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Exercise and Manipulative Therapy for Older Persons With Headache

26 januari 2016 bijgewerkt door: 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

Studie Overzicht

Toestand

Voltooid

Conditie

Gedetailleerde beschrijving

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.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

65

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

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

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

50 jaar tot 75 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Dubbele

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Usual care intervention
Primary care as required including medication
The usual care intervention will include appropriate primary care as required including medication
Experimenteel: 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)

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Headache frequency
Tijdsspanne: 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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Headache intensity
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Onderzoekers

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

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 december 2012

Primaire voltooiing (Werkelijk)

1 december 2014

Studie voltooiing (Werkelijk)

1 juli 2015

Studieregistratiedata

Eerst ingediend

22 november 2012

Eerst ingediend dat voldeed aan de QC-criteria

26 november 2012

Eerst geplaatst (Schatting)

29 november 2012

Updates van studierecords

Laatste update geplaatst (Schatting)

28 januari 2016

Laatste update ingediend die voldeed aan QC-criteria

26 januari 2016

Laatst geverifieerd

1 januari 2016

Meer informatie

Termen gerelateerd aan deze studie

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • MRG5580145

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