Manual Therapy for Tension Headache With Psychological Disorders
Condition: Tension-type Headache
MeSH terms: Tension-Type Headache; Headache
Study type: Interventional

Summary: 
      Introduction. Tension-type headache is a highly prevalent disorder with a significant
      socio-economic impact, affecting psychological aspects. This study aims to assess aspects
      pertaining to anxiety, depression, headache frequency and pain intensity.

      Subjects and methods. A clinical trial was conducted on 84 participants suffering from
      tension-type headache, divided into 4 groups, the mean age being 39.76 years (SD 11.38). The
      first group received suboccipital soft tissue treatment (ST); the second group was treated
      with articulatory technique (AT); the third group was applied a combination of both
      techniques (ST and AT) and a forth group which served as control group. Treatment sessions
      were administered during four weeks, with a post-treatment assessment, and follow-up after
      one month. The investigators conducted Repeated measures Analysis of Covariance (RM-MANCOVA)
      to evaluate the effect of treatment on between and within-subject conditions and their
      interaction on reported depression, anxiety, and headache pain frequency and intensity.
    


Intervention name(s): The suboccipital technique; The articulatory technique; Combined treatment
Intervention type(s): Other; Other; Other
Intervention description(s): The suboccipital technique (ST) aims to release the spasm of the muscles affected in tension-type headaches and in general of suboccipital soft tissues, as they are responsible for the mobility dysfunction of the occiput-atlas-axis joint; this releases the facial restriction of this region. Patients lied on the stretcher, in supine position, with their occiput resting against the physiotherapist's hands. Fingertips slide until contacting the posterior arch of atlas so that it "hangs" from the fingers. A deep and progressive pressure is applied, perpendicularly to muscle fibers, until the therapist perceives that muscle tone decreases. Approximate duration of ST is 10 minutes and it is performed with patients' eyes closed because of the connection between craniocervical muscle tone and eye movements; The articulatory technique (AT) was administered to correct and restore the mobility of joints between occiput, atlas and axis - correcting a global joint dysfunction. This technique was performed in supine position, in the same manner as the preceding technique, bilaterally and in two phases. First, a gentle head decompression is applied, followed by small circumduction searching for the joint barrier in rotation through selective tension. Second, the manipulation is performed by a cranial rotation towards the same side as the circumduction and around a vertical axis passing through the axis, without cervical flexion or extension and very little bending; Combined treatment (ST and AT). Combination treatment consisted of the application of the two preceding treatments in the same sequence: first, treatment with ST and then AT, thereafter maintaining the resting position for five minutes
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Tension-type headache; Depression; Anxiety; Manual therapy; Spinal manipulation; Patients diagnosed with tension-type headache