The effect of manual therapies on tension-type headache in patients who do not respond to drug therapy: a randomized clinical trial

Myofascial Release for the Treatment of Tension-Type, Cervicogenic Headache or Migraine: A Systematic Review and Meta-Analysis

“…The control group interventions included no intervention, placebo control, drug therapy, exercise, physiotherapy program, and SNAG technique + physiotherapy program. Among them, seven RCTs included pain outcome measures: four used VAS [ 24 , 25 , 30 , 33 ], and three used NRS [ 26 , 28 , 31 ]. In nine RCTs, disability outcomes were measured: six used NDI [ 25 , 26 , 28 , 30 , 31 , 33 ], three used HIT-6 [ 27 , 30 , 32 ], one used HDI [ 28 ], and one used MIDAS [ 27 ].…”

“…Among them, seven RCTs included pain outcome measures: four used VAS [ 24 , 25 , 30 , 33 ], and three used NRS [ 26 , 28 , 31 ]. In nine RCTs, disability outcomes were measured: six used NDI [ 25 , 26 , 28 , 30 , 31 , 33 ], three used HIT-6 [ 27 , 30 , 32 ], one used HDI [ 28 ], and one used MIDAS [ 27 ]. One RCT [ 27 ] used both MIDAS and HIT-6 to assess disability, while one RCT [ 30 ] used HIT-6 and NDI separately to evaluate disability ( Table 1 ).…”

“…An additional two articles were excluded due to language reasons (Supplementary Materials). Ultimately, ten articles were included in the meta-analysis [24][25][26][27][28][29][30][31][32][33]. A detailed literature search process is shown in Figure 1.…”

“…Only the proof of disability improvement in CGH and TTH is of moderate quality, while the rest of the outcome measures are of low or very low quality. Furthermore, only three articles in the study conducted follow-ups [ 30 , 31 , 33 ], with follow-up times ranging from three days to three months, making it impossible to pool and analyze the data. Since none of the RCTs in this review reported adverse events, making any statements regarding safety and compliance is currently impossible.…”

“…Different forms and durations of MFR intervention may yield diverse results, contributing to the observed high heterogeneity. Lastly, except for two studies [ 24 , 31 ] that explicitly used drug therapy as a control group, the remaining studies did not report the use of drugs, and the participants' use of drugs may be a source of heterogeneity.…”