized controlled trials

The Journal of Headache and Pain

Review Article

Michael Bjørn Russell¹  Aleksander Chaibi¹ 

[1] Head and Neck Research Group, Research Centre, Akershus University Hospital, 1478 Lørenskog, Oslo, Norway;Institute of Clinical Medicine, Akershus University Hospital, University of Oslo, 1474 Nordbyhagen, Oslo, Norway;

关键词: Randomized clinical trials;    Primary chronic headache;    Manual therapies;    Massage;    Physiotherapy;    Chiropractic;   

DOI  :  10.1186/1129-2377-15-67

 received in 2014-08-15, accepted in 2014-09-16,  发布年份 2014

来源: Springer

【 摘 要 】

This is to our knowledge the first systematic review regarding the efficacy of manual therapy randomized clinical trials (RCT) for primary chronic headaches. A comprehensive English literature search on CINHAL, Cochrane, Medline, Ovid and PubMed identified 6 RCTs all investigating chronic tension-type headache (CTTH). One study applied massage therapy and five studies applied physiotherapy. Four studies were considered to be of good methodological quality by the PEDro scale. All studies were pragmatic or used no treatment as a control group, and only two studies avoided co-intervention, which may lead to possible bias and makes interpretation of the results more difficult. The RCTs suggest that massage and physiotherapy are effective treatment options in the management of CTTH. One of the RCTs showed that physiotherapy reduced headache frequency and intensity statistical significant better than usual care by the general practitioner. The efficacy of physiotherapy at post-treatment and at 6 months follow-up equals the efficacy of tricyclic antidepressants. Effect size of physiotherapy was up to 0.62. Future manual therapy RCTs are requested addressing the efficacy in chronic migraine with and without medication overuse. Future RCTs on headache should adhere to the International Headache Society’s guidelines for clinical trials, i.e. frequency as primary end-point, while duration and intensity should be secondary end-point, avoid co-intervention, includes sufficient sample size and follow-up period for at least 6 months.

【 授权许可】

CC BY   
© Chaibi and Russell; licensee Springer. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.