- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01736774
Exercise and Manipulative Therapy for Older Persons With Headache
January 26, 2016 updated by: Sureeporn Uthaikhup, Chiang Mai University
A Randomized Controlled Trial of Exercise and Manipulative Therapy for Older Persons With Frequent Intermittent Headaches Associated With Neck Pain and Impairment
The presence of cervical musculoskeletal impairment is not specific to cervicogenic headache but other various frequent intermittent headache types (i.e.
migraine and tension-type headache) in the elderly population.
There has been no trial to date which has investigated the effectiveness of physiotherapy treatment specifically for older persons with various types of headache with associated neck pain and cervical musculoskeletal impairment.
Thus, the purpose of study investigate the efficacy of physiotherapy treatment for older persons who have headache concomitant with neck pain and musculoskeletal impairment
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Headache is a common health problem that affects quality of life in an older population and imposes substantial economic costs.
Headache changes with age.
Features of headache become less typical and neck pain is more frequently associated with headache in older persons.
We recently demonstrated that the presence of cervical musculoskeletal impairment is not specific to cervicogenic headache (headache caused by the neck).
Rather it was present in various frequent intermittent headache types in elders when compared to elders without headache.
Changes in headache characteristics with age play an important role not only in diagnosis but also in treatment choice.
Impairment in cervical musculoskeletal function found in older persons with headache has implications for headache management choices as the evidence indicates that physiotherapy management methods such as manual therapy and therapeutic exercise are an effective management approach for headache associated with the neck.
Physiotherapy treatment would be a safe therapeutic option and may have a beneficial effect for elders with headache who have neck pain and concomitant cervical musculoskeletal dysfunction.
This is particularly relevant as there are widespread concerns about medication overuse, adverse drug events and drug interactions in older persons.
The effective management of older persons with headache in particular of those with atypical features of headache remains a challenge.
Physiotherapy is indicated in those older persons diagnosed with cervicogenic headache but could also be adjunct treatment for those with cervical musculoskeletal signs who are suspected of having transitional headache.
At present, there has been no trial to date which has investigated the effectiveness of physiotherapy treatment specifically for older persons with various types of headache with associated neck pain and cervical musculoskeletal impairment.
A clinical trial of treatment of cervical musculoskeletal impairment in older persons with various headache types may help guide management of headache in attempts to lesson medication use and cost in this population.
Physiotherapy management may be a worthy treatment option particularly in older persons with headache who do not respond well to medication.
Study Type
Interventional
Enrollment (Actual)
65
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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-
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Chiang Mai, Thailand
- Department of Physical Therapy, Faculty of Associated Medical Sciences
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
50 years to 75 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Volunteers suffering from frequent intermittent headache (either migraine, tension-type headache or cervicogenic headache) at least one per month over a period of 3 months or longer
- Aged 50 years or older, female or male
- A score of ≥ 3/10 on visual analogue scale (VAS) of neck pain
- Evidence of cervical musculoskeletal impairment: restriction in active range of cervical motion in extension and rotation and join tenderness in at least one of the upper joint as detected by manual palpation
Exclusion Criteria:
- Headache diagnosed as following: temporal arteritis, trigeminal neuralgia, cluster headache, chronic paroxysmal hemicrania/hemicranias continua, temporomandibular joint dysfunction
- Other diagnosed disorders: cerebrovascular disease, Parkinson disease, cognitive disturbance
- Previous history of head or neck surgery
- Lack of willingness to receive either pragmatic treatment or usual care
- Physiotherapy or chiropractic treatment for headache in previous 6 months
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Usual care intervention
Primary care as required including medication
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The usual care intervention will include appropriate primary care as required including medication
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Experimental: Physiotherapy treatment
Exercise and manipulative therapy
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Exercise and manipulative therapy treatment for 10 weeks:The treatment intervention consists of two visits per week for the first four weeks (8 treatments) and one visit per week for the last six weeks (6 treatments)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Headache frequency
Time Frame: Change from baseline in headache frequency at week 11 and 6 months after intervention
|
The number of headache frequency in the past week
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Change from baseline in headache frequency at week 11 and 6 months after intervention
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Headache intensity
Time Frame: Change from baseline in headache intensity at week 11 and 6 months after intervention
|
An average intensity in the past week will be rated on a 1-10 VAS
|
Change from baseline in headache intensity at week 11 and 6 months after intervention
|
Headache duration
Time Frame: Change from baseline in headache duration at week 11 and 6 months after intervention
|
The number of hours of headache in the past week
|
Change from baseline in headache duration at week 11 and 6 months after intervention
|
Neck pain intensity
Time Frame: Change from baseline in neck pain intensity at week 11 and 6 months after intervention
|
Intensity of neck pain will be measured using a 1-10 VAS
|
Change from baseline in neck pain intensity at week 11 and 6 months after intervention
|
Neck pain and disability
Time Frame: Change from baseline in neck pain and disability at week 11 and 6 months after intervention
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Neck pain and disability will be measured using neck disability index (NDI-Thai version)
|
Change from baseline in neck pain and disability at week 11 and 6 months after intervention
|
Quality of life
Time Frame: Change from baseline in quality of life at week 11 and 6 months after intervention
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The Quality of life will be measured using SF-36 (Thai version)
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Change from baseline in quality of life at week 11 and 6 months after intervention
|
Medication intake
Time Frame: Change from baseline in medication intake at week 11 and 6 months after intervention
|
type and dose of all medications taken by subjects will be recorded one week at baseline and prior to follow-up points on a medication diary
|
Change from baseline in medication intake at week 11 and 6 months after intervention
|
Global assessment of treatment benefit
Time Frame: Changes from baseline in global assessment of treatment benefit at week 11 and 6 months after intervention
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Patients perceived benefit of treatment will be measured on a scale from 0 (no benefit) to 10 (maximum benefit)
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Changes from baseline in global assessment of treatment benefit at week 11 and 6 months after intervention
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Sureeporn Uthaikhup, Ph.D., Department of Physical Therapy, Faculty of Associated Medical Sciences
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
December 1, 2012
Primary Completion (Actual)
December 1, 2014
Study Completion (Actual)
July 1, 2015
Study Registration Dates
First Submitted
November 22, 2012
First Submitted That Met QC Criteria
November 26, 2012
First Posted (Estimate)
November 29, 2012
Study Record Updates
Last Update Posted (Estimate)
January 28, 2016
Last Update Submitted That Met QC Criteria
January 26, 2016
Last Verified
January 1, 2016
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- MRG5580145
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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