Limits...
Specific strength training compared with interdisciplinary counseling for girls with tension-type headache: a randomized controlled trial.

Tornøe B, Andersen LL, Skotte JH, Jensen R, Jensen C, Madsen BK, Gard G, Skov L, Hallström I - J Pain Res (2016)

Bottom Line: For both groups, neck extension strength decreased significantly with a decrease in cervicothoracic extension/flexion ratio to 1.7, indicating a positive change in muscle balance.The results indicate that both physical health and HRQOL can be influenced significantly by physical exercise and nurse counseling.Thus, empowering patient education to promote maximum possible outcomes for all children needs more attention.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Sciences, Lund University, Lund, Sweden; Department of Pediatrics E, Children's Headache Clinic, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark; Department of Physiotherapy and Occupational Therapy, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark; Department of Physiotherapy, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark.

ABSTRACT

Background: Childhood tension-type headache (TTH) is a prevalent and debilitating condition for the child and family. Low-cost nonpharmacological treatments are usually the first choice of professionals and parents. This study examined the outcomes of specific strength training for girls with TTH.

Methods: Forty-nine girls aged 9-18 years with TTH were randomized to patient education programs with 10 weeks of strength training and compared with those who were counseled by a nurse and physical therapist. Primary outcomes were headache frequency, intensity, and duration; secondary outcomes were neck-shoulder muscle strength, aerobic power, and pericranial tenderness, measured at baseline, after 10 weeks intervention, and at 12 weeks follow-up. Health-related quality of life (HRQOL) questionnaires were assessed at baseline and after 24 months.

Results: For both groups, headache frequency decreased significantly, P=0.001, as did duration, P=0.022, with no significant between-group differences. The odds of having headache on a random day decreased over the 22 weeks by 0.65 (0.50-0.84) (odds ratio [95% confidence interval]). For both groups, neck extension strength decreased significantly with a decrease in cervicothoracic extension/flexion ratio to 1.7, indicating a positive change in muscle balance. In the training group, shoulder strength increased $10% in 5/20 girls and predicted [Formula: see text] increased $15% for 4/20 girls. In the training group, 50% of girls with a headache reduction of $30% had an increase in [Formula: see text] >5%. For the counseling group, this was the case for 29%. A 24-month follow-up on HRQOL for the pooled sample revealed statistically significant improvements. Fifty-five percent of the girls reported little to none disability.

Conclusion: The results indicate that both physical health and HRQOL can be influenced significantly by physical exercise and nurse counseling. More research is needed to examine the relationship between physical exercise, [Formula: see text], and TTH in girls. Thus, empowering patient education to promote maximum possible outcomes for all children needs more attention.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of enrollment and allocation.Note:aOne participant was sick at test 2 and therefore data for this participant is missing. The participant reentered at test 3.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4862389&req=5

f1-jpr-9-257: Flow diagram of enrollment and allocation.Note:aOne participant was sick at test 2 and therefore data for this participant is missing. The participant reentered at test 3.

Mentions: All participants were diagnosed and recruited from the Children’s Headache Clinic, Glostrup and Herlev Hospitals, University of Copenhagen. Before inclusion, the girls with TTH underwent a clinical diagnostic and neurological examination that included examination of the spine by the department’s neuropediatricians and one specialist physical therapist. The diagnosis was clarified using 1- to 6-month headache reports from a diary similar to that recommended by Jensen et al.19 Exclusion criteria were set by the neuropediatrician from anamnestic, observational and clinical assessments. Exclusion criteria were: migraine headache with more than one episode per month for a period of 6 months; a history of trauma, arterial hypertension, or intracranial hypertension; headache secondary to a cervical or other morbidity; and headache associated with a psychiatric comorbidity. Another exclusion criterion was headache associated with a significant learning disability or complicated social situation that required special education and/or community involvement. Girls who had been or were enrolled in other treatment programs at the Children’s Headache Clinic were also excluded. No preventive headache medication and/or analgesic overuse were allowed before or during the study period. None of the participants were allowed the intake of analgesics, taken for any reason, within 12 hours before testing. At the first diagnostic visit, all participants were informed by the contact physician and nurse about the basic needs a child has for adequate food, liquids, sleep, and activity. Figure 1 depicts a flow diagram of the study enrollment and allocation.


