The effect of a strength training program on muscle cross-sectional area (CSA) and pain in people with chronic tension-type headache

arm 1: Strength training program. developed by an expert physical therapist (PT) with more than 20 years of experience in the field. theraband with a resistance in accordance to their strength level was delivered to the intervention group participants (looking for a 7/10 Borg scale) 12 week intervention program. Participants must complete two training sessions (with at least one day rest between sessions) per week. after the first 4 weeks they can advance to 3 days per week if they feel capable and with the PT permission as part of the training progression (1 day rest in between training sessions always). the exercises will be first explained by the expert and then perform supervised by the same expert. afterwards and with the permission of the expert they can do the training program at home. A video with the expert doing the exercises will be delivered to the training group so the can follow the training session watching the expert doing the exercises exercises; conventional warm up, consisting in mobility and activation exercises will be always perform before the strength training session. Training session: 3 sets of 10 repetitions (6 seconds of isometric contraction each rep). Intensity 70% of the maximum voluntary contraction (MVC) for neck movements:inclinations, rotations, flexion and extension for a total of 6 neck exercises. 3 sets of 8repetitions. Intensity 70% of the 1 repetition maximum (RM), (7/10 RPE) for shoulder upper body exercises. 5 exercises in total everybody will perform at least 28 training session in 12 weeks Each session will last around 25 minutes including the warm up