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

治疗性按摩治疗疼痛

• 批准号: 7659280
• 负责人: ALBERT F MORASKA
• 金额: $ 23.25万
• 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/7659280
• 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; 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）：慢性或阵发性紧张型头痛 (TTH) 影响很大比例的人口，不仅影响个人生活，而且还会造成工作日损失和工人减少等重大社会经济负担生产率。尽管 TTH 是最常见的头痛疾病，但对具体治疗方法的研究还不够充分，并且落后于所有其他主要头痛分类。国际头痛协会指出，肌肉受累与某些形式的紧张型头痛有关。研究文献证实了肌肉受累，TTH 患者经常报告肌肉压痛、肌筋膜触发点 (MTrP) 升高以及颈部和颅骨肌肉的身体异常。因此，针对骨骼肌系统的治疗方法可能是 TTH 治疗的重要组成部分。治疗紧张型头痛的补充和替代医学方法（例如按摩）越来越受患者欢迎，但支持其疗效的证据有限。 TTH患者的肌肉组织与健康对照人群存在显着差异，这为手法治疗TTH的治疗提供了理论基础。例如，肌肉内的 MTrP 可以引起局部疼痛（点压痛）和远处部位疼痛（牵涉疼痛），模仿患者头痛的疼痛主诉，这使其成为头痛患者和按摩治疗师特别感兴趣的部位。我们最近在一个病例系列中报道，以 MTrP 疗法为重点的按摩疗法显着减少了紧张型头痛患者的头痛频率和持续时间。然而，按摩作为临床资源的潜力受到对照临床试验有效性验证的限制。该提案的目的是在安慰剂对照、随机临床试验中评估治疗性按摩对紧张型头痛的有效性。具体来说，该提案的目的是确定结构化按摩治疗计划（重点关注肌筋膜触发点治疗）对 TTH 参与者的疼痛和残疾措施的影响。 60 名患有 TTH 的受试者将被随机分为按摩治疗组、安慰剂组或等待名单对照组。训练有素的治疗师将遵循既定方案，在六周内进行 12 次按摩治疗或 12 次假治疗。受试者将在日记中记录头痛参数并完成评估以评估 TTH 造成的残疾。因此，具体目标#1是证实并扩展我们最近的研究结果，即在一项随机、安慰剂对照试验中，按摩疗法将减少 TTH 患者头痛的频率、强度和持续时间。由于 TTH 也会影响日常生活质量，因此具体目标 #2 是确定按摩疗法对 TTH 患者与头痛相关的残疾的影响。 公众健康相关性：紧张型头痛是一种痛苦的病症，可能会影响一个人多年的生活质量和生产力，但治疗选择很少。在随机对照试验设计中验证按摩疗法治疗紧张型头痛将为患有这种疾病的患者创造新的治疗选择。