体位矫正配合骨科按摩治疗对偏头痛患者头痛频率及肌肉压痛的影响

Vahtrik Doris, Bergmann Margot, Vanahunt Ingrid, Braschinsky Mark
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引用次数: 0

摘要

背景:由于不同物理治疗方法在治疗偏头痛患者中的效果存在争议,本研究的目的是评估体位矫正和骨科按摩作为治疗头痛和颈肩肌肉压痛的干预措施,在改善发作性偏头痛患者(n = 10)在治疗前、治疗后5周和治疗后6个月的颈椎活动范围和上肢姿势的有效性。方法:采用头痛治疗反应不足(HURT)问卷对干预措施的有效性进行测量。颈部和肩部肌肉压痛采用总压痛评分(TTS)和颈椎活动度(caAROM)进行评估。通过观察从侧面和后部观察上半身的排列。结果:与治疗前相比,治疗5周后(P < 0.05, g = 0.98, 95% CI = 0.06, 1.91)和治疗6个月后(P < 0.05, g = 1.08, 95% CI = 0.14, 2.02)患者的HURT-3评分均显著降低。治疗5周后TTS显著降低(P < 0.01, g = 1.40, 95% CI = 0.42, 2.38),半年后TTS升高,但无显著性差异(P > 0.05, g = 0.51, 95% CI = -0.38, 1.40)。治疗5周后,6个不同方向的caAROM均增加,但治疗6个月后,仅右侧屈曲有显著增加(P < 0.05, g = -1.17, 95% CI = -2.12, -0.22)。治疗5周后和治疗6个月后(P < 0.05, g = -1.25, 95% CI = -2.21, -0.29),患者侧位体位明显改善(P < 0.05, g = -1.22, 95% CI = -2.18, -0.27)。从后视图来看,只有在5周的治疗方案后才有显著的姿势矫正(P < 0.05, g = -1.37, 95% CI = -2.34, -0.39)。结论:经体位矫正及矫形按摩治疗半年后,头痛发生率降低,但颈肩区肌肉压痛加重。治疗后6个月,患者头痛频率和体位矫正效果显著。治疗5周后和治疗6个月后,颈椎运动特征与标准值相当。体位矫正和矫形按摩对减少发作性偏头痛患者的头痛频率是有效的。
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Effect of Postural Correction and Orthopedic Massage Therapy on the Frequency of Headaches and Tenderness of Muscles in Migraine Patients
Background: Due to controversial information about the effect of different physiotherapy methods used in the treatment of migraine patients, the aim of the study was to assess the effectiveness of postural correction and orthopedic massage as interventions against headache, and neck and shoulder area muscles tenderness, on improving active range of cervical motion and upper body posture in episodic migraine patients (n = 10) before, after five-week therapy program and 6 months after the therapy. Methods: Effectiveness of interventions against headache was measured by the Headache Under-Response to Treatment (HURT) Questionnaire. Neck and shoulder area muscles tenderness was assessed using Total Tenderness Score (TTS) and active range of cervical motion (caAROM) by cervical goniometry. Upper body alignment from lateral and posterior view was assessed by observation. Results: HURT-3 score was significantly lower both after five-week therapy program (P < 0.05, g = 0.98, 95% CI = 0.06, 1.91) and 6 months after the therapy (P < 0.05, g = 1.08, 95% CI = 0.14, 2.02) as compared to the respective characteristics before the therapy. TTS was significantly lower after five-week therapy program (P < 0.01, g = 1.40, 95% CI = 0.42, 2.38), increasing during half a year, but not significantly (P > 0.05, g = 0.51, 95% CI = -0.38, 1.40). Six different directions of caAROM increased after five-week therapy, but significant increase was registered only in lateral flexion to the right 6 months after the therapy (P < 0.05, g = -1.17, 95% CI = -2.12, -0.22). Upper body posture from lateral view was significantly improved after five-week therapy (P < 0.05, g = -1.25, 95% CI = -2.21, -0.29) and 6 months after the therapy (P < 0.05, g = -1.22, 95% CI = -2.18, -0.27). From posterior view significant postural correction was registered only after five-week therapy program (P < 0.05, g = -1.37, 95% CI = -2.34, -0.39). Conclusions: Half a year after the postural correction and orthopedic massage therapy the frequency of headaches is lowered, but neck and shoulder area muscles tenderness has increased. Significant positive effect on the frequency of headaches and correct upper body posture from lateral view is maintained 6 months after the therapy. Characteristics of cervical motions are comparable to standard values both after five-week therapy program and 6 months after the therapy. Postural correction and orthopedic massage are effective in reducing frequency of headaches in episodic migraine patients.
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