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Exercise and Manipulative Therapy for Older Persons With Headache

26. januar 2016 oppdatert av: 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

Studieoversikt

Status

Fullført

Forhold

Detaljert beskrivelse

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

Intervensjonell

Registrering (Faktiske)

65

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

50 år til 75 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Usual care intervention
Primary care as required including medication
The usual care intervention will include appropriate primary care as required including medication
Eksperimentell: 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)

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Headache frequency
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Headache intensity
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

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

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. desember 2012

Primær fullføring (Faktiske)

1. desember 2014

Studiet fullført (Faktiske)

1. juli 2015

Datoer for studieregistrering

Først innsendt

22. november 2012

Først innsendt som oppfylte QC-kriteriene

26. november 2012

Først lagt ut (Anslag)

29. november 2012

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

28. januar 2016

Siste oppdatering sendt inn som oppfylte QC-kriteriene

26. januar 2016

Sist bekreftet

1. januar 2016

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • MRG5580145

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