慢性原发性头痛患者比无症状和发作性原发性头痛患者有更严重的头部前倾姿势：系统评价和荟萃分析。

Chronic Primary Headache Subjects Have Greater Forward Head Posture than Asymptomatic and Episodic Primary Headache Sufferers: Systematic Review and Meta-analysis.

作者信息

Elizagaray-Garcia Ignacio, Beltran-Alacreu Hector, Angulo-Díaz Santiago, Garrigós-Pedrón Miriam, Gil-Martínez Alfonso

机构信息

Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.

CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.

出版信息

Pain Med. 2020 Oct 1;21(10):2465-2480. doi: 10.1093/pm/pnaa235.

DOI:10.1093/pm/pnaa235

PMID:33118601

Abstract

OBJECTIVE

To summarize the cervical physical examination characteristics in subjects with chronic primary headache and compare those with a healthy population and a population with episodic primary headache.

DESIGN

Systematic review and meta-analysis.

SUBJECTS

Humans ≥18 years old. At least one of the study groups should be constituted by subjects diagnosed with one of the chronic primary headache subtypes according to the International Classification of Headache Disorders, 3rd Edition.

COMPARISON

Neck physical examination outcomes of subjects with chronic primary headache compared with a healthy population or subjects with episodic primary headache.

OUTCOMES

Forward head posture (FHP), cervical range of movement, motor control, neck muscle activity, and reproduction and resolution of symptoms.

METHODS

Two reviewers assessed independently the MEDLINE, EMBASE, WOS, MEDES, PEDro, and CINAHL databases to select observational studies. First, both implemented an agreement for a search strategy. Then, they screened independently for duplicates, titles, abstracts, and full-text information. A meta-analysis was conducted to compare measures between groups.

RESULTS

Twelve studies (N = 1,083) with moderate quality (mean ± SD = 7.75 ± 1.48 on the Newcastle Ottawa Scale) were selected for the qualitative analysis. The meta-analysis showed that patients with chronic primary headache presented greater forward head posture than asymptomatic participants (N = 275, Hg = 0.68, 95% CI = 0.25-1.1, Z = 3.14, P < 0.01) and patients with episodic primary headache (N = 268, Hg = 0.39, 95% CI = 0.13-0.65, Z = 2.98, P < 0.01).

CONCLUSIONS

There is moderate to strong evidence that patients with chronic primary headache present greater FHP than asymptomatic individuals and moderate evidence that patients with chronic primary headache present greater forward head posture than those with episodic primary headache.

摘要

目的

总结慢性原发性头痛患者的颈部体格检查特征，并与健康人群和发作性原发性头痛人群进行比较。

设计

系统评价和荟萃分析。

研究对象

年龄≥18岁的人群。至少有一个研究组应由根据《国际头痛疾病分类》第3版诊断为慢性原发性头痛亚型之一的患者组成。

比较

慢性原发性头痛患者与健康人群或发作性原发性头痛患者的颈部体格检查结果。

观察指标

头部前倾姿势（FHP）、颈部活动范围、运动控制、颈部肌肉活动以及症状再现和缓解情况。

方法

两名研究者独立评估MEDLINE、EMBASE、WOS、MEDES、PEDro和CINAHL数据库，以筛选观察性研究。首先，两人就检索策略达成一致。然后，他们独立筛选重复项、标题、摘要和全文信息。进行荟萃分析以比较组间测量值。

结果

选择了12项质量中等（纽卡斯尔渥太华量表平均±标准差=7.75±1.48）的研究（N = 1,083）进行定性分析。荟萃分析表明，慢性原发性头痛患者的头部前倾姿势比无症状参与者更明显（N = 275，Hg = 0.68，95%CI = 0.25 - 1.1，Z = 3.14，P < 0.01），且比发作性原发性头痛患者更明显（N = 268，Hg = 0.39，95%CI = 0.13 - 0.65，Z = 2.98，P < 0.01）。