| 1. |
- Tornøe, Birte, et al.
(författare)
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Specific strength training compared with interdisciplinary counseling for girls with tension-type headache : A randomized controlled trial
- 2016
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Ingår i: Journal of Pain Research. - 1178-7090. ; 9, s. 257-270
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood tension-type headache (TTH) is a prevalent and debilitating condition for the child and family. Low-cost nonpharmacological treatments are usually the first choice of professionals and parents. This study examined the outcomes of specific strength training for girls with TTH. Methods: Forty-nine girls aged 9–18 years with TTH were randomized to patient education programs with 10 weeks of strength training and compared with those who were counseled by a nurse and physical therapist. Primary outcomes were headache frequency, intensity, and duration; secondary outcomes were neck–shoulder muscle strength, aerobic power, and pericranial tenderness, measured at baseline, after 10 weeks intervention, and at 12 weeks follow-up. Health-related quality of life (HRQOL) questionnaires were assessed at baseline and after 24 months. Results: For both groups, headache frequency decreased significantly, P=0.001, as did duration, P=0.022, with no significant between-group differences. The odds of having headache on a random day decreased over the 22 weeks by 0.65 (0.50–0.84) (odds ratio [95% confidence interval]). For both groups, neck extension strength decreased significantly with a decrease in cervicothoracic extension/flexion ratio to 1.7, indicating a positive change in muscle balance. In the training group, shoulder strength increased ≥10% in 5/20 girls and predicted VO2max increased ≥15% for 4/20 girls. In the training group, 50% of girls with a headache reduction of ≥30% had an increase in VO2max >5%. For the counseling group, this was the case for 29%. A 24-month follow-up on HRQOL for the pooled sample revealed statistically significant improvements. Fifty-five percent of the girls reported little to none disability. Conclusion: The results indicate that both physical health and HRQOL can be influenced significantly by physical exercise and nurse counseling. More research is needed to examine the relationship between physical exercise, VO2max, and TTH in girls. Thus, empowering patient education to promote maximum possible outcomes for all children needs more attention.
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| 2. |
- Krøll, Lotte Skytte, et al.
(författare)
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Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain
- 2017
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Ingår i: Journal of Headache and Pain. - : Springer Science and Business Media LLC. - 1129-2369 .- 1129-2377. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The prevalence of migraine with co-existing tension-type headache and neck pain is high in the general population. However, there is very little literature on the characteristics of these combined conditions. The aim of this study was to investigate a) the prevalence of migraine with co-existing tension-type headache and neck pain in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain compared to healthy controls, c) the perceived ability of persons with migraine and co-existing tension-type headache and neck pain to perform physical activity, and d) which among the three conditions (migraine, tension-type headache or neck pain) is rated as the most burdensome condition. Methods: The study was conducted at a tertiary referral specialised headache centre where questionnaires on physical activity, psychological well-being, perceived stress and self-rated health were completed by 148 persons with migraine and 100 healthy controls matched by sex and average age. Semi-structured interviews were conducted to assess characteristics of migraine, tension-type headache and neck pain. Results: Out of 148 persons with migraine, 100 (67%) suffered from co-existing tension-type headache and neck pain. Only 11% suffered from migraine only. Persons with migraine and co-existing tension-type headache and neck pain had lower level of physical activity and psychological well-being, higher level of perceived stress and poorer self-rated health compared to healthy controls. They reported reduced ability to perform physical activity owing to migraine (high degree), tension-type headache (moderate degree) and neck pain (low degree). The most burdensome condition was migraine, followed by tension-type headache and neck pain. Conclusions: Migraine with co-existing tension-type headache and neck pain was highly prevalent in a clinic-based sample. Persons with migraine and co-existing tension-type headache and neck pain may require more individually tailored interventions to increase the level of physical activity, and to improve psychological well-being, perceived stress and self-rated health.
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| 3. |
- Krøll, Lotte Skytte, et al.
