紧张型头痛女孩的特定力量训练与跨学科咨询比较：一项随机对照试验
Specific strength training compared with interdisciplinary counseling for girls with tension-type headache: a randomized controlled trial.
作者信息
Tornøe Birte, Andersen Lars L, Skotte Jørgen H, Jensen Rigmor, Jensen Claus, Madsen Bjarne K, Gard Gunvor, Skov Liselotte, Hallström Inger
机构信息
Department of Health Sciences, Lund University, Lund, Sweden; Department of Pediatrics E, Children's Headache Clinic, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark; Department of Physiotherapy and Occupational Therapy, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark; Department of Physiotherapy, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark.
National Research Centre for the Working Environment, Copenhagen, Denmark; Physical Activity and Human Performance group, SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
出版信息
J Pain Res. 2016 May 4;9:257-70. doi: 10.2147/JPR.S97826. eCollection 2016.
BACKGROUND
Childhood tension-type headache (TTH) is a prevalent and debilitating condition for the child and family. Low-cost nonpharmacological treatments are usually the first choice of professionals and parents. This study examined the outcomes of specific strength training for girls with TTH.
METHODS
Forty-nine girls aged 9-18 years with TTH were randomized to patient education programs with 10 weeks of strength training and compared with those who were counseled by a nurse and physical therapist. Primary outcomes were headache frequency, intensity, and duration; secondary outcomes were neck-shoulder muscle strength, aerobic power, and pericranial tenderness, measured at baseline, after 10 weeks intervention, and at 12 weeks follow-up. Health-related quality of life (HRQOL) questionnaires were assessed at baseline and after 24 months.
RESULTS
For both groups, headache frequency decreased significantly, P=0.001, as did duration, P=0.022, with no significant between-group differences. The odds of having headache on a random day decreased over the 22 weeks by 0.65 (0.50-0.84) (odds ratio [95% confidence interval]). For both groups, neck extension strength decreased significantly with a decrease in cervicothoracic extension/flexion ratio to 1.7, indicating a positive change in muscle balance. In the training group, shoulder strength increased $10% in 5/20 girls and predicted [Formula: see text] increased $15% for 4/20 girls. In the training group, 50% of girls with a headache reduction of $30% had an increase in [Formula: see text] >5%. For the counseling group, this was the case for 29%. A 24-month follow-up on HRQOL for the pooled sample revealed statistically significant improvements. Fifty-five percent of the girls reported little to none disability.
CONCLUSION
The results indicate that both physical health and HRQOL can be influenced significantly by physical exercise and nurse counseling. More research is needed to examine the relationship between physical exercise, [Formula: see text], and TTH in girls. Thus, empowering patient education to promote maximum possible outcomes for all children needs more attention.
背景
儿童紧张型头痛（TTH）是一种在儿童及其家庭中普遍存在且使人衰弱的疾病。低成本的非药物治疗通常是专业人员和家长的首选。本研究考察了针对患紧张型头痛女童的特定力量训练的效果。
方法
49名年龄在9至18岁的患紧张型头痛女童被随机分配到接受为期10周力量训练的患者教育项目组，并与接受护士和物理治疗师咨询的女童进行比较。主要结局指标为头痛频率、强度和持续时间；次要结局指标为颈肩肌肉力量、有氧能力和颅周压痛，在基线、10周干预后及12周随访时进行测量。在基线和24个月后评估健康相关生活质量（HRQOL）问卷。
结果
两组的头痛频率均显著降低，P = 0.001，持续时间也显著降低，P = 0.022，组间无显著差异。在22周内，随机某一天出现头痛的几率降低了0.65（0.50 - 0.84）（比值比[95%置信区间]）。两组的颈部伸展力量均显著下降，颈胸伸展/屈曲比值降至1.7，表明肌肉平衡有积极变化。在训练组中，5/20的女童肩部力量增加了10%，4/20的女童预测[公式：见原文]增加了15%。在训练组中，头痛减轻30%的女童中有50%的[公式：见原文]增加超过5%。在咨询组中，这一比例为29%。对合并样本进行的24个月HRQOL随访显示有统计学意义的改善。55%的女童报告几乎没有残疾。
结论
结果表明，体育锻炼和护士咨询均可显著影响身体健康和HRQOL。需要更多研究来考察体育锻炼、[公式：见原文]与女童紧张型头痛之间的关系。因此，加强患者教育以促进所有儿童尽可能获得最佳结局需要更多关注。
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