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Specific strength training compared with interdisciplinary counseling for girls with tension-type headache : A randomized controlled trial

Tornøe, Birte LU ; Andersen, Lars L.; Skotte, Jørgen H.; Jensen, Rigmor; Jensen, Claus; Madsen, Bjarne K.; Gard, Gunvor LU ; Skov, Liselotte and Hallström, Inger LU (2016) In Journal of Pain Research 9. p.257-270
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... (More)

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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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiovascular fitness, Child, Empowering patient education, Headache, Health and physical therapy, Muscular fitness, Neck and shoulder muscles
in
Journal of Pain Research
volume
9
pages
14 pages
publisher
Dove Press
external identifiers
  • Scopus:84974698171
ISSN
1178-7090
DOI
10.2147/JPR.S97826
language
English
LU publication?
yes
id
ee3c3a51-df09-48da-9914-2abd0f70bae0
date added to LUP
2016-07-07 12:19:18
date last changed
2017-01-01 08:30:03
@article{ee3c3a51-df09-48da-9914-2abd0f70bae0,
  abstract     = {<p>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 VO<sub>2max</sub> increased ≥15% for 4/20 girls. In the training group, 50% of girls with a headache reduction of ≥30% had an increase in VO<sub>2max</sub> &gt;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, VO<sub>2max</sub>, and TTH in girls. Thus, empowering patient education to promote maximum possible outcomes for all children needs more attention.</p>},
  author       = {Tornøe, Birte and Andersen, Lars L. and Skotte, Jørgen H. and Jensen, Rigmor and Jensen, Claus and Madsen, Bjarne K. and Gard, Gunvor and Skov, Liselotte and Hallström, Inger},
  issn         = {1178-7090},
  keyword      = {Cardiovascular fitness,Child,Empowering patient education,Headache,Health and physical therapy,Muscular fitness,Neck and shoulder muscles},
  language     = {eng},
  month        = {05},
  pages        = {257--270},
  publisher    = {Dove Press},
  series       = {Journal of Pain Research},
  title        = {Specific strength training compared with interdisciplinary counseling for girls with tension-type headache : A randomized controlled trial},
  url          = {http://dx.doi.org/10.2147/JPR.S97826},
  volume       = {9},
  year         = {2016},
}