Manual therapy as a prophylactic treatment for migraine: design of a randomized controlled trial

Amons, Andreas Leonard; Castien, René; Wouden, Johannes C. van der; Hertogh, Willem De; Dekker, Joost; Horst, Henriëtte E. van der

doi:10.1186/s13063-019-3937-8

Cited by 4 publications

(3 citation statements)

References 42 publications

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“…The present study showed that the CST improved deep cervical flexor muscle activation by an average of 3.87 mmHg and this improvement was also clinically significant (Jørgensen et al, 2017). Likewise, previous studies demonstrated that exercise was effective in increasing deep cervical flexor muscle activation in patients with TTH and CGH (Amons et al, 2019;Côté et al, 2019;Varatharajan et al, 2016).…”

Section: Cervical Musculoskeletal Systemsupporting

confidence: 79%

Effects of cervical stabilization training in patients with headache: A single‐blinded randomized controlled trial

Altmis Kacar,

Ozkul,

Baran

et al. 2023

European Journal of Pain

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BackgroundThis study aimed to investigate the effects of Cervical Stabilization Training (CST) on the headache, neck pain and cervical musculoskeletal system in patients with headache compared to the control group.MethodsA total of 90 female patients with migraine, tension‐type headache and cervicogenic headache (CGH) participated in this study. The patients were divided into the cervical stabilization training group (CSTG) and the control group (CG). The CSTG performed the CST three times a week for 8 weeks while the CG continued their ongoing medical treatment. The pain intensity was assessed by Visual Analogue Scale, forward head posture by craniovertebral angle measurement, the endurance of deep cervical flexor muscles by craniocervical flexion test and the endurance of cervical muscles by flexor and extensor endurance tests before and after 8 weeks. In addition, disability levels, health‐related quality of life, sleep quality and mood were assessed by the Migraine Disability Assessment questionnaire, Neck Disability Index (NDI), Short Form 36 Quality of Life Scale, the Pittsburgh Sleep Quality Index and Beck Depression Scale, respectively.ResultsHeadache frequency, duration and intensity, neck pain intensity and forward head posture reduced while activation and performance of deep cervical flexor muscles, the endurance of cervical flexor and extensor muscles increased in the CSTG (p < 0.05). Furthermore, the disability levels, quality of life, sleep quality and mood also improved in the CSTG (p < 0.05).ConclusionsThis study suggests that CST reduces headaches and neck pain by improving the cervical musculoskeletal system in patients with headache.SignificanceThe CST improved the headache frequency, duration and intensity, neck pain intensity, cervical posture, activation of deep cervical flexor muscles and endurance of cervical muscles in patients with headache. In addition, improvements in the cervical musculoskeletal system contributed to a reduction in the intensity of headaches and neck pain. Therefore, CST may be preferred in the treatment of headaches, especially with coexisting neck pain.

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Section: Cervical Musculoskeletal Systemsupporting

confidence: 79%

Effects of cervical stabilization training in patients with headache: A single‐blinded randomized controlled trial

Altmis Kacar,

Ozkul,

Baran

et al. 2023

European Journal of Pain

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“…Further research is needed to determine if MPTs can be of value in treatment programs to reduce headache in patients with migraine. At least one trial is currently ongoing (34).…”

Section: Discussionmentioning

confidence: 99%

Modulation of central nociceptive transmission by manual pressure techniques in patients with migraine: an observational study

Hertogh

Amons

daele

et al. 2022

Preprint

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Background Manual pressure techniques are used in the upper cervical spine to provoke and reduce the familiar headache in patients with migraine. So far, information is scarce on which segmental levels and myofascial structures provocation and reduction occur. Also, the required dosage (amount of pressure, number of repetitions and duration) has not been objectified yet. Therefore, we assessed the controlled application of manual pressure to provoke and reduce headache in patients with migraine. Methods Thirty patients with migraine were examined interictally. Manual pressure was applied at four sites being the posterior arch of C1, the articular pillar of C2, the Rectus Capitis Posterior Major muscle and the Obliquus Capitis Inferior muscle, bilaterally. Pressure was constantly measured via force sensors. On sites where the familiar headache was provoked, the pressure was sustained to induce pain reduction. This was repeated three times. Provocation of familiar headache (yes/no), headache intensity (numerical pain rating scale), time to obtain reduction of the headache (seconds) and applied pressure (g/cm²) were recorded. Results Provocation of the familiar headache occurred on at least one of the posterior arches in 92 % of cases, one of the articular pillars of C2 in 65.3%, one of the Rectus Capitus Major muscles in 84.6% and one of the Oblique Capitis Inferior muscles in 76.9%. The applied mean pressure ranged from 0.82 kg/cm² to 1.2 kg/cm2 across all measurements. Maintaining the pressure resulted in a significant reduction in headache pain intensity between the start and the end of each of three consecutive trials (p<0.04). This reduction was obtained more rapidly in the third application than in the first application (p=0.03).Conclusion Manual pressure at the upper cervical segments provokes familiar referred headache in migraine, with a low pressure. Maintaining the pressure reduces the referred head pain significantly, indicating modulation of central nociceptive transmission. The underlying neurophysiological mechanisms need to be further elucidated.

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“…Further research is needed to determine if MPTs can be of value in treatment programs to reduce headaches in patients with migraine. At least one trial is currently ongoing [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Modulation of Central Nociceptive Transmission by Manual Pressure Techniques in Patients with Migraine: An Observational Study

Hertogh

Amons

daele

et al. 2022

JCM

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Background: Manual pressure in the upper cervical spine is used to provoke and reduce the familiar migraine headache. Information is scarce on the segmental levels, myofascial structure provocation, and reduction occurrences. The required dosage (amount of pressure, number of repetitions, and duration) has not been objectified yet. Methods: Prospective observational study. Thirty patients with migraine were examined interictally. Manual pressure was applied at four sites: the posterior arch of C1, the articular pillar of C2, the rectus capitis posterior major muscle, and the obliquus capitis inferior muscle, bilaterally. On sites where the familiar headache was provoked, the pressure was sustained to induce pain reduction (three repetitions). Provocation of familiar headache (yes/no), headache intensity (numerical pain rating scale), time to obtain a reduction of the headache (seconds), and applied pressure (g/cm2) were recorded. Results: Provocation of the familiar headache occurred at the posterior arches C1 in 92%, and at one of the articular pillars of C2 in 65.3% of cases. At one of the rectus capitis major muscles, the familiar headache was provoked in 84.6% of cases; at one of the oblique capitis inferior muscles, the familiar headache was provoked in 76.9% of cases. The applied mean pressure ranged from 0.82 to 1.2 kg/cm2. Maintaining the pressure reduced headache pain intensity significantly between the start and end of each of the three consecutive trials (p < 0.04). This reduction occurred faster in the third application than in the first application (p = 0.03). Conclusion: Manual pressure at upper cervical segments provokes familiar referred migraine headaches, with low manual pressure. Maintaining the pressure reduces the referred head pain significantly, indicating modulation of central nociceptive transmission.

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Manual therapy as a prophylactic treatment for migraine: design of a randomized controlled trial

Cited by 4 publications

References 42 publications

Effects of cervical stabilization training in patients with headache: A single‐blinded randomized controlled trial

Effects of cervical stabilization training in patients with headache: A single‐blinded randomized controlled trial

Modulation of central nociceptive transmission by manual pressure techniques in patients with migraine: an observational study

Modulation of Central Nociceptive Transmission by Manual Pressure Techniques in Patients with Migraine: An Observational Study

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