Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil.
Physiotherapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil.
Disabil Rehabil. 2022 May;44(10):1780-1789. doi: 10.1080/09638288.2020.1813817. Epub 2020 Sep 12.
To systematically review the evidence about the effectiveness of manual therapy (MT) on pain intensity, frequency and impact of headache in individuals with tension-type headache (TTH).
Medline, Embase, Scopus, Web of Science, CENTRAL, and PEDro were searched in June 2020. Randomized controlled trials that applied MT not associated with other interventions for TTH were selected. The level of evidence was synthesized using GRADE, and Standardized Mean Differences (SMD) were calculated for meta-analysis.
Fifteen studies were included with a total sample of 1131 individuals. High velocity and low amplitude techniques were not superior to no treatment on reducing pain intensity (SMD = 0.01, low evidence) and frequency (SMD = -0.27, moderate evidence). Soft tissue interventions were superior to no treatment on reducing pain intensity (SMD = -0.86, low evidence) and frequency of pain (SMD = -1.45, low evidence). Dry needling was superior to no treatment on reducing pain intensity (SMD = -5.16, moderate evidence) and frequency (SMD = -2.14, moderate evidence). Soft tissue interventions were not superior to no treatment and other treatments on the impact of headache.
Manual therapy may have positive effects on pain intensity and frequency, but more studies are necessary to strengthen the evidence of the effects of manual therapy on subjects with tension-type headache.Implications for rehabilitationSoft tissue interventions and dry needling can be used to improve pain intensity and frequency in patients with tension type headache.High velocity and low amplitude thrust manipulations were not effective for improving pain intensity and frequency in patients with tension type headache.Manual therapy was not effective for improving the impact of headache in patients with tension type headache.
系统回顾关于手法治疗（MT）对紧张型头痛（TTH）患者疼痛强度、频率和头痛影响的有效性的证据。
于 2020 年 6 月检索了 Medline、Embase、Scopus、Web of Science、CENTRAL 和 PEDro。选择了应用 MT 且不与其他干预措施联合治疗 TTH 的随机对照试验。使用 GRADE 对证据水平进行综合评估，并计算标准化均数差（SMD）进行荟萃分析。
共纳入 15 项研究，总计 1131 名患者。高速度低幅度技术在减轻疼痛强度（SMD=0.01，低证据）和频率（SMD=-0.27，中证据）方面并不优于不治疗。软组织干预在减轻疼痛强度（SMD=-0.86，低证据）和疼痛频率（SMD=-1.45，低证据）方面优于不治疗。干针疗法在减轻疼痛强度（SMD=-5.16，中证据）和频率（SMD=-2.14，中证据）方面优于不治疗。软组织干预在头痛影响方面并不优于不治疗和其他治疗。
手法治疗可能对疼痛强度和频率有积极影响，但需要更多的研究来加强手法治疗对紧张型头痛患者的疗效证据。
软组织干预和干针疗法可用于改善紧张型头痛患者的疼痛强度和频率。高速度低幅度推压手法治疗对改善紧张型头痛患者的疼痛强度和频率无效。手法治疗对改善紧张型头痛患者的头痛影响无效。
