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Exercise and Manipulative Therapy for Older Persons With Headache

26 janvier 2016 mis à jour par: 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

Aperçu de l'étude

Statut

Complété

Les conditions

Description détaillée

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.

Type d'étude

Interventionnel

Inscription (Réel)

65

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

      • Chiang Mai, Thaïlande
        • Department of Physical Therapy, Faculty of Associated Medical Sciences

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

50 ans à 75 ans (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La 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

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Double

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Usual care intervention
Primary care as required including medication
The usual care intervention will include appropriate primary care as required including medication
Expérimental: Physiotherapy treatment
Exercise and manipulative therapy
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)

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Headache frequency
Délai: Change from baseline in headache frequency at week 11 and 6 months after intervention
The number of headache frequency in the past week
Change from baseline in headache frequency at week 11 and 6 months after intervention

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Headache intensity
Délai: 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
Délai: 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
Délai: 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
Délai: Change from baseline in neck pain and disability at week 11 and 6 months after intervention
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
Délai: Change from baseline in quality of life at week 11 and 6 months after intervention
The Quality of life will be measured using SF-36 (Thai version)
Change from baseline in quality of life at week 11 and 6 months after intervention
Medication intake
Délai: 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
Délai: Changes from baseline in global assessment of treatment benefit at week 11 and 6 months after intervention
Patients perceived benefit of treatment will be measured on a scale from 0 (no benefit) to 10 (maximum benefit)
Changes from baseline in global assessment of treatment benefit at week 11 and 6 months after intervention

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: Sureeporn Uthaikhup, Ph.D., Department of Physical Therapy, Faculty of Associated Medical Sciences

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 décembre 2012

Achèvement primaire (Réel)

1 décembre 2014

Achèvement de l'étude (Réel)

1 juillet 2015

Dates d'inscription aux études

Première soumission

22 novembre 2012

Première soumission répondant aux critères de contrôle qualité

26 novembre 2012

Première publication (Estimation)

29 novembre 2012

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

28 janvier 2016

Dernière mise à jour soumise répondant aux critères de contrôle qualité

26 janvier 2016

Dernière vérification

1 janvier 2016

Plus d'information

Termes liés à cette étude

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • MRG5580145

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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