Migraine, Neck Pain, Tension-Type Headache
Conditions
Keywords
migraine, tension-type headache, strength training, neck pain, exercise
Brief summary
A Single-Arm Open-Label Trial was performed at the Danish Headache Center (DHC), Department of Neurology, Rigshospitalet - Glostrup as part of the clinic. Purpose: To examine the effects of supervised group strength training and posture correction on headache frequency and muscle function around the neck and shoulders in patients with migraine and tension-type headaches. Hypothesis: Strength training of the neck and shoulders results in improved muscle function, which leads to a reduction in headache.
Interventions
BEHAVIORALstrength training
A targeted 8-week strength-training course was offered as an intervention in combination with ergonomics and posture corrections and recommendations
Sponsors
Danish Headache Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
A Single-Arm Open-Label Trial
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Migraine patients with stable CGRP or botox. * Tension type headache with no more than 5 migraine days/month. * At least four days/months of headache at the moment of recruitment.
Exclusion criteria
* Pregnancy * Post-traumatic headache, or headache that is likely to be associated with trauma. * Significant psychiatric comorbidities, such as severe depression * Medication Overuse Headaches. * Severe arthrosis in the neck, shoulder, or disc herniation in the neck.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| headache frequency | two weeks prior to intervention, last two weeks of intervention | number of days with headache |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| neck pain average intensity | two weeks prior to intervention, last two weeks of intervention, and weeks 4 and 5 after intervention | average neck pain intensity percieved by patient in a 0-10 NRPS |
| neck pain frequency | two weeks prior to intervention, last two weeks of intervention, and weeks 4 and 5 after intervention | number of days with neck pain |
| headache duration | two weeks prior to intervention, last two weeks of intervention, and weeks 4 and 5 after intervention | hours with headache |
| medication intake | two weeks prior to intervention, last two weeks of intervention, and weeks 4 and 5 after intervention | number of days with medication for pain taked |
| neck pain maximal intensity | two weeks prior to intervention, last two weeks of intervention, and weeks 4 and 5 after intervention | maximal neck pain intensity percieved by patient in a 0-10 NRPS |
| Headache average Intensity | two weeks prior to intervention, last two weeks of intervention, and weeks 4 and 5 after intervention | average headache intensity percieved by patient in a 0-10 NRPS |
| Headache maximal Intensity | two weeks prior to intervention, last two weeks of intervention, and weeks 4 and 5 after intervention | maximal headache intensity percieved by patient in a 0-10 NRPS |
| headache frequency | weeks 4 and 5 after intervention | number of days with headache |
| Functional level | Before intervention, after intervention and at 1 month follow up | Self-reported limitated activities due to headache in a 0-10 scale thourgh the Patient-Specific Functional Scale |
Other
| Measure | Time frame | Description |
|---|---|---|
| Moment arm fof the shoulder elevation | Before intervention, after intervention and at 1 month follow up | Peak of the Maximal Voluntary Contraction x Moment arm of the shoulder elevation (N\*m) |
| Extension-Flexion ratio | Before intervention, after intervention and at 1 month follow up | Ratio between moment arm of the neck extension and moment arm of the neck flexion. |
| Rate of force development of the shoulder elevation | Before intervention, after intervention and at 1 month follow up | (75% of the peak value of the shoulder elevation (N) - 25% of the peak value of the shoulder elevation)/(time at de 75% of the peak of shoulder elevation (s) - time at 25% of the peak of shoulder elevation) in Newtons per second (N/s) |
| Early rate of force development of the shoulder elevation | Before intervention, after intervention and at 1 month follow up | (Value of the peak of the shoulder elevation at 250ms after the 2,5% of the peak (N) - 2,5% of the peak value of the shoulder elevation)/0,250 (s) in Newtons per second (N/s) |
| Muscle tenderness | Before intervention, after intervention and at 1 month follow up | Total Tenderness Score (0-48) |
| Percieved intensity | During the intervention | Level of intensity percieved by patients in each exercise session |
| Muscle tenderness of the neck | Before intervention, after intervention and at 1 month follow up | Total Tenderness Score of the last 4 spots: mastoid process, sternocleidmastoid, occipitalis and superior trapezius (0-24) |
| Craniocervical flexion score | Before intervention, after intervention and at 1 month follow up | Craniocervical flexion test score. Possible values: 20, 22, 24, 26, 28 or 30 mmHg |
| Exercise sessions completed | During the intervention | Number of training sessions performed by the participants |
| Adherence to exercise | Week 1 to 5 after intervention | Ratio between the number of exercise sessions completed after intervention until the follow-up. |
| Compliance of the programm | post-intervention | Product between intensity coherence and adherence. |
| Muscle tenderness of the face | Before intervention, after intervention and at 1 month follow up | Total Tenderness Score of the first 4 spots: masseter, coronoid process, temporalis and frontalis (0-24) |
| Intensity coherence | post-intervention | Ratio between average of rate of percieved exertion by the patients and 10 (coefficient from 0 to 1). |
| Adherence of the programm | post-intervention | Ratio between the number of exercise sessions completed by patients versus number of exercise sessions planned in the programm |
| Maximal Voluntary Contraction of the Neck extension | Before intervention, after intervention and at 1 month follow up | Maximal force of the neck extension (Newtons) |
| Maximal Voluntary Contraction of the Neck flexion | Before intervention, after intervention and at 1 month follow up | Maximal force of the neck flexion (Newtons) |
| Maximal Voluntary Contraction of the Shoulder elevation | Before intervention, after intervention and at 1 month follow up | Maximal force of the shoulder elevation (Newtons) |
| Moment arm for neck flexion and extension | Before intervention | Distance between C7 and Protuberancia occipitalis (m) |
| Moment arm for shoulder elevation | Before intervention | Distance between C7 and acromion of the right shoulder (m) |
| Moment arm for neck flexion | Before intervention, after intervention and at 1 month follow up | Peak of the Maximal Voluntary Contraction x Moment arm of the neck flexion (N\*m) |
| Moment arm of the neck extension | Before intervention, after intervention and at 1 month follow up | Peak of the Maximal Voluntary Contraction x Moment arm of the neck extension (N\*m) |
Countries
Denmark
Outcome results
None listed