Rinne Marjo, Garam Sanna, Häkkinen Arja, Ylinen Jari, Kukkonen-Harjula Katriina, Nikander Riku
M. Rinne, PT, PhD, UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, Tampere 33500, Finland.
S. Garam, PT, MSc, Helsinki Metropolia University of Applied Sciences, Helsinki, Finland.
Phys Ther. 2016 May;96(5):631-40. doi: 10.2522/ptj.20150267. Epub 2015 Oct 15.
Cervicogenic headache and migraine are common causes of visits to physicians and physical therapists. Few randomized trials utilizing active physical therapy and progressive therapeutic exercise have been previously published. The existing evidence on active treatment methods supports a moderate effect on cervicogenic headache.
The aim of this study is to investigate whether a progressive, group-based therapeutic exercise program decreases the intensity and frequency of chronic headache among women compared with a control group receiving a sham dose of transcutaneous electrical nerve stimulation (TENS) and stretching exercises.
A randomized controlled trial with 6-month intervention and follow-up was developed. The participants were randomly assigned to either a treatment group or a control group.
The study is being conducted at 2 study centers.
The participants are women aged 18 to 60 years with chronic cervicogenic headache or migraine.
The treatment group's exercise program consisted of 6 progressive therapeutic exercise modules, including proprioceptive low-load progressive craniocervical and cervical exercises and high-load exercises for the neck muscles. The participants in the control group received 6 individually performed sham TENS treatment sessions.
The primary outcome is the intensity of headache. The secondary outcomes are changes in frequency and duration of headache, neck muscle strength, neck and shoulder flexibility, impact of headache on daily life, neck disability, fear-avoidance beliefs, work ability, and quality of life. Between-group differences will be analyzed separately at 6, 12, and 24 months with generalized linear mixed models. In the case of count data (eg, frequency of headache), Poisson or negative binomial regression will be used.
The therapists are not blinded.
The effects of specific therapeutic exercises on frequency, intensity, and duration of chronic headache and migraine will be reported.
颈源性头痛和偏头痛是患者就诊于医生和物理治疗师的常见原因。此前很少有关于积极物理治疗和渐进性治疗性锻炼的随机试验发表。现有关于积极治疗方法的证据支持其对颈源性头痛有中度疗效。
本研究旨在调查与接受假剂量经皮电刺激神经疗法（TENS）和伸展运动的对照组相比，基于小组的渐进性治疗性锻炼计划是否能降低女性慢性头痛的强度和频率。
开展一项为期6个月干预和随访的随机对照试验。参与者被随机分配到治疗组或对照组。
该研究在2个研究中心进行。
参与者为年龄在18至60岁之间患有慢性颈源性头痛或偏头痛的女性。
治疗组的锻炼计划包括6个渐进性治疗性锻炼模块，包括本体感觉低负荷渐进性颅颈和颈部锻炼以及颈部肌肉的高负荷锻炼。对照组的参与者接受6次单独进行的假TENS治疗。
主要结局是头痛强度。次要结局包括头痛频率和持续时间的变化、颈部肌肉力量、颈部和肩部灵活性、头痛对日常生活的影响、颈部功能障碍、恐惧回避信念、工作能力和生活质量。组间差异将在6个月、12个月和24个月时分别使用广义线性混合模型进行分析。对于计数数据（如头痛频率），将使用泊松或负二项回归。
治疗师未设盲。
将报告特定治疗性锻炼对慢性头痛和偏头痛的频率、强度和持续时间的影响。