Specific strength training compared with interdisciplinary counseling for girls with tension-type headache: a randomized controlled trial.

Tornøe B, Andersen LL, Skotte JH, Jensen R, Jensen C, Madsen BK, Gard G, Skov L, Hallström I - J Pain Res (2016)

Flow diagram of enrollment and allocation.Note:aOne participant was sick at test 2 and therefore data for this participant is missing. The participant reentered at test 3.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4862389&req=5

f1-jpr-9-257: Flow diagram of enrollment and allocation.Note:aOne participant was sick at test 2 and therefore data for this participant is missing. The participant reentered at test 3.
Mentions: All participants were diagnosed and recruited from the Children’s Headache Clinic, Glostrup and Herlev Hospitals, University of Copenhagen. Before inclusion, the girls with TTH underwent a clinical diagnostic and neurological examination that included examination of the spine by the department’s neuropediatricians and one specialist physical therapist. The diagnosis was clarified using 1- to 6-month headache reports from a diary similar to that recommended by Jensen et al.19 Exclusion criteria were set by the neuropediatrician from anamnestic, observational and clinical assessments. Exclusion criteria were: migraine headache with more than one episode per month for a period of 6 months; a history of trauma, arterial hypertension, or intracranial hypertension; headache secondary to a cervical or other morbidity; and headache associated with a psychiatric comorbidity. Another exclusion criterion was headache associated with a significant learning disability or complicated social situation that required special education and/or community involvement. Girls who had been or were enrolled in other treatment programs at the Children’s Headache Clinic were also excluded. No preventive headache medication and/or analgesic overuse were allowed before or during the study period. None of the participants were allowed the intake of analgesics, taken for any reason, within 12 hours before testing. At the first diagnostic visit, all participants were informed by the contact physician and nurse about the basic needs a child has for adequate food, liquids, sleep, and activity. Figure 1 depicts a flow diagram of the study enrollment and allocation.

Bottom Line: For both groups, neck extension strength decreased significantly with a decrease in cervicothoracic extension/flexion ratio to 1.7, indicating a positive change in muscle balance.The results indicate that both physical health and HRQOL can be influenced significantly by physical exercise and nurse counseling.Thus, empowering patient education to promote maximum possible outcomes for all children needs more attention.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Sciences, Lund University, Lund, Sweden; Department of Pediatrics E, Children's Headache Clinic, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark; Department of Physiotherapy and Occupational Therapy, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark; Department of Physiotherapy, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark.

ABSTRACT

Background: Childhood tension-type headache (TTH) is a prevalent and debilitating condition for the child and family. Low-cost nonpharmacological treatments are usually the first choice of professionals and parents. This study examined the outcomes of specific strength training for girls with TTH.

Methods: Forty-nine girls aged 9-18 years with TTH were randomized to patient education programs with 10 weeks of strength training and compared with those who were counseled by a nurse and physical therapist. Primary outcomes were headache frequency, intensity, and duration; secondary outcomes were neck-shoulder muscle strength, aerobic power, and pericranial tenderness, measured at baseline, after 10 weeks intervention, and at 12 weeks follow-up. Health-related quality of life (HRQOL) questionnaires were assessed at baseline and after 24 months.

Results: For both groups, headache frequency decreased significantly, P=0.001, as did duration, P=0.022, with no significant between-group differences. The odds of having headache on a random day decreased over the 22 weeks by 0.65 (0.50-0.84) (odds ratio [95% confidence interval]). For both groups, neck extension strength decreased significantly with a decrease in cervicothoracic extension/flexion ratio to 1.7, indicating a positive change in muscle balance. In the training group, shoulder strength increased $10% in 5/20 girls and predicted [Formula: see text] increased $15% for 4/20 girls. In the training group, 50% of girls with a headache reduction of $30% had an increase in [Formula: see text] >5%. For the counseling group, this was the case for 29%. A 24-month follow-up on HRQOL for the pooled sample revealed statistically significant improvements. Fifty-five percent of the girls reported little to none disability.

Conclusion: The results indicate that both physical health and HRQOL can be influenced significantly by physical exercise and nurse counseling. More research is needed to examine the relationship between physical exercise, [Formula: see text], and TTH in girls. Thus, empowering patient education to promote maximum possible outcomes for all children needs more attention.

No MeSH data available.


Related in: MedlinePlus