1. Short-term effects of manual therapy on heart rate variability, mood state, and pressure pain sensitivity in patients with chronic tension-type headache: a pilot study.

Toro-Velasco C, Arroyo-Morales M, Fernández-de-Las-Peñas C, Cleland JA, Barrero-Hernández FJ.

http://www.ncbi.nlm.nih.gov/pubmed/19748404

 

Source

Department of Physical Therapy, Health Sciences School, Universidad Granada, Spain.

Abstract

OBJECTIVE:

The purpose of this study was to investigate the immediate effects of head-neck massage on heart rate variability (HRV), mood states, and pressure pain thresholds (PPTs) in patients with chronic tension-type headache (CTTH).

METHODS:

Eleven patients (8 females), between 20 and 68 years old, with CTTH participated in this crossover study. Patients received either the experimental treatment (massage protocol) or a placebo intervention (detuned ultrasound). Holter electrocardiogram recordings (standard deviation of the normal-to-normal interval, square root of mean squared differences of successive NN intervals, index HRV, low-frequency component, and high-frequency component), PPT over both temporalis muscles, and Profile of Mood States questionnaire (tension-anxiety, depression-dejection, anger-hostility, vigor, fatigue, confusion) were obtained preintervention, immediately after intervention, and 24 hours postintervention. Self-reported head pain was also collected preintervention and 24 hours postintervention. Separate analyses of covariance (ANCOVAs) were performed with each dependent variable. The hypothesis of interest was group x time interaction.

RESULTS:

The ANCOVA showed a significant group x time interaction for index HRV (F = 4.5, P = .04), but not for standard deviation of the normal-to-normal interval (F = 1.1, P = .3), square root of mean squared differences of successive NN intervals (F = 0.9, P = .3), low-frequency component (F = 0.03, P = .8), or high-frequency component (F = 0.4, P = .5) domains. Pairwise comparisons found that after the manual therapy intervention, patients showed an increase in the index HRV (P = .01) domain, whereas no changes were found after the placebo intervention (P = .7). The ANCOVA also found a significant group x time interaction for tension-anxiety (F = 5.3, P = .03) and anger-hostility (F = 4.6, P = .04) subscales. Pairwise comparisons found that after the manual therapy intervention, patients showed a decrease in tension-anxiety (P = .002) and anger-hostility (P = .04) subscales, whereas no changes were found after the placebo intervention (P > .5 both subscales). No significant changes were found in PPT levels (right F = 0.3, P = .6, left F = 0.4, P = .5). A significant group x time interaction for pain (F = 4.8, P = .04) was identified. No influence of sex was found (F = 1.5, P = .3). Pairwise comparisons showed that head pain (numerical pain rating scale) decreased 24 hours after manual therapy (P < .05) but not after the placebo intervention (P = .9).

CONCLUSIONS:

The application of a single session of manual therapy program produces an immediate increase of index HRV and a decrease in tension, anger status, and perceived pain in patients with CTTH.

PMID: 19748404

[PubMed - indexed for MEDLINE]

 

2. Impact of physiotherapy, massages and lymphatic drainage in migraine therapy

[Article in German]

Gaul C, Busch V.

http://www.ncbi.nlm.nih.gov/pubmed/19562382

 

Source

Klinik und Poliklinik für Neurologie, Westdeutsches Kopfschmerzzentrum, Universitätsklinikum Essen, Hufelandstr. 26, 45147, Essen, Deutschland. Charly.Gaul@gmx.de

Abstract

Physical treatment, spinal manipulative therapy and massages are often recommended to treat migraine as a prophylactic therapy. Clinical experience and theoretical concepts support their usefulness. However, data on these therapies are scarce. On the basis of the available studies, it is impossible to determine whether or not these therapies are effective. There is a lack of well-designed prospective, randomized controlled trials with a sufficiently long follow-up to observe these therapies. Due to the high acceptance of physical treatment on the one hand and preconceptions about drug treatment on the other, these types of therapies may be an alternative option for some patients if their efficacy is established. A cost-benefit analysis of theses therapies should consider the long amount of time required for them compared with drug intake.

PMID:

19562382

[PubMed - indexed for MEDLINE]

 

3. The qi-regulating massotherapy for treatment of tonic headache in 150 cases.

Tan T, Wang JG, Sun Q, Shi YS.

http://www.ncbi.nlm.nih.gov/pubmed/19514182

 

Source

Department of Orthopedics and Massotherapy, the First Hospital Affiliated to Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China.

Abstract

OBJECTIVE:

To observe the therapeutic effects of the qi-regulating massotherapy for treatment of tonic headache.

METHODS:

According to different clinical types, 150 cases of tonic headache were treated by the qi-regulating massotherapy. Evaluations were done according to the scores for physiology, behavior, intensity of pain, and the therapeutic effects.

RESULTS:

After treatment, the total score in the 150 cases significantly decreased as compared with that before treatment (P<0.01). The total effective rate was 93.3%, and the effective rates for all the types were over 90%.

CONCLUSION:

The qi-regulating massotherapy is indicated for all types of tonic headache with obvious therapeutic effects.

PMID: 19514182

[PubMed - indexed for MEDLINE]

 

4. Myofascial trigger points in children with tension-type headache: a new diagnostic and therapeutic option.

von Stülpnagel C, Reilich P, Straube A, Schäfer J, Blaschek A, Lee SH, Müller-Felber W, Henschel V, Mansmann U, Heinen F.

http://www.ncbi.nlm.nih.gov/pubmed/19339283

 

Source

Department of Pediatric Neurology and Developmental Medicine, Dr von Haunersches Kinderspital, Ludwig-Maximilians-University Munich, 80337 Munich, Germany.