(författare)
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Migraine co-existing tension-type headache and neck pain : Validation of questionnaires
- 2015
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter GmbH. - 1877-8860 .- 1877-8879. ; 8, s. 10-16
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: Migraine often includes co-existing tension-type headache (TTH) and neck pain (NP). Multiple headache questionnaires assessing headache impact have been described previously; however, none of the existing questionnaires have been designed to cover migraine with co-existing TTH and NP. Therefore a new questionnaire was developed to measure these co-morbidities. The aim was to determine face and content validity of the newly developed questionnaire, "Impact of Migraine, Tension-Type Headache and Neck Pain" (impact M-TTH-NP) and to determine face and content validity of the International Physical Activity Questionnaire (IPAQ short form), Migraine-Specific Quality of Life Questionnaire (MSQ v. 2.1), WHO-Five Well-Being Index (WHO-5), Major Depression Inventory (MDI) and Neck Disability Index (NDI) not yet validated in this target population. Material and methods: The new multi-dimensional questionnaire "Impact M-TTH-NP" cover pain, triggers, psychosocial, socioeconomic and work related aspects, based on a four-week recall period. The items are rated on an 11-point numeric rating scale with the end points 0 = no impact and 10 = most imaginable impact. Face validity was assessed by migraine patients with co-existing TTH and NP. They were recruited between September 2012 and March 2013 from a tertiary referral headache centre. Nine women with a mean age of 38 years participated in group interviews. The questionnaires were reviewed for relevance and meaningfulness. Content validity was assessed by 13 headache experts. They had worked with headache diseases for an average of 9 (range, 2-38) years. Experts were recruited between August 2012 and October 2012. Nine medical doctors, two physical therapists, one headache nurse and one psychologist (eight women and five men, mean age of 42 years) participated. The experts rated each item of the questionnaires using a four-point Likert scale with the end points 1 = not relevant and 4 = highly relevant. The quantitative measurement of content validity was calculated by the item-level content validity index (I-CVI) and the scale-level content validity average method (S-CVI/Ave). The average deviation (AD) index was used as a measure of interrater agreement. Results: Impact M-TTH-NP showed acceptable face validity. Of 78 items twelve were revised and one was added based on group interviews and expert review. Seventy-two items (92%) obtained I-CVI. ≥ 0.78 (range 0.78-1.00) indicating excellent content validity, 71 items (91%) obtained acceptable AD index. Nine items did not meet either the limit for excellent I-CVI and/or acceptable AD index. The overall S-CVI/Ave was 0.92 indicating an excellent content validity. In addition, four of the five additional questionnaires showed acceptable face validity (MSQ, WHO-5, MDI and NDI) and three showed excellent content validity (WHO-5, MDI and NDI) for patients suffering from migraine and co-existing TTH and NP. Conclusions and implications: The impact M-TTH-NP questionnaire showed acceptable face validity and excellent content validity and may be useful when evaluating treatment effect in this target group. The new impact M-TTH-NP questionnaire in combination with the additional questionnaires that together assess pain, triggers, psychosocial and socioeconomic aspects may provide a deeper understanding of the complexity of migraine with co-existing TTH and NP.
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| 4. |
- Krøll, Lotte Skytte, et al.
(författare)
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The effects of aerobic exercise for persons with migraine and co-existing tension-type headache and neck pain. A randomized, controlled, clinical trial
- 2018
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Ingår i: Cephalalgia. - : SAGE Publications. - 0333-1024 .- 1468-2982. ; 38:12, s. 1805-1816
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate aerobic exercise in migraine and co-existing tension-type headache and neck pain. Methods: Consecutively recruited persons with migraine and co-existing tension-type headache and neck pain were randomized into an exercise group or control group. Aerobic exercise consisted of bike/cross-trainer/brisk walking for 45 minutes, three times/week. Controls continued usual daily activities. Pain frequency, intensity, and duration; physical fitness, level of physical activity, well-being and ability to engage in daily activities were assessed at baseline, after treatment and at follow-up. Results: Fifty-two persons completed the study. Significant between-group improvements for the exercise group were found for physical fitness, level of physical activity, migraine burden and the ability to engage in physical activity because of reduced impact of tension-type headache and neck pain. Within the exercise group, significant reduction was found for migraine frequency, pain intensity and duration, neck pain intensity, and burden of migraine; an increase in physical fitness and well-being. Conclusions: Exercise significantly reduced the burden of migraine and the ability to engage in physical activity because of reduced impact of tension-type headache and neck pain. Exercise also reduced migraine frequency, pain intensity and duration, although this was not significant compared to controls. These results emphasize the importance of regular aerobic exercise for reduction of migraine burden.
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| 5. |
- Madsen, Bjarne K, et al.
(författare)
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Efficacy of strength training on tension-type headache : A randomised controlled study
- 2018
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Ingår i: Cephalalgia. - : SAGE Publications. - 0333-1024 .- 1468-2982. ; 38:6, s. 1071-1080
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Tidskriftsartikel (refereegranskat)abstract
- Background Strength training has shown effects in reducing neck pain. As neck pain is highly prevalent in tension-type headache (TTH), it is relevant to examine the effect of strength training of the shoulder muscles on TTH patients. Aim To examine the effect of strength training of the shoulder/neck muscles on TTH frequency and duration. Methods Sixty patients with TTH were randomised into strength training or a control group. The strength training group trained ten weeks with elastic resistance bands. The control group performed ergonomic and posture correction. Efficacy was evaluated at follow-up after 19-22 weeks. Results Twenty-three patients completed strength training and 21 completed ergonomic and posture correction (per-protocol). No between-group effect was detected, but within groups numerical reductions were noted in both groups from baseline to follow-up. Frequency of TTH in the strength training group decreased by 11% ( P = 0.041) and duration decreased by10% ( P = 0.036), while the ergonomic and posture correction group showed a significant reduction in frequency of 24% ( P = 0.0033) and a decrease in duration of 27% ( P = 0.041). Conclusion No significant difference between the groups was found and the within-group effects did not reach clinical significance. Combining all the elements into a multifaceted intervention could prove more useful and should be further explored in future studies. Clinical trials registration number NCT02984826.
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| 8. |
- Mitsikostas, Dimos D., et al.
