Mingels Sarah, Granitzer Marita
Faculty Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
Faculty Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
J Manipulative Physiol Ther. 2018 Jul-Aug;41(6):488-495. doi: 10.1016/j.jmpt.2017.11.005. Epub 2018 Aug 16.
The purpose of this study was to compare pericranial tenderness of females with episodic cervical headache vs matched asymptomatic controls.
Through a single-blind, cross-sectional study, pericranial tenderness was compared between 20 females with episodic cervical headaches (29.4 ± 13.2 years) and 20 age-matched female asymptomatic controls (30.1 ± 13.7 years). Pericranial tenderness was bilaterally measured in a headache-free period with the "total tenderness score" (TTS) in the suboccipital, temporal, frontal, masseter, upper trapezius (UT), levator scapula, and sternocleidomastoid (SCM) muscle insertions. Passive cervical mobility, headache intensity, frequency, and duration were secondary outcomes. Analysis was done with a 95% confidence level (SPSS version 22). The Mann-Whitney U-test was used to compare pericranial, cephalic, cervical, and muscle-specific tenderness between groups. Correlations between passive cervical mobility and headache characteristics and the TTS were estimated with Spearman's ρ.
The headache group (1.25 ± 0.89) showed a 2 times higher (P < .05) pericranial TTS compared to the control group (0.62 ± 0.70). Higher (P < .05) scores were observed for the left suboccipital, temporal, masseter, UT, levator scapula, and SCM muscles and the right suboccipital, frontal, UT, and levator scapula muscles. Grouping the tenderness scores into cervical (suboccipital, UT, levator scapula, SCM) and cephalic (frontal, temporal, masseter) regions revealed greater scores (P < .05) in the headache group. In the latter, the TTS was significantly positively correlated with passive cervical extension (ρ = 0.78).
Consistent higher tenderness scores were observed and suggest involvement of sensitization in patients with episodic cervical headaches. A positive correlation was seen between passive cervical extension and sensitivity.
本研究旨在比较发作性颈源性头痛女性患者与匹配的无症状对照者的颅周压痛情况。
通过一项单盲横断面研究，比较了20例发作性颈源性头痛女性患者（29.4±13.2岁）和20例年龄匹配的无症状女性对照者（30.1±13.7岁）的颅周压痛情况。在无头痛期双侧测量颅周压痛，采用“总压痛评分”（TTS）评估枕下、颞部、额部、咬肌、上斜方肌（UT）、肩胛提肌和胸锁乳突肌（SCM）肌肉附着点处的压痛。被动颈椎活动度、头痛强度、频率和持续时间为次要观察指标。分析采用95%置信水平（SPSS 22版）。采用曼-惠特尼U检验比较两组间的颅周、头部、颈部和特定肌肉压痛情况。用斯皮尔曼ρ系数估计被动颈椎活动度与头痛特征及TTS之间的相关性。
头痛组（1.25±0.89）的颅周TTS比对照组（0.62±0.70）高2倍（P<.05）。左侧枕下、颞部、咬肌、UT、肩胛提肌和SCM肌肉以及右侧枕下、额部、UT和肩胛提肌出现更高（P<.05）的评分。将压痛评分分为颈部（枕下、UT、肩胛提肌、SCM）和头部（额部、颞部、咬肌）区域，头痛组的评分更高（P<.05）。在后者中，TTS与被动颈椎伸展显著正相关（ρ=0.78）。
观察到头痛组压痛评分持续较高，提示发作性颈源性头痛患者存在致敏现象。被动颈椎伸展与敏感性之间呈正相关。
