慢性偏头痛与慢性紧张型头痛患者肌肉骨骼功能障碍和姿势改变的差异:一项横断面研究。
Differences in musculoskeletal dysfunctions and in postural alterations between chronic migraine and chronic tension type headache: A cross-sectional study.
机构信息
Department of Life Sciences, University of Trieste, Adress: via Pascoli 31, 34100, Trieste, Italy; Department of Medical, Surgical and Health Sciences, University of Trieste, Adress: via Pascoli 31, 34100, Trieste, Italy; Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy.
Department of Medical, Surgical and Health Sciences, University of Trieste, Adress: via Pascoli 31, 34100, Trieste, Italy; Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy.
出版信息
J Bodyw Mov Ther. 2024 Jan;37:404-411. doi: 10.1016/j.jbmt.2023.11.011. Epub 2023 Nov 17.
OBJECTIVE
The aim of present study is to assess postural alterations and musculoskeletal dysfunctions over all spine in patients with chronic migraine and chronic tension type headache, moreover to highlight the differences between these two forms of primary headache.
METHODS
A Cross sectional study was adopted to evaluate the musculoskeletal profile in patients with chronic migraine and with chronic tension type headache. The Bio photogrammetric evaluation was performed using the postural assessment software PAS/SAPO, while unilateral passive accessory intervertebral motion (PAIM) were applied for manual examinations of spine segments from C0 to L5 vertebra. The One-way Analysis of Variance (ANOVA) test was used to compare the three groups with the software GraphPad InStat 3.06.
RESULTS
A total of 60 patients were recruited, 20 for chronic tension type group, 20 for chronic migraine group and 20 healthy controls. The most interesting findings was that patients with chronic primary headaches presented postural alterations in all parameters (cranio-vertebral angle and lumbar-pelvic angle) and musculoskeletal dysfunctions in all spine with respect to healthy controls. Finally, the most clinically relevant finding was that no differences were found between chronic migraine and chronic tension type headache concerning the postural alterations nor the musculoskeletal dysfunctions.
CONCLUSION
The sensitization acts as a substrate or consequence of these musculoskeletal dysfunctions in chronic primary headache. Therefore, non-pharmacological treatments targeted in the musculoskeletal system may be a good option in the management of chronic primary headache, especially when these therapies integrate various techniques that involve all spine.
目的
本研究旨在评估慢性偏头痛和慢性紧张型头痛患者整个脊柱的姿势改变和肌肉骨骼功能障碍,并强调这两种原发性头痛之间的差异。
方法
采用横断面研究评估慢性偏头痛和慢性紧张型头痛患者的肌肉骨骼状况。使用姿势评估软件 PAS/SAPO 进行生物光测评估,同时对 C0 至 L5 椎体的脊柱节段进行单侧被动辅助椎间运动(PAIM)的手动检查。使用 GraphPad InStat 3.06 软件的单因素方差分析(ANOVA)检验比较三组。
结果
共招募了 60 名患者,20 名慢性紧张型头痛组,20 名慢性偏头痛组,20 名健康对照组。最有趣的发现是,慢性原发性头痛患者在所有参数(颅-脊柱角和腰椎-骨盆角)和整个脊柱的肌肉骨骼功能障碍方面都存在姿势改变,与健康对照组相比。最后,最具临床意义的发现是,慢性偏头痛和慢性紧张型头痛在姿势改变或肌肉骨骼功能障碍方面没有差异。
结论
敏化作用是慢性原发性头痛中这些肌肉骨骼功能障碍的基础或结果。因此,针对肌肉骨骼系统的非药物治疗可能是慢性原发性头痛治疗的一个不错选择,尤其是当这些治疗整合了涉及整个脊柱的各种技术时。