Minen Mia T, Whetten Christopher, Messier Danielle, Mehta Sheena, Williamson Anne, Verhaak Allison, Grosberg Brian
Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA.
Hartford HealthCare Headache Center, West Hartford, Connecticut, USA.
Headache. 2025 Jan;65(1):90-100. doi: 10.1111/head.14801. Epub 2024 Sep 4.
The objective of this pilot study was to assess physical therapists' (PTs) knowledge and needs regarding headache diagnosis and management.
While there is significant research on physical therapy and cervicogenic headache, studies suggest that migraine is often under-recognized, misdiagnosed, and inadequately treated across society despite its high prevalence and burden. Because migraine commonly includes concurrent neck pain and/or vestibular symptoms, patients with migraine may present to PTs for treatment. Very little is known about PTs' headache and migraine education, knowledge, and clinical practices.
A team of headache specialists and PTs adapted a previously used headache knowledge and needs assessment survey to help ascertain PTs' knowledge and needs regarding headache treatment. The cross-sectional survey was distributed online via Research Electronic Data Capture (REDCap) to PTs within a large healthcare system in Connecticut.
An estimated 50.5% (101/200) of PTs invited to complete the survey did so. Only 37.6% (38/101) of respondents reported receiving any formal headache or migraine education in their professional training, leading to knowledge gaps in differentiating and responding to headache subtypes. Only 45.5% (46/101) were able to identify that migraine is characterized by greater pain intensity than tension-type headache, and 22.8% (23/101) reported not knowing the duration of untreated migraine. When asked about the aspects of care they believe their patients with headache would like to see improved, PTs reported education around prevention and appropriate medication use (61/100 [61.0%]), provider awareness of the degree of disability associated with migraine (51/100 [51.0%]), and diagnostics (47/100 [47.0%]).
This sample of PTs from one healthcare system demonstrates knowledge gaps and variations in clinical practice for managing their patients with headache. Future research on integrating additional opportunities for headache education for physical therapists, including evidence-based behavioral therapies, is needed to ascertain whether it is likely to improve patient care.
本初步研究的目的是评估物理治疗师（PT）在头痛诊断和管理方面的知识与需求。
虽然有大量关于物理治疗和颈源性头痛的研究，但研究表明，尽管偏头痛患病率高且负担重，但在整个社会中，偏头痛常常未得到充分认识、误诊和治疗。由于偏头痛通常伴有颈部疼痛和/或前庭症状，偏头痛患者可能会寻求物理治疗师进行治疗。对于物理治疗师的头痛和偏头痛教育、知识及临床实践，人们了解甚少。
一个由头痛专家和物理治疗师组成的团队改编了之前使用的头痛知识与需求评估调查问卷，以帮助确定物理治疗师在头痛治疗方面的知识与需求。该横断面调查通过研究电子数据采集（REDCap）在线分发给康涅狄格州一个大型医疗系统内的物理治疗师。
受邀完成调查的物理治疗师中，估计有50.5%（101/200）完成了调查。只有37.6%（38/101）的受访者报告在其专业培训中接受过任何正式的头痛或偏头痛教育，这导致在区分和应对头痛亚型方面存在知识差距。只有45.5%（46/101）的人能够识别偏头痛的疼痛强度大于紧张型头痛，22.8%（23/101）的人报告不知道未经治疗的偏头痛持续时间。当被问及他们认为头痛患者希望改善的护理方面时，物理治疗师报告了预防和适当用药方面的教育（61/100 [61.0%]）、医疗服务提供者对偏头痛相关残疾程度的认识（51/100 [51.0%]）以及诊断（47/100 [47.0%]）。
来自一个医疗系统的该物理治疗师样本表明，在管理头痛患者方面存在知识差距和临床实践差异。未来需要开展研究，为物理治疗师整合更多头痛教育机会，包括循证行为疗法，以确定这是否可能改善患者护理。
