The Addition of Diacutaneous Fibrolysis to a Pharmacological Intervention in Patients with Tension-Type Headache: A Randomized Controlled Trial

Abstract

Background: Tension-type headache (TTH) is the most common headache worldwide. Pharmacological interventions are the most investigated therapies in patients with TTH. The addition of physical therapy treatments such as diacutaneous fibrolysis (DF) may have promising results. The aim of this study was to investigate the addition of three sessions of DF to a pharmacological intervention in patients with TTH. Methods: A single-blinded randomized controlled trial was carried out. Participants were randomly assigned to the standard care group or to the DF group. Both groups received a pharmacological intervention. Three sessions of DF in the thoracic and cervicocranial region were added in the DF group. The impact caused by headache (HIT-6), headache intensity, and cervical range of motion were measured by blinded assessors at baseline, after the intervention, and at 1 month follow-up. Results: Eighty-two patients with TTH were included (41 standard care group; 41 DF group). Statistically significant differences were found between both groups in all the variables after the intervention and at 1 month follow-up (p < 0.001). No adverse effects or side-effects were reported during the study. Conclusions: The addition of three sessions of DF to a pharmacological therapy provided improvements in the impact caused by headache, headache intensity, and cervical range of motion after the intervention and at 1 month follow-up compared to a pharmacological therapy in isolation. Further research is needed to investigate long-term effects.

Diacutaneous Fibrolysis: An Update on Research into Musculoskeletal and Neural Clinical Entities

“…The active cervical range of motion in the three planes ameliorated more in the DF group compared with the standard care group at the end of the treatment and at the one-month follow-up. The intensity of pain perceived at the moment of the assessment ameliorated more in the DF group but only after treatment and not at follow-up [42]. The worst and the usual intensity of pain ameliorated more in the DF group at the one-month follow-up (after treatment they were not assessed) [43].…”

“…The worst and the usual intensity of pain ameliorated more in the DF group at the one-month follow-up (after treatment they were not assessed) [43]. A higher percentage of subjects said that they felt better in the DF group compared with the standard care group at the end of the treatment and at the one-month follow-up [42,43]. The main limitation of this study was a follow-up period of only one month in a pathology that might be chronic.…”

Osteopathie und evidenzbasierte Medizin, Teil 1: die EBM

“…Nach dem GRADE-Verfahren können wir den Grad der Evidenz bestimmen und in mehrere Levels einteilen. Aber auch systematische Übersichtsarbeiten können einem Bias unterliegen 21 . Daher ist es wichtig, alle Studien zum entsprechenden Thema zu untersuchen und kritisch zu würdigen 22 .…”

Osteopathie und evidenzbasierte Medizin, Teil 3: Bedeutung der EBM für die Osteopathie

“…Das Nichtveröffentlichen von osteopathischen Studien führt wiederholt zu einem Mangel an Informationen und zu oftmals schlechteren Bewertungen in systematischen Reviews und in GRADE. Als Beispiel möchte ich auf das systematische Review zur Wirksamkeit der Osteopathie bei Dreimonatskoliken von Cabanillas-Barea et al verweisen 10 und diesem den Kommentar von Franke und Prediger gegenüberstellen. Diese kommen zu einer besseren Bewertung der Wirksamkeit der Kinderosteopathie bei Dreimonatskoliken, insbesondere, weil sie auch bisher nicht veröffentlichte osteopathische Studien mit herangezogen haben 11 .…”