Exercise and Manipulative Therapy for Older Persons With Headache
Condition: Headache
MeSH terms: Headache
Study type: Interventional

Summary: 
      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
    

Detailed description: 
      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.
    

Intervention name(s): Usual care intervention; Physiotherapy treatment
Intervention type(s): Other; Other
Intervention description(s): The usual care intervention will include appropriate primary care as required including medication; 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)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Manual therapy; Exercise