| 1. |
- Klausen, Susanne Hwiid, et al.
(författare)
-
Nonpharmacological Interventions Addressing Pain, Sleep, and Quality of Life in Children and Adolescents with Primary Headache : A Systematic Review
- 2019
-
Ingår i: Journal of Pain Research. - 1178-7090. ; 12, s. 3437-3459
-
Forskningsöversikt (refereegranskat)abstract
- Purpose: Children and adolescents with primary headache are at risk of persistent somatic symptoms and reduced quality of life (Qol) due to pain and pain-related behaviors, such as avoiding school and activities. Sleep is essential to health, and children and adolescents with primary headaches have more sleep complaints than do healthy controls. A treatment approach that addresses multifactorial causes is likely important. Nonpharmacological interventions seem promising. However, knowledge about effective strategies is limited. The objective of this review is to assess the effect of nonpharmacological interventions in randomized controlled trials (RCTs) among children and adolescents with primary headache in order to identify useful strategies.Patients and methods: Outcome measures are pain, sleep, Qol, and coping versus no intervention or control intervention. Medline, CINAHL, EMBASE, and PsycINFO were searched for eligible trials. ClinicalTrials.gov. was searched for ongoing trials. Initial searches yielded 2588 publications. After initial screening and subsequent full-text review and quality assessment, 13 RCTs reported in 15 articles were selected for review. All reviewers independently assessed study quality using the CONSORT criteria for nonpharmacological interventions.Results: Cognitive behavioral therapy (CBT), including education on pain-related topics, sleep, coping, and stress management, is an effective strategy for reducing headache and pain within groups over time. Fifteen studies assessed pain, 3 studies assessed sleep, 6 studies assessed Qol, and 11 studies assessed coping.Conclusion: Strategies identified as useful were parts of CBT interventions. However, it was not possible to identify a single effective intervention addressing pain, sleep, Qol, and coping in children and adolescents with headache, primarily because sleep was infrequently addressed. Various aspects of Qol and coping strategies were assessed, rendering comparison difficult. Strategies for future interventions should include descriptions of theory-driven CBT interventions, depending on clinical setting and based on local resources, to promote a solid evidence base for nonpharmacological interventions.
|
|
| 2. |
- Madsen, Bjarne K, et al.
(författare)
-
Efficacy of strength training on tension-type headache : A randomised controlled study
- 2018
-
Ingår i: Cephalalgia. - : SAGE Publications. - 0333-1024 .- 1468-2982. ; 38:6, s. 1071-1080
-
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.
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
- Tornöe, Birte, et al.
(författare)
-
Computer Animated Relaxation Therapy in Children Between 7 and 13 Years with Tension-Type Headache: A Pilot Study
- 2012
-
Ingår i: Applied Psychophysiology and Biofeedback. - : Springer Science and Business Media LLC. - 1573-3270 .- 1090-0586. ; 37:1, s. 35-44
-
Tidskriftsartikel (refereegranskat)abstract
- This pilot study evaluated the effect of computer animated relaxation therapy in children between 7 and 13 years with tension-type headache and the children's experiences with the therapy. The therapy consisted of an uncontrolled nine-session course in modified progressive relaxation therapy assisted by computer animated surface EMG provided from the trapezius muscles and with the physiotherapist as a participant observer. Outcome measures were (a) headache frequency and intensity, (b) pericranial tenderness, (c) tension patterns, and (d) evaluations assessed at baseline and at 3 months follow up. Nine children, mean age 10.9 (SD 1.7) years, diagnosed with frequent episodic or chronic tension-type headache completed the course. The results showed a mean improvement of 45% for headache frequency at 3 months follow up versus baseline and a significant reduction in headache frequency for all participants and in Total Tenderness Score for children with frequent episodic tension-type headache. The children expressed a growing understanding of body reactions and an acquired ability to deactivate and regulate these reactions. Computer animated SEMG seems an applicable learning strategy for young headache sufferers. This study suggests that children below the age of 13 need both the dialog and guidance from a participant observer in order to achieve body awareness.
|
|
| 6. |
|
|
| 7. |
- Tornøe, Birte, et al.
