Fernández-de-las-Peñas César, Alonso-Blanco Cristina, Cuadrado Maria Luz, Gerwin Robert D, Pareja Juan A
Department of Physical Therapy, University Rey Juan Carlos, Madrid, Spain.
Headache. 2006 Mar;46(3):454-60. doi: 10.1111/j.1526-4610.2006.00288.x.
To assess the presence of trigger points (TrPs) in the suboccipital muscles and forward head posture (FHP) in subjects with chronic tension-type headache (CTTH) and in healthy subjects, and to evaluate the relationship of TrPs and FHP with headache intensity, duration, and frequency.
Tension-type headache (TTH) is a prototypical headache in which myofascial TrPs in the cervical and pericranial musculature can play an important role.
A blinded, controlled pilot study.
Twenty CTTH subjects and 20 matched controls without headache participated. TrPs were identified by eliciting referred pain with palpation, and increased referred pain with muscle contraction. Side-view pictures of each subject were taken in sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. Both measures were taken by a blinded assessor. A headache diary was kept for 4 weeks in order to assess headache intensity, frequency, and duration.
Sixty-five percent (13/20) CTTH subjects showed active TrPs and 35% (7/20) had latent TrPs in the suboccipital muscles. Six (30%) controls also had latent TrPs. Differences in the presence of suboccipital muscle TrPs between both the groups were significant for active TrPs (P < .001) but not for latent TrPs (P > .5). CTTH subjects with active TrPs reported a greater headache intensity and frequency than those with latent TrPs (P < .05). The degree of FHP was greater in CTTH subjects than in controls in both sitting and standing positions (P < .01). Within the CTTH group, there was a negative correlation between the craniovertebral angle and the frequency of headache (r(s) = -0.6, P < .01, in sitting position; r(s) = -0.5, P < .05, in standing position). CTTH subjects with active TrPs had a greater FHP than those with latent TrPs, though this difference was not significant.
Suboccipital active TrPs and FHP were associated with CTTH. CCTH subjects with active TrPs reported a greater headache intensity and frequency than those with latent TrPs. The degree of FHP correlated positively with headache duration, headache frequency, and the presence of suboccipital active TrPs.
评估慢性紧张型头痛（CTTH）患者和健康受试者枕下肌肉中触发点（TrP）的存在情况及头部前伸姿势（FHP），并评估TrP和FHP与头痛强度、持续时间及频率的关系。
紧张型头痛（TTH）是一种典型的头痛类型，其中颈部和颅周肌肉组织中的肌筋膜TrP可能起重要作用。
一项双盲、对照的试点研究。
20名CTTH患者和20名无头痛的匹配对照者参与研究。通过触诊引发牵涉痛以及肌肉收缩时牵涉痛增加来确定TrP。为评估FHP，在坐位和站立位拍摄每位受试者的侧视图，通过测量颅椎角来进行评估。这两项测量均由一名不知情的评估者进行。记录4周的头痛日记，以评估头痛强度、频率和持续时间。
65%（13/20）的CTTH患者枕下肌肉中存在活跃TrP，35%（7/20）有潜伏TrP。6名（30%）对照者也有潜伏TrP。两组之间枕下肌肉TrP存在情况的差异在活跃TrP方面具有显著性（P <.001），但在潜伏TrP方面无显著性差异（P >.5）。有活跃TrP的CTTH患者报告的头痛强度和频率高于有潜伏TrP的患者（P <.05）。在坐位和站立位，CTTH患者的FHP程度均高于对照者（P <.01）。在CTTH组内，颅椎角与头痛频率之间存在负相关（坐位时r(s)= -0.6，P <.01；站立位时r(s)= -0.5，P <.05）。有活跃TrP的CTTH患者的FHP高于有潜伏TrP的患者，尽管这种差异不显著。
枕下活跃TrP和FHP与CTTH相关。有活跃TrP的CCTH患者报告的头痛强度和频率高于有潜伏TrP的患者。FHP程度与头痛持续时间、头痛频率以及枕下活跃TrP的存在呈正相关。