Abstract

The goal of this pilot study was to evaluate the effect of a trigger point-specific physiotherapy on headache frequency, intensity, and duration in children with episodic or chronic tension-type headache. Patients were recruited from the special headache outpatient clinic. A total of 9 girls (mean age 13.1 years; range, 5-15 years) with the diagnosis of tension-type headache participated in the pilot study from May to September 2006 and received trigger point-specific physiotherapy twice a week by a trained physiotherapist. After an average number of 6.5 therapeutic sessions, the headache frequency had been reduced by 67.7%, intensity by 74.3%, and duration by 77.3%. No side effects were noted during the treatment. These preliminary findings suggest a role for active trigger points in children with tension-type headache. Trigger point-specific physiotherapy seems to be an effective therapy in these children. Further prospective and controlled studies in a larger cohort are warranted.

PMID: 19339283

[PubMed - indexed for MEDLINE]

 

5. Massaging over the greater occipital nerve reduces the intensity of migraine attacks: evidence for inhibitory trigemino-cervical convergence mechanisms.

Piovesan EJ, Di Stani F, Kowacs PA, Mulinari RA, Radunz VH, Utiumi M, Muranka EB, Giublin ML, Werneck LC.

http://www.ncbi.nlm.nih.gov/pubmed/17876398

 

Source

Neurology Division, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Rua General Carneiro 181, 80060-900 Curitiba, PR, Brazil. piovesan@avalon.sul.com.br

Abstract

Activation of the trigemino-cervical system constitutes one of the first steps in the genesis of migraine. The objective of this study was to confirm the presence of trigemino-cervical convergence mechanisms and to establish whether such mechanisms may also be of inhibitory origin. We describe a case of a 39-years-old woman suffering from episodic migraine who showed a significant improvement in her frontal headache during migraine attacks if the greater occipital nerve territory was massaged after the appearance of static mechanical allodynia (cortical sensitization). We review trigemino-cervical convergence and diffuse nociceptive inhibitory control (DNIC) mechanisms and suggest that the convergence mechanisms are not only excitatory but also inhibitory.

PMID: 17876398

[PubMed - indexed for MEDLINE]

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6. A randomized, controlled trial of massage therapy as a treatment for migraine.

Lawler SP, Cameron LD.

http://www.ncbi.nlm.nih.gov/pubmed/16827629

 

Source

Department of Psychology, The University of Auckland. s.lawler@uq.edu.au

Abstract

BACKGROUND:

Migraine is a distressing disorder that is often triggered by stress and poor sleep. Only one randomized controlled trial (RCT) has assessed the effects of massage therapy on migraine experiences, which yielded some promising findings.

PURPOSE:

An RCT was designed to replicate and extend the earlier findings using a larger sample, additional stress-related indicators, and assessments past the final session to identify longer-term effects of massage therapy on stress and migraine experiences.

METHODS:

Migraine sufferers (N = 47) who were randomly assigned to massage or control conditions completed daily assessments of migraine experiences and sleep patterns for 13 weeks. Massage participants attended weekly massage sessions during Weeks 5 to 10. State anxiety, heart rates, and salivary cortisol were assessed before and after the sessions. Perceived stress and coping efficacy were assessed at Weeks 4, 10, and 13.

RESULTS:

Compared to control participants, massage participants exhibited greater improvements in migraine frequency and sleep quality during the intervention weeks and the 3 follow-up weeks. Trends for beneficial effects of massage therapy on perceived stress and coping efficacy were observed. During sessions, massage induced decreases in state anxiety, heart rate, and cortisol.

CONCLUSIONS:

The findings provide preliminary support for the utility of massage therapy as a nonpharmacologic treatment for individuals suffering from migraines.

PMID: 16827629

[PubMed - indexed for MEDLINE]

 

7. Changes in Psychological Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study.

Moraska A, Chandler C.

http://www.ncbi.nlm.nih.gov/pubmed/20046550

 

Abstract

Investigations into complementary and alternative medicine (CAM) approaches to address stress, depression, and anxiety of those experiencing chronic pain are rare. The objective of this pilot study was to assess the value of a structured massage therapy program, with a focus on myofascial trigger points, on psychological measures associated with tension-type headache. Participants were enrolled in an open-label trial using a baseline control with four 3-week phases: baseline, massage (two 3-week periods) and a follow-up phase. Eighteen subjects with episodic or chronic tension-type headache were enrolled and evaluated at 3-week intervals using the State-Trait Anxiety Inventory, Beck Depression Inventory, and the Perceived Stress Scale. The Daily Stress Inventory was administered over 7-day periods during baseline and the final week of massage. Twice weekly, 45-minute massage therapy sessions commenced following the baseline phase and continued for 6 weeks. A significant improvement in all psychological measures was detected over the timeframe of the study. Post hoc evaluation indicated improvement over baseline for depression and trait anxiety following 6 weeks of massage, but not 3 weeks. A reduction in the number of events deemed stressful as well as their respective impact was detected. This pilot study provides evidence for reduction of affective distress in a chronic pain population, suggesting the need for more rigorously controlled studies using massage therapy to address psychological measures associated with TTH.

PMID: 20046550

[PubMed - in process]

PMCID: PMC2700492

Free PMC Article