Therapeutic Massage for Management of Pain & Disability in Tension-Type Headache

治疗性按摩治疗疼痛

• 批准号: 7935497
• 负责人: ALBERT F MORASKA
• 金额: $ 22.96万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2012-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7935497
• 关键词: Accounting; Address; Affect; Case Series; Cephalic; Cervical; Chronic; Classification; Clinical; Clinical Trials Design; Complementary and alternative medicine; Consumption; Control Groups; Controlled Clinical Trials; Data; Distant; Economic Burden; Effectiveness; Employment; Evaluation; Expectancy; Foundations; Frequencies; Goals; Headache; Headache Disorders; Healthcare; Impairment; Insurance Carriers; International; Intervention; Investigation; Life; Literature; Manuals; Massage; Measures; Modality; Muscle; Myofascial Trigger Point; Outcome; Pain; Pain management; Participant; Patients; Personal Satisfaction; Pharmaceutical Preparations; Placebo Control; Placebos; Population; Population Control; Productivity; Protocols documentation; Quality of life; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Relative (related person); Reporting; Research; Resources; Site; Skeletal Muscle; Societies; Structure; Symptoms; Tension Headache; Testing; Therapeutic; Therapeutic Effect; Training; Waiting Lists; base; diaries; disability; experience; interest; meetings; programs; public health relevance; randomized placebo controlled trial; skeletal; socioeconomics; therapeutic effectiveness

DESCRIPTION (provided by applicant): Chronic or episodic forms of tension-type headache (TTH) affect a high percentage of the population and not only impact personal life, but also pose a significant socio-economic burden in terms of lost workdays and decreased worker productivity. Although TTH is the most prevalent of the headache disorders, research into specific treatments is inadequate and lags all other major headache classifications. The International Headache Society indicates that a muscular involvement is associated with some forms of tension-type headache. A muscular involvement is confirmed in the research literature, as elevation in muscle tenderness, myofascial trigger point's (MTrP's), and physical abnormalities in cervical and cranial muscles are often reported by patients with TTH. Thus, a treatment approach that addresses the skeletal musculature may be an important component in the management of TTH. Complementary and alternative medicine approaches, such as massage, to the treatment of tension-type headache are increasingly popular among patients, but evidence supporting their efficacy is limited. Muscle tissues of patients with TTH have noteworthy differences from a healthy control population, which provide a theoretical basis for manual therapy as a treatment for TTH. For example, a MTrP within a muscle can elicit pain locally (point tenderness) and at distant sites (referred pain) that mimic the patient headache pain complaint, which makes it a site of particular interest by both the headache patient and massage therapist. We recently reported, in a case series, that massage therapy with a focus on MTrP therapy significantly reduced frequency and duration of headache in those with tension-type headache. However, the potential for massage to be used as a clinical resource is limited by verification of its effectiveness in a controlled clinical trial. The intent in this proposal is to assess the effectiveness of therapeutic massage for tension-type headache in a placebo-controlled, randomized clinical trial. Specifically, the objective of this proposal is to determine the impact of a structured massage therapy program, with a focus on myofascial trigger point therapy, on pain and disability measures in participants with TTH. Sixty subjects with TTH will be randomized into massage therapy, placebo or wait-list control groups. Trained therapists will follow a defined protocol to administer 12 massage therapy sessions or 12 sham treatments over a six-week period. Subjects will record headache parameters in a daily diary and complete evaluations to assess disability due to TTH. Thus, Specific Aim #1 is to confirm and extend our recent findings that massage therapy will reduce the frequency, intensity and duration of headache in patients with TTH in a randomized, placebo-controlled trial. Since TTH can also affect the quality of daily living, Specific Aim #2 is to determine the effect of massage therapy on disability associated with headache in patients with TTH. PUBLIC HEALTH RELEVANCE: Tension-type headache is a painful condition that can affect ones quality of life and productivity for many years, but has few treatment options. Verification of massage therapy for the treatment of tension-type headache in a randomized, controlled trial design will create new treatment options for patients with this condition.

描述（由申请人提供）：紧张型头痛（TTH）的慢性或情节形式会影响人口的很高比例，不仅会影响个人生活，而且还会影响损失的工作日和降低工人生产率的社会经济负担。尽管TTH是头痛障碍中最普遍的，但对特定疗法的研究不足，并且所有其他主要的头痛分类滞后。国际头痛协会表明，肌肉的参与与某些形式的紧张型头痛有关。研究文献证实了肌肉的参与，因为肌肉压痛，肌筋膜触发点（MTRP）以及宫颈和颅肌的身体异常经常被TTH报告。因此，解决骨骼肌的治疗方法可能是TTH管理中的重要组成部分。互补和替代药物方法（例如按摩）治疗紧张型头痛的治疗越来越受欢迎，但支持其功效的证据受到限制。患有TTH患者的肌肉组织与健康对照人群的差异值得注意，这为手动治疗作为TTH的治疗提供了理论基础。例如，肌肉中的MTRP可以在局部引起疼痛（点压痛），并在模仿患者的头痛疼痛抱怨的遥远部位（转介疼痛），这使其成为头痛患者和按摩治疗师特别感兴趣的部位。我们最近在一个案例系列中报道说，侧重于MTRP治疗的按摩疗法显着降低了张力型头痛患者的头痛频率和头痛持续时间。但是，按摩用作临床资源的潜力受对照临床试验的有效性的验证限制。该提案的目的是评估在安慰剂对照的，随机的临床试验中，治疗性按摩对张力型头痛的有效性。具体而言，该提案的目的是确定结构化按摩治疗计划的影响，重点是肌​​筋膜触发点疗法，对TTH参与者的疼痛和残疾度量。 TTH的60名受试者将被随机分为按摩疗法，安慰剂或等待名单对照组。训练有素的治疗师将遵循定义的方案，在六周的时间内管理12次按摩治疗课程或12次假手术治疗。受试者将在每日日记中记录头痛参数，并进行完整的评估，以评估由于TTH引起的残疾。因此，具体目标是确认和扩展我们最近的发现，即按摩疗法将在一项随机的安慰剂对照试验中降低TTH患者的头痛的频率，强度和持续时间。由于TTH也会影响日常生活的质量，因此特定的目标是确定按摩治疗对TTH患者头痛相关的残疾的影响。 公共卫生相关性：紧张类型的头痛是一种痛苦的疾病，可以影响多年的生活质量和生产力，但治疗方案很少。在随机，对照试验设计中对按摩疗法治疗张力型头痛的验证将为患有这种疾病的患者创建新的治疗选择。