Onan Dilara, Arıkan Halime, Ekizoğlu Esme, Taşdelen Bahar, Özge Aynur, Martelletti Paolo
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Yozgat Bozok University, 66100 Yozgat, Türkiye.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tokat Gaziosmanpasa University, 60000 Tokat, Türkiye.
J Oral Facial Pain Headache. 2025 Mar;39(1):34-48. doi: 10.22514/jofph.2025.003. Epub 2025 Mar 12.
Although pharmacologic therapies are considered the first choice for the treatment of chronic tension-type headache (CTTH), physiotherapy and rehabilitation approaches are also used in the management of patients with CTTH. This study aimed to investigate the efficacy of physiotherapy approaches in CTTH through a systematic review and meta-analysis.
The following electronic databases were searched, PubMed and Web of Science databases. Common primary outcomes from randomized controlled trials (RCTs) were changes in the intensity and duration of headaches, headache frequency, disability and headache impact. The methodologic quality (completeness of reporting and risk of bias) of trial reports included in systematic reviews was assessed using the Physiotherapy Evidence Database scale ratings. We also performed data synthesis and quantitative analysis of the eligible data.
Nine RCTs were included in the review. Seven studies related to intensity of headache (IH), three on headache frequency (HF), three on headache duration (HD), and two on headache impact were eligible for quantitative analysis. Analysis of the data showed that neck-shoulder strength exercises, electroacupuncture, and approaches targeting muscle relaxation improved the IH (-1.17 (-1.86, -0.49) < 0.01) and reduced the HD (-0.71 (-1.31, -0.12), = 0.02); the approaches targeting muscle relaxation and neck-shoulder strength exercises induced a significant decrease in the HF (-1.36 (-2.47, -0.26), = 0.02) in patients with CTTH in comparison with the control groups.
Neck-shoulder strength exercises and muscle relaxation are effective in reducing the intensity, duration, and frequency of headaches and electroacupuncture causes significant improvement in the duration and intensity of headaches in patients with CTTH.
PROSPERO number is CRD42023457085.
尽管药物治疗被认为是慢性紧张型头痛（CTTH）治疗的首选，但物理治疗和康复方法也用于CTTH患者的管理。本研究旨在通过系统评价和荟萃分析来研究物理治疗方法在CTTH中的疗效。
检索了以下电子数据库，即PubMed和Web of Science数据库。随机对照试验（RCT）的常见主要结局是头痛强度和持续时间的变化、头痛频率、残疾情况和头痛影响。使用物理治疗证据数据库量表评分评估系统评价中纳入的试验报告的方法学质量（报告完整性和偏倚风险）。我们还对符合条件的数据进行了数据合成和定量分析。
该评价纳入了9项RCT。7项研究与头痛强度（IH）相关，3项关于头痛频率（HF），3项关于头痛持续时间（HD），2项关于头痛影响的研究符合定量分析条件。数据分析表明，颈肩力量锻炼、电针以及针对肌肉放松的方法改善了IH（-1.17（-1.86，-0.49），<0.01）并缩短了HD（-0.71（-1.31，-0.12），=0.02）；与对照组相比，针对肌肉放松和颈肩力量锻炼的方法使CTTH患者的HF显著降低（-1.36（-2.47，-0.26），=0.02）。
颈肩力量锻炼和肌肉放松在降低头痛强度、持续时间和频率方面有效，电针可使CTTH患者的头痛持续时间和强度得到显著改善。
PROSPERO注册号：PROSPERO编号为CRD42023457085。
