The effect of myofascial release and microwave diathermy combined with acupuncture versus acupuncture therapy in tension‐type headache patients: A pragmatic randomized controlled trial

Georgoudis, George; Felah, Bledjana; Nikolaidis, Pantelis Theodoros; Damigos, D.

doi:10.1002/pri.1700

Cited by 15 publications

(18 citation statements)

References 42 publications

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“…In this technique, the needle usually moves in vertical direction at approximately 1 Hz with or without rotations [38]. Sometimes the needles may be left in place for approximately 20 min with or without manual stimulation [60]. Simons et al [61] mentioned that dry needling targeting TrPs can disrupt the dysfunctional neuromuscular activity in the muscles, decrease muscle tone, and normalize the neurochemical pathways of muscles.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of dry needling for improving pain and disability in adults with tension-type, cervicogenic, or migraine headaches: protocol for a systematic review

et al. 2019

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Background Headache is the most common neurological symptoms worldwide, as over 90% of people have noted at least one headache during their lifetime. Tension-type headaches, cervicogenic headaches, and migraines are common types of headache which can have a significant impact on social, physical, and occupational functioning. Therapeutic management of headaches mainly includes physical therapy and pharmacological interventions. Dry needling is a relatively new therapeutic approach that uses a thin filiform needle without injectate to penetrate the skin and stimulate underlying tissues for the management of neuromusculoskeletal pain and movement impairments. The main objective of this systematic review and meta-analysis is to evaluate the effectiveness of dry needling in comparison to other interventions on pain and disability in patients with tension-type headache, cervicogenic headache, and migraine. Methods/design We will focus on clinical trials with concurrent control group(s) and comparative observational studies assessing the effect of dry needling in patients with tension-type headache, cervicogenic headache, and migraine. Electronic databases from relevant fields of research (PubMed/ Medline, Scopus, Embase®, PEDro, Web of Science, Ovid, AMED, CENTRAL, and Google Scholar) will be searched from inception to June 2019 using defined search terms. No restrictions for language of publication or geographic location will be applied. Moreover, grey literature, citation tracking, and reference lists scanning of the selected studies will be searched manually. Primary outcomes of this study are pain intensity and disability, and secondary outcomes are cervical spine ROM, frequency of headaches, health-related quality of life, and TrPs tenderness. Studies will be selected by three independent reviewers based on prespecified eligibility criteria. Three reviewers will independently extract data in each eligible study using a pre-piloted Microsoft Excel data extraction form. The assessment of risk of bias will be implemented using the Cochrane Back and Neck Review Group 13-item criteria and NOS. Direct meta-analysis will be performed using a fixed or random effects model to estimate effect size such as standardized mean difference (Morris’s dppc) and 95% confidence intervals. Statistical heterogeneity will also be evaluated using the I2 statistic and the χ2 test. All meta-analyses will be performed using Stata V.11 and V.14 softwares. The overall quality of the evidence for the primary outcomes will be assessed using GRADE. Discussion All analyses in this study will be based on the previous published papers. Therefore, ethical approval and patient consent are not required. The findings of this study will provide important information on the value of dry needling for the management of tension-type headache, cervicogenic headache, and migraine. Trial registration PROSPERO registration number: CRD42019124125.

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Section: Methodsmentioning

confidence: 99%

Effectiveness of dry needling for improving pain and disability in adults with tension-type, cervicogenic, or migraine headaches: protocol for a systematic review

et al. 2019

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“…Secondary Outcomes.-Secondary outcomes were change in headache days from baseline in the 4-week period ending at week 32, change in 6-item Headache Impact Test (HIT-6) score from baseline for the 4 weeks ending at week 30 (ie, weeks [27][28][29][30], and proportion of patients with a ≥70% decrease in headache days from baseline in the 4-week period ending at week 32.…”

Section: Studymentioning

confidence: 99%

“…In 1967, Schwartz and Lellouch first used the term "pragmatic" to describe trials that assess an intervention in clinical practice to determine which of 2 treatments should be preferred. [22][23][24][25][26][27][28][29][30] The primary goal of the FORWARD study was to compare the effectiveness of onabotulinumtoxinA and topiramate in preventive treatment of CM via a pragmatic design and to explore the clinical utility of onabot-ulinumtoxinA in those who discontinued topiramate. 20 The National Institutes of Health and the Patient-Centered Outcomes Research Initiative support and promote pragmatic clinical trial methodology to obtain information directly relevant for the needs of healthcare providers.…”

Section: Introductionmentioning

confidence: 99%

“…21 Such trials have been conducted in chronic pain, schizophrenia, depression, multiple sclerosis, headache, and migraine. [22][23][24][25][26][27][28][29][30] The primary goal of the FORWARD study was to compare the effectiveness of onabotulinumtoxinA and topiramate in preventive treatment of CM via a pragmatic design and to explore the clinical utility of onabot-ulinumtoxinA in those who discontinued topiramate.…”

