Effects of Different Therapeutic Exercise Modalities on Migraine or Tension-Type Headache: A Systematic Review and Meta-Analysis with a Replicability Analysis

Varangot‐Reille, Clovis; Suso‐Martí, Luis; Romero-Palau, Mario; Suárez-Pastor, Pablo; Cuenca‐Martínez, Ferrán

doi:10.1016/j.jpain.2021.12.003

Cited by 39 publications

(38 citation statements)

References 82 publications

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“…In both cases, the evaluation by a physical therapist is recommended. On the other hand, a systematic review conducted in 2022 concluded that craniocervical exercises (involving the deep cervical musculature [ 49 ]) improve disability and quality of life in patients with primary headache, especially in patients with TTH [ 50 ]. In our systematic review we observed morphometric changes in patients with primary headache in comparison with healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

Are Morphometric Alterations of the Deep Neck Muscles Related to Primary Headache Disorders? A Systematic Review

Hermosa

Mesa-Jiménez

Manion

et al. 2023

Sensors

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This systematic review aims to summarise the evidence from studies that examined morphometric alterations of the deep neck muscles using diagnostic imaging (ultrasound imaging, magnetic resonance imaging, and computed tomography) in patients diagnosed with primary headache disorders (PHD). No previous reviews have focused on documenting morphometric changes in this population. We searched five databases (up to 12 November 2022) to identify the studies. The risk of bias (RoB) was assessed using the Quality in Prognostic Studies (QUIPS) tool and the overall quality of the evidence was assessed using The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. A total of 1246 studies were screened and five were finally included; most were at high RoB, and the overall level of confidence in results was very low. Only two studies showed a significant association between morphometric alterations of the deep neck muscles and PHD (p < 0.001); nevertheless, their RoB was high. Contradictory and mixed results were obtained. The overall evidence did not show a clear association between morphometric alterations of the deep neck muscles in patients diagnosed with PHD. However, due to the limited number of studies and low confidence in the evidence, it is necessary to carry out more studies, with higher methodological quality to better answer our question.

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Section: Discussionmentioning

confidence: 99%

Are Morphometric Alterations of the Deep Neck Muscles Related to Primary Headache Disorders? A Systematic Review

Hermosa

Mesa-Jiménez

Manion

et al. 2023

Sensors

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“…In cases of dropouts, lost participants can be disregarded or data imputed. Even in the face of this limitation, as the dropout number was below (11.9%) that stipulated in the literature (15%) [ 18 ], it was decided to exclude these patients from the analysis. We recognize that for primary outcomes the sample size calculation was based on previous studies and the expected differences of 3.3 for headache frequency and 1.5 for intensity were not achieved.…”

Section: Discussionmentioning

confidence: 99%

“…According to the current literature, strength exercises have a moderate clinical effect only in patients with tension-type headache. However, with a low quality of evidence [ 18 ]. Although pathophysiology has demonstrated a relationship between migraine and cervical spine in migraine patients [ 9 , 10 ], there is no evidence on the effectiveness of localized exercises, including CMSE.…”

Section: Introductionmentioning

confidence: 99%

Neck-specific strengthening exercise compared with placebo sham ultrasound in patients with migraine: a randomized controlled trial

