Université du Québec à Trois-Rivières, Canada.
Cephalalgia. 2013 Dec;33(16):1319-36. doi: 10.1177/0333102413492913. Epub 2013 Jun 26.
Individuals with tension-type headache (TTH), in addition to headache pain, typically suffer from pericranial muscle tenderness and increased cervical muscle tone. Physical and physiological outcomes related to musculoskeletal function, however, are not commonly assessed in clinical studies and not systematically proposed as outcome measures in headache-related practice guidelines.
To review which musculoskeletal outcomes are used in the clinical assessment of patients with TTH and which are associated with headache pain and related dysfunction.
Literature searches were performed in MEDLINE, PubMed, the Cochrane databases and EMBASE using terms relating to musculoskeletal physical outcomes in TTH.
Twenty-six studies met selection criteria. Physiological outcomes typically reported in laboratory studies were trigger points, pressure pain threshold, range of motion and tenderness. A greater number of trigger points and lower pressure pain threshold were reported in patients with episodic TTH in comparison with healthy subjects. Individuals with chronic TTH, when compared with non-headache controls, consistently showed a greater number of trigger points, a lower value of pressure pain threshold and a more severe forward head posture.
Musculoskeletal outcomes, such as trigger points, pressure pain threshold and forward head posture should inform TTH pathophysiology, diagnosis and interdisciplinary patient care.
除了头痛，紧张型头痛（TTH）患者通常还伴有颅周肌肉压痛和颈椎肌肉张力增加。然而，与肌肉骨骼功能相关的生理和临床结果在临床研究中通常未被评估，也未被系统地提出作为头痛相关实践指南中的疗效指标。
综述 TTH 患者临床评估中使用的肌肉骨骼结局指标，以及这些结局指标与头痛疼痛和相关功能障碍的相关性。
使用与 TTH 肌肉骨骼物理结局相关的术语，在 MEDLINE、PubMed、Cochrane 数据库和 EMBASE 中进行文献检索。
26 项研究符合入选标准。在实验室研究中，通常报告的生理结局指标有触发点、压痛阈、关节活动度和压痛。与健康受试者相比，发作性 TTH 患者的触发点更多，压痛阈更低。与非头痛对照组相比，慢性 TTH 患者的触发点更多，压痛阈更低，且头部前倾姿势更为严重。
触发点、压痛阈和头部前倾姿势等肌肉骨骼结局指标可以为 TTH 的病理生理学、诊断和跨学科患者管理提供信息。