(författare)
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Refractory chronic cluster headache: a consensus statement on clinical definition from the European Headache Federation
- 2014
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Ingår i: Journal of Headache and Pain. - : Springer Science and Business Media LLC. - 1129-2369 .- 1129-2377. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Chronic cluster headache (CCH) often resists to prophylactic pharmaceutical treatments resulting in patients' life damage. In this rare but pragmatic situation escalation to invasive management is needed but framing criteria are lacking. We aimed to reach a consensus for refractory CCH definition for clinical and research use. The preparation of the final consensus followed three stages. Internal between authors, a larger between all European Headache Federation members and finally an international one among all investigators that have published clinical studies on cluster headache the last five years. Eighty-five investigators reached by email. Proposed criteria were in the format of the International Classification of Headache Disorders III-beta (description, criteria, notes, comments and references). Following this evaluation eight drafts were prepared before the final. Twenty-four (28.2%) international investigators commented during two rounds. Refractory CCH is described in the present consensus as a situation that fulfills the criteria of ICHD-3 beta for CCH with at least three severe attacks per week despite at least three consecutive trials of adequate preventive treatments. The condition is rare, but difficult to manage and invasive treatments may be needed. The consensus addresses five specific clinical and paraclinical diagnostic criteria followed by three notes and specific comments. Although refractory CCH may be not a separate identity these specific diagnostic criteria should help clinicians and investigators to improve patient's quality of life.
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| 9. |
- Tibaek, Sigrid, et al.
(författare)
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Are activity limitations associated with lower urinary tract symptoms in stroke patients? A cross-sectional, clinical survey.
- 2009
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 43:5, s. 383-389
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Tidskriftsartikel (refereegranskat)abstract
- Objective . To assess self-reported activity limitations in a clinical sample of stroke patients and to identify their association with prevalence, severity and impact on daily life of lower urinary tract symptoms (LUTS). Material and methods . A cross-sectional, clinical survey was initiated whereby stroke patients were invited to complete four activity limitations measurements: Barthel Index, mobility velocity, mobility distance, mobility aids and one LUTS measurement: the Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire. Of 519 stroke patients, 482 subjects were eligible. Results . The response rate was 84%. The activity limitations were reported by 17-34% depending on the measurement. Mobility velocity was highly significantly associated (p=0.01) with severity of LUTS. In the LUTS incontinence symptom group, Barthel Index and mobility velocity were significantly associated with prevalence [p=0.03, odds ratio (OR) 2.08 and p=0.05, OR 1.87, respectively]. Barthel Index and mobility distance were also associated with severity (p=0.03 and p=0.04, respectively) and Barthel Index was associated with the prevalence of bother (p=0.02, OR 2.12). Conclusion . This study indicate for the first time that activity limitations are closely related to LUTS in stroke patients and that rehabilitation should also be directed towards the treatment of LUTS.
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| 10. |
- Tibaek, Sigrid, et al.
(författare)
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Can pelvic floor muscle training improve quality of life in men with mild to moderate post-stroke and lower urinary tract symptoms?
- 2017
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Ingår i: European Journal of Physical and Rehabilitation Medicine. - : Edizioni Minerva Medica. - 1973-9087 .- 1973-9095. ; 53:3, s. 416-425
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Lower urinary tract symptoms (LUTS) have a significant impact on quality of life (QoL) in post-stroke patients. AIM: The aim of this study was to evaluate the effect of pelvic floor muscle training (PFMT) on QoL parameters in men with post-stroke LUTS. DESIGN: Randomized, controlled and single-blinded trial. SETTING: Outpatients, University Hospital. POPULATION: Thirty-one men, median age 68 (interquartile range 60-74) years, with post-stroke LUTS were included. Thirty participants completed the study. METHODS: The participants randomized to the treatment group were treated in a systematic, controlled and intensive PFMT program over 3 months (12 weekly sessions). The participants randomized to the control group did not receive specific LUTS treatment. The effect was measured on the 36-Item Short Form Health Survey (SF-36) and the Nocturia Quality-of-Life (N-QoL) Questionnaire. RESULTS: The results on SF-36 indicated significant improvement within pre- and post-test in the domains emotional role (median 77 to 100, P=0.03) and vitality (median 65 to 70, P=0.03) in the treatment group, but not the control group. There were no statistically significant differences between groups at pre-test, post-test or 6-month follow-up. The results on N-QoL indicated statistically significant differences between pre- and post-test in the bother/concern domain in both groups and in sleep/energy for the control group, but not the treatment group. There were no statistically significant differences between groups. CONCLUSIONS: PFMT may improve the emotional health and vitality domains of QoL in men with mild to moderate post-stroke and LUTS; however the improvements in the treatment group were not significantly better than for the control group. PFMT did not improve nocturia-related QoL. CLINICAL REHABILITATION IMPACT: This study is the first to evaluate the effect of PFMT on QoL parameters in men with mild to moderate post-stroke and LUTS. The results indicate some short-term effect on SF-36 but none on N-QoL. However, further studies with larger sample sizes and with less restrictive inclusion and exclusion criteria are requested.
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