The Effects of Transcutaneous Occipital Nerve Stimulation and Instrument-Assisted Soft Tissue Mobilization on Patients With Chronic Migraine

Study Overview
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Brief Summary
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In this study, it was aimed to examine the effects of two different treatments applied to the neck region, which have been popular in recent years, on migraine.The study included 45 female patients aged 20-50 years with migraine complaints. The patients were divided into 3 randomized groups: control group (n=15), Instrument-Assisted Soft tissue Mobilization (EDYDM) group (n=15) and on Occipital nerve TENS (OTES) group(n=15).Each group was given home exercise to their treatment. Home exercises applied 1 time per day for 5 weeks. Each exercise in the exercise program was performed with 10 repetitions

Official Title
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Effects of Transcutaneous Occipital Nerve Stimulation and Instrument-Assisted Soft Tissue Mobilization in Chronic Migraine

Conditions
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Migraine

Intervention / Treatment
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* Other: IASTM
* Other: home exercise
* Device: Chattanooga direct Tens device (DJO UK Ltd, Guildford Surrey, United Kingdom)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Be between the ages of 20-50 International Classification of headache disorders, Third Edition (beta), using the criteria to be diagnosed with migraine without aura, migraine with a history of being at least an annual, VAS neck pain to be on Level 4, the hit-6 score is greater than 56 Exclusion Criteria: receiving pharmacological or non-pharmacological treatment regularly in the last three months, using a pacemaker, being an epileptic or severely psychiatric patient, conducting a surgical operation from the neck region, cervical disc degeneration or prolapse, the presence of different diagnoses of headaches

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Control Group<br>participants were given home exercise (once a day for 5 weeks) | Other: home exercise<br>* home exercise<br>|
| Experimental: IASTM (instrument-assisted soft tissue mobilization)<br>IASTM was applied to the patients (M. Sternocleidomastoideus, M. Trapezius, M. Paraspinales and M. Levator Scapula) in the IASTM group twice a week for 5 weeks. | Other: IASTM<br>* instrument-assisted soft tissue mobilization<br>|
| Experimental: OTES (Occipital Transcutenous Electric Stimulation)<br>Participants in the OTES group were treated with a Chattanooga direct Tens device (DJO UK Ltd, Guildford Surrey, United Kingdom) 3 times a week for 5 weeks. Four self-adhesive 40*40 mm sized electrodes were attached to the occipital region of the patients bilaterally, covering the occipital nerves. The current intensity was adjusted according to the patient. The current intensity started from 0 mA and the current intensity was increased one by one every 30 seconds, the patient was allowed to tolerate the current by giving current without muscle twitching or harmful stimulation. The current frequency was determined as 2/100 Hz. Square waves at 2 Hz were applied for 3 seconds followed by an automatic shift to 100 Hz for another 3 seconds. | Device: Chattanooga direct Tens device (DJO UK Ltd, Guildford Surrey, United Kingdom)<br>* OTES (Occipital Transcutenous Electric Stimulation)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visuel Analog Skale | VAS is a one-dimensional scale used to determine the severity of pain. The patient is asked to mark the pain he feels on a straight line of 10 cm. the value '0 means that there is no pain at all, and the value 10 means the most severe pain | Change from Baseline Pain at 5 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Headache effect test (HIT-6) | The Headache Impact Test-6 (HIT-6) has been developed to measure the factors contributing to headache and provides quantitative information about the impact of headache. HIT-6 consists of 6 items: pain, social functioning, role function, vitality, cognitive function and psychological distress. Scores ranging from 36 to 78 are obtained from the test Dec High scores indicate that the patient's headache negatively affects his daily life | Change from baseline headache at 5 weeks | 
| Pittsburgh sleep quality index (PQI) | The Pittsburgh sleep quality index (PQI) consists of 24 questions in total. The individual himself answers 19 of these questions. The remaining five questions are answered by the person staying with him, if the person is left alone, they are evaluated for informational purposes and are not added as scoring. There are seven dimensions in the index, namely subjective sleep quality, sleep latency, sleep duration, habitual sleep pattern, sleep disorder status, drug use to fall asleep, daytime dysfunction. The question of each dimension Dec a score between 0 and 3. A total score of 7 dimensions in total gives a sleep quality score. The total score is the range from 0 to 21. The sleep quality of people with a score total below 5 is 'good'; for those with more than 5, their sleep quality is interpreted as 'bad | change from baseline sleep at 5 weeks | 
| SF 36 | The SF-36 quality of life index is a scale that evaluates a person's general health status. 2 basic parameters (mental and physical) and 8 sub-parameter (emotional function, physical function, physical role, social function, mental health, general health, vitality, and pain) to rate on the total consists of 36 questions. From 0 to 100 points can be obtained from each parameter. High scores indicate that a person's quality of life is good | Change from baseline quality of life at 5 weeks |