et al. 2022

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Background Migraine patients have musculoskeletal disorders and pain in the cervical. And, despite the pathophysiology demonstrating the relationship between migraine and the cervical spine, the effectiveness of craniocervical exercises in these patients has not been verified. So, the aimed of this study was verify the effectiveness of craniocervical muscle-strengthening exercise (CMSE) in reducing the frequency and intensity of headache in migraine patients. Methods A two-armed, parallel-group randomized controlled trial with a 3-month follow-up was performed. For eight weeks, the volunteers in the intervention group (n = 21) performed a protocol of CMSE, while those in the sham ultrasound group (n = 21) received the application of disconnected therapeutic ultrasound in the upper trapezius and guideline for home-stretching. The primary outcomes were the frequency and intensity of the headache. The secondary outcomes were questionnaires about migraine and neck disability, and satisfaction with the treatment, cervical range of motion, the pressure pain threshold, craniocervical flexion test (CCFT), cervical muscle strength and endurance test, and the cervical muscle activity during the physical tests. Results No differences were observed for the changes observed in primary outcomes after eight weeks and at the 3-months follow up (p > 0.05). For the secondary outcomes, craniocervical exercises improved the sensitivity of the frontal muscle (p = 0.040) and promoted a reduced amplitude of muscle activity of the anterior scalene and upper trapezius in the last stages of CCFT (p ≤ 0.010). There was also reduced muscle activity of the anterior scalene and splenius capitis in the endurance test (p ≤ 0.045), as evaluated by surface electromyography. Conclusion CMSE were insufficient in reducing the frequency and intensity of headache, improving the performance of the cervical muscles, or reducing migraine and neck pain-related disabilities. This was found despite a decreased electromyographic activity of the cervical muscles during the last stages of CCFT and increased median frequency during the endurance test. Trial registration Accession code RBR-8gfv5j, registered 28/11/2016 in the Registro Brasileiro de Ensaios Clínicos (ReBEC).

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“…In this case, it was necessary to scale the results to achieve a uniform unit of measure (scale) before combining studies. We interpreted SMD based on previous studies (Varangot-Reille et al, 2022 ) (0–0.2, trivial; 0.2–0.6, small; 0.6–1.2, moderate; 1.2–2.0, large; 2.0–4.0, very large; >4.0, extremely large). The CI showed the degree to which the true value of this parameter has a certain probability to fall around the measurement result, and it gave credibility to the measured value of the measured parameter.…”

Section: Methodsmentioning

confidence: 99%

Is transcranial direct current stimulation beneficial for treating pain, depression, and anxiety symptoms in patients with chronic pain? A systematic review and meta-analysis

Wen

Shi

et al. 2022

Front. Mol. Neurosci.

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BackgroundChronic pain is often accompanied by emotional dysfunction. Transcranial direct current stimulation (tDCS) has been used for reducing pain, depressive and anxiety symptoms in chronic pain patients, but its therapeutic effect remains unknown.ObjectivesTo ascertain the treatment effect of tDCS on pain, depression, and anxiety symptoms of patients suffering from chronic pain, and potential factors that modulate the effectiveness of tDCS.MethodsLiterature search was performed on PubMed, Embase, Web of Science, and Cochrane Library from inception to July 2022. Randomized controlled trials that reported the effects of tDCS on pain and depression and anxiety symptoms in patients with chronic pain were included.ResultsTwenty-two studies were included in this review. Overall pooled results indicated that the use of tDCS can effectively alleviate short-term pain intensity [standard mean difference (SMD): −0.43, 95% confidence interval (CI): −0.75 to −0.12, P = 0.007] and depressive symptoms (SMD: −0.31, 95% CI, −0.47 to −0.14, P < 0.001), middle-term depressive symptoms (SMD: −0.35, 95% CI: −0.58 to −0.11, P = 0.004), long-term depressive symptoms (ES: −0.38, 95% CI: −0.64 to −0.13, P = 0.003) and anxiety symptoms (SMD: −0.26, 95% CI: −0.51 to −0.02, P = 0.03) compared with the control group.ConclusiontDCS may be an effective short-term treatment for the improvement of pain intensity and concomitant depression and anxiety symptoms in chronic pain patients. Stimulation site, stimulation frequency, and type of chronic pain were significant influence factors for the therapeutic effect of tDCS.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=297693, identifier: CRD42022297693.

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Effects of Different Therapeutic Exercise Modalities on Migraine or Tension-Type Headache: A Systematic Review and Meta-Analysis with a Replicability Analysis

Cited by 39 publications

References 82 publications

Are Morphometric Alterations of the Deep Neck Muscles Related to Primary Headache Disorders? A Systematic Review

Are Morphometric Alterations of the Deep Neck Muscles Related to Primary Headache Disorders? A Systematic Review

Neck-specific strengthening exercise compared with placebo sham ultrasound in patients with migraine: a randomized controlled trial

Is transcranial direct current stimulation beneficial for treating pain, depression, and anxiety symptoms in patients with chronic pain? A systematic review and meta-analysis

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