The diagnostic accuracy of headache measurement instruments: A systematic review and meta-analysis focusing on headaches associated with musculoskeletal symptoms

Meer, Hedwig A. van der; Visscher, Corine M.; Vredeveld, Tom; Sanden, Maria W. G. Nijhuis-van der; Engelbert, Raoul; Speksnijder, Caroline M.

doi:10.1177/0333102419840777

Cited by 15 publications

(10 citation statements)

References 73 publications

(365 reference statements)

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“…An international Delphi study found that physiotherapists evaluate several musculoskeletal impairments of the cervical spine related to joint-biased interventions, e.g., manual joint palpation, cervical flexion-rotation test, cervical range of motion, passive physiological intervertebral movements, reproduction/resolution of headache symptoms and combined movement tests [27]. A recent meta-analysis concluded that the cervical flexion-rotation test has a pooled sensitivity of 0.83 (95%CI 0.72-0.94) and specificity of 0.82 (95%CI 0.73-0.91) for the assessment of patients with CeH [28]. In addition, the high prevalence of neck pain in primary headaches, such as TTH and migraine [29], may also benefit from joint-biased interventions.…”

Section: Scientific Evidence Of Joint-biased Interventions For Headachesmentioning

confidence: 99%

Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review

Fernández‐de‐las‐Peñas

Plaza-Manzano

Arias-Buría

2020

IJERPH

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Headache is the clinical syndrome most commonly observed by neurologists in daily practice. Pharmacological and non-pharmacological treatments are commonly used for the management of headaches; however, the clinical reasoning behind these interventions is not properly applied. We conducted a narrative literature review using as data sources for academic PubMed, MEDLINE, EMBASE, AMED, CINAHL, EBSCO, PEDro, Cochrane Database of Systematic Reviews, Cochrane Collaboration Trials Register, and SCOPUS. This narrative literature review mainly considered systematic reviews, meta-analyses, randomised clinical trials, and expert opinions published after the year 2000 discussing clinical reasoning for application of non-pharmacological interventions in individuals with tension-type, migraine, and cervicogenic headaches. After the data extraction, we organized the literature thematically as follows: (1) mapping of theoretical aspects of non-pharmacological interventions; (2) summarizing most updated literature about effectiveness of non-pharmacological interventions grouped by targeted tissue and headache; (3) identifying research gaps in the existing literature and proposing hypotheses for better understanding of current clinical reasoning. We found that there are many non-pharmacological treatment strategies used for headaches, including beyond the tissue-based impairment treatments (bottom-up) and strategies targeting the central nervous system (top down). Bottom-up strategies include joint-biased, soft-tissue biased, or needling interventions, whereas top-down strategies include exercise and cognitive interventions. Evidence shows that the effectiveness of these interventions depends on the application of proper clinical reasoning, since not all strategies are effective for all headaches. For instance, evidence of non-pharmacological interventions is more controversial for migraines than for tension-type or cervicogenic headaches, since migraine pathogenesis involves activation of sub-cortical structures and the trigemino- vascular system, whereas pathogenesis of tension-type or cervicogenic headaches is most associated to musculoskeletal impairments of the cervical spine. We conclude that current literature suggests that not all non-pharmacological interventions are effective for all headaches, and that multimodal, not isolated, approaches seem to be more effective for patients with headaches. Most published studies have reported small clinical effects in the short term. This narrative literature review provides some hypotheses for discrepancies in the available literature and future research. Clinical reasoning should be applied to better understand the effects of non-pharmacological interventions.

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Section: Scientific Evidence Of Joint-biased Interventions For Headachesmentioning

confidence: 99%

Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review

Fernández‐de‐las‐Peñas

Plaza-Manzano

Arias-Buría

2020

IJERPH

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“…Results of the search and the process of screening and selecting studies for inclusion in the review will be presented in a flow diagram described by PRISMA-P guidelines 27 28…”

Section: Methodsmentioning

confidence: 99%

“…Two systematic reviews24 25 have attempted to assess the usefulness of physical examination and manual examination, respectively, for the differential diagnosis of CGH, and a further systematic review26 was directed at elucidating which examination tests can be useful to detect musculoskeletal impairment in migraine sufferers. In addition, another systematic review27 assessed diagnostic accuracy of headache measurement instruments. Although for migraine all of these tools were questionnaires, and the diagnostic accuracy of only one physical test was evaluated for CGH.…”

Section: Introductionmentioning

confidence: 99%

Can physical testing be used to distinguish between migraine and cervicogenic headache sufferers? A protocol for a systematic review

et al. 2019

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IntroductionDifferential diagnosis of migraine and cervicogenic headache (CGH) can be challenging given the large overlap of symptoms, commonly leading to misdiagnosis and ineffective treatment. In order to strengthen the differential diagnosis of headache, previous studies have evaluated the utility of physical tests to examine for musculoskeletal impairment, mainly in the cervical spine, which could be provoking or triggering headache. However, no systematic review has attempted to evaluate whether physical tests can differentiate CGH from migraine or both conditions from asymptomatic subjects.Methods/analysisA systematic review protocol has been designed and is reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). A sensitive topic-based search strategy is planned which will include databases, hand searching of key journals and consultation of relevant leading authors in this field. Terms and keywords will be selected after discussion and agreement. Two independent reviewers will perform the search and select studies according to inclusion and exclusion criteria, including any cohort or observational studies evaluating the topic of this review; a third reviewer will confirm accuracy. A narrative synthesis will be developed for all included studies and, if possible, a meta-analysis will be conducted. The overall quality of the evidence will be assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist for diagnostic accuracy studies and the Downs and Black scale for those studies where the QUADAS-2 checklist cannot be applied.Ethics and disseminationEthical approval is not required since no patient information will be collected. The results will provide a deeper understanding about the possibility of using physical tests to differentiate cervicogenic headache from migraine and from asymptomatic subjects, which has direct relevance for clinicians managing people with headache. The results will be published in a peer-reviewed journal and presented at scientific conferences.PROSPERO registration numberCRD42019135269.

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“…Content: The questions of the HSQ cover the following subjects: frequency of headaches, frequency of headache attacks, days with headaches, the timespan of the headache crisis, characteristic of the headache (pulsating, tight, burning, one or both sides of the head), the severity of the headaches, activities that worse the headache and avoidance of activities due to headache [54,55].…”

Section: Headache Screening Questionnaire (Hsq)mentioning

confidence: 99%

“…How to obtain: The English version of the HSQ is available in the manuscripts previously published [54,55] (Figure 1).…”

Section: Practical Applicationmentioning

confidence: 99%

Patient-Reported Outcome Measurements in Temporomandibular Disorders and Headaches: Summary of Measurement Properties and Applicability

Aguiar

Carrer

Lira

et al. 2021

JCM

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Introduction: Several patient-reported outcome measurements (PROMs) are available in the literature to support the evaluation and diagnosis of temporomandibular disorders and headaches. However, clinicians and researchers usually complain that they had no education on PROMs and low overall knowledge about PROMs. Objective: This study aimed to summarize, describing the measurement properties and clinical applicability of the main condition-specific PROMs available in the literature to the assessment of patients with Temporomandibular Disorders and Headaches. Methods: The current manuscript reviewed 10 PROMs commonly used in the field. Four instruments about functioning and disability: 1. Mandibular Function Impairment Questionnaire (MFIQ), 2. Craniofacial Pain and Disability Inventory (CF-PDI), 3. 8-item and 20-item Jaw Functional Limitation Scale (JFLS), and 4. Manchester Orofacial Pain Disability Scale (MOPDS). Two instruments about headache-related disability: 5. Headache-Related Disability Index (HDI) and 6. Headache Impact Test-6 (HIT-6). Three instruments focused on TMD and headache screening: 7. 3Q/TMD, 8. Short-Form Anamnestic Fonseca Index (SFAI), 9. Headache Screening Questionnaire. In addition, one instrument about maladaptive beliefs regarding pain and injury: 10. Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD). Conclusions: The knowledge about the limitations and applicability of the PROMs commonly used to assess TMDs and Headaches can help clinicians and researchers to obtain reliable and valid outcomes to support the decision-making process. The current review recognizes the importance of using patient-reported outcome measures in research and clinical practice. However, our findings call the attention that further studies on the measurement properties of such instruments are imperative.

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The diagnostic accuracy of headache measurement instruments: A systematic review and meta-analysis focusing on headaches associated with musculoskeletal symptoms

Cited by 15 publications

References 73 publications

Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review

Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review

Can physical testing be used to distinguish between migraine and cervicogenic headache sufferers? A protocol for a systematic review

Patient-Reported Outcome Measurements in Temporomandibular Disorders and Headaches: Summary of Measurement Properties and Applicability

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