Efficacy of physiotherapy interventions for the management of adults with cervicogenic headache: A systematic review and meta‐analyses