(författare)
-
Specific strength training compared with interdisciplinary counseling for girls with tension-type headache : A randomized controlled trial
- 2016
-
Ingår i: Journal of Pain Research. - 1178-7090. ; 9, s. 257-270
-
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.
|
|
| 8. |
|
|
| 9. |
- Tornöe, Birte
(författare)
-
The child with tension-type headache. Physical factors and interactive interventions
- 2014
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Tension-type headache (TTH) in children and especially girls is a prevalent problem worldwide, and means there is a risk of school absenteeism, medication overuse and persistent headache. Knowledge about the associated physical factors is limited, as is knowledge on evidence based interventions. The overall aim of this thesis was to examine the associations of physical factors with frequent or chronic TTH in children. Furthermore to examine aspects of interactive interventions as empowering patient education studying where and how to direct interdisciplinary headache services for the child and parents from the perspective of a physiotherapist. The first study piloted computer-animated relaxation therapy with children 7-13 years of age and investigated how so young the children experienced the therapy. Furthermore it piloted enrolment procedures, the compliance of the child and parents and to gauge whether a large-scale controlled trial was warranted. The second study aimed at determining the test-retest repeatability of neck-shoulder muscle strength in healthy children 9-18 years of age. The second study also determined the test-retest repeatability of the Total Tenderness Score (TTS) and of a sub-maximal cycle ergometer test predicting maximal oxygen uptake. The third study was a case-control study aiming at examining the combined measurements of muscle strength in the neck-shoulder region, aerobic power, and pericranial tenderness in girls 9 to 18 years of age, and the measurements associations with frequent episodic or chronic TTH compared to healthy controls. The fourth study based on a randomized controlled trial examined the outcomes of specific strength training of shoulder muscles compared with counselling with nurse and physiotherapist in short defined patient education programmes for girls 9-18 years with TTH. Results from study I indicated that a nine session computer-animated relaxation therapy seemed a significantly effective learning strategy presenting a mean improvement percent of 45% of headache frequency. The children expressed a growing understanding of body reactions and an acquired ability to deactivate and regulate these reactions. The study also elucidated the enrolment procedures and capacity of the clinic for the planning of the larger study. The results from study II found acceptable test-retest repeatability,providing a stable basis for the research in study III and IV. The main findings in study III were that girls with TTH had significantly higher pericranial tenderness than controls in correlation with headache frequency (r=0.66, p<0.001). Results indicated a significant association between reduced shoulder and neck strength and headache. There was likewise a significant association between reduced predicted VO2max and headache. From study IV the girls self-reported health related quality of life indicated experienced difficulties in physical health, emotional health and school functioning. The results showed a significant effect on headache frequency and duration from both strength training and counselling with no significant between group differences. During 22 weeks 33% of the girls had a headache reduction ≥ 30% and 26% reached a reduction of ≥ 50%. Both groups also seemed to benefit from exercising or body awareness with a significant reduction in neck extension/flexion ratio. Strength training showed a potential to increase strength and oxygen uptake. Perceived lack of time and/ or motivation constrained inclusion and dropouts.As a conclusion the results highlight that physiotherapy plays a central role in headache services in educating the children in strategies to enhance health-related physical factors and body-awareness, reduce headache and thus improve their quality of life. Strength training or relaxation therapy in combination with interdisciplinary counselling will provide positive outcomes. As both relaxation therapy and strength training presented significant outcomes the use of these interventions should be decided by the physiotherapist, the child and parents an evaluation of the child’s individual needs. Interpreting the results within an empowering patient education we can summarize that the interventions and materials used in the studies were relevant and suitable for children 7-18 years of age. It is recommended to consider the relationship between weekly exercise intensity and exercise variation in order to keep a stable weekly exercise volume. Motivation for change and the barriers the contemporary family, children and parents may experience in order to integrate learning and change habitual physical behaviours need to be examined. The organization of patient education is recommended to be considered innovatively in order to further reach the needs of the contemporary family. This thesis presents the dimensions of empowerment that are essential in relation to the child with TTH and their parents.
|
|