Section: Introductionmentioning

confidence: 99%

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FORWARD Study: Evaluating the Comparative Effectiveness of OnabotulinumtoxinA and Topiramate for Headache Prevention in Adults With Chronic Migraine

et al. 2019

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Objective To compare effectiveness of onabotulinumtoxinA and topiramate for chronic migraine (CM) prevention. Background The efficacy* of onabotulinumtoxinA and topiramate has been established in placebo‐controlled randomized clinical trials (*defined as the benefit of treatment under ideal conditions). The effectiveness* of the 2 preventive treatments, however, has not been established (*the benefit of treatment under real‐world conditions, representing a blend of efficacy and tolerability). Methods In this multicenter, randomized, parallel‐group, post‐authorization, open‐label prospective study (FORWARD; http://ClinicalTrials.gov, NCT02191579), we randomized adults with CM (1:1) to onabotulinumtoxinA 155 U every 12 weeks for 3 cycles or topiramate “immediate release” 50‐100 mg/day to week 36. Primary outcome measure was proportion of patients achieving ≥50% reduction in headache days (weeks 29‐32). Missing values were imputed using baseline observation carried forward (BOCF) methodology. After 12 weeks, patients initially randomized to topiramate could cross over to onabotulinumtoxinA treatment. We monitored and recorded all adverse events (AEs). Results We enrolled 282 patients (onabotulinumtoxinA, n = 140; topiramate, n = 142) and 148 patients completed randomized treatment (onabotulinumtoxinA, n = 120 [86%]; topiramate, n = 28 [20%]). Primary reasons for withdrawal were ineffective treatment (onabotulinumtoxinA, n = 7 [5%]; topiramate, n = 27 [19%]) and AEs (onabotulinumtoxinA, n = 5 [4%]; topiramate, n = 72 [51%]). Eighty topiramate patients crossed over to onabotulinumtoxinA. In the BOCF analysis, a significantly higher proportion of patients randomized to onabotulinumtoxinA experienced ≥50% reduction in headache frequency compared with those randomized to topiramate (40% [56/140] vs 12% [17/142], respectively; adjusted OR, 4.9 [95% CI, 2.7‐9.1]; P < .001). OnabotulinumtoxinA was superior to topiramate in meeting secondary endpoints. In a post hoc analysis using observed data, the 50% responder rates at week 12 were 45.6% for onabotulinumtoxinA (n = 125) and 29.4% for topiramate (n = 109) (P = .015). AEs were reported by 48% (105/220) of onabotulinumtoxinA and 79% (112/142) of topiramate patients. Results were similar in those who crossed over to onabotulinumtoxinA. Conclusions While using imputation methods of accounting for differences in discontinuation rates, we found onabotulinumtoxinA to have greater clinical utility than topiramate, largely because of tolerability issues associated with the latter and a relatively higher number of onabotulinumtoxinA patients remaining on treatment.

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“…Acupuncture and dry needling are a therapeutic modalities that involves inserting needles into pathological parts of muscles 1 and they are effective in the short term for pain relief, increasing range of motion and improving quality of life when compared to no intervention/sham/placebo 2 . Acupuncture 3–5 and dry needling 1,6 are the most commonly used techniques for the treatment of myofascial pain caused by the myofascial trigger points, which are identifiable as a hyperirritable focus located in a tense band of muscular fibers, and are often responsible of hyperalgesia and allodynia. Furthermore, active trigger points can produce sensorial, autonomic and motor dysfunctions (weakness, stiffness, restricted range of motion and alteration in the normal patterns of motor activation) 7 .…”

Section: Introductionmentioning

confidence: 99%

Scanning electron microscopy examination of needle tips after different procedures of deep dry needling in humans

Poveda-Pagán

Hernández-Sánchez

Rhys-Jones-López

et al. 2018

Sci Rep

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The aim of this study was to evaluate the tips and the surface conditions of two types of needles with different quality and their possible alterations after performing different needling on human beings. A total of 160 needles from AguPunt brand were examined. Surface conditions (lumps and scratches) and tip of the needles after needling procedures in humans were tested using a JEOL JSM-6360LV microscopy device. Additionally, a group of physiotherapists assessed the use of both types of needles in clinical practice using a self-reported questionnaire. Both types of needles, after performing different needling on human beings, kept the needle tips well preserved although the dry needle (Type B) suffered very little deformation even touching the bone of the scapula 10 times versus acupuncture needle (Type A), which were deformed slightly. The surface conditions revealed irregularities and scratches in both types of needles but the tips of Type A suffered more damage after different procedures (Odds ratio = 0.04,95% CI:0.01–0.13, p < 0.001). The cellular tissue adhered to the surface was similar in both types of needles and the questionnaire about clinical practice of both types of needles showed that Type B seemed easier than Type A when the physical therapist penetrated the skin and when the needle went out the skin.

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The effect of myofascial release and microwave diathermy combined with acupuncture versus acupuncture therapy in tension‐type headache patients: A pragmatic randomized controlled trial

Cited by 15 publications

References 42 publications

Effectiveness of dry needling for improving pain and disability in adults with tension-type, cervicogenic, or migraine headaches: protocol for a systematic review

Effectiveness of dry needling for improving pain and disability in adults with tension-type, cervicogenic, or migraine headaches: protocol for a systematic review

FORWARD Study: Evaluating the Comparative Effectiveness of OnabotulinumtoxinA and Topiramate for Headache Prevention in Adults With Chronic Migraine

Scanning electron microscopy examination of needle tips after different procedures of deep dry needling in humans

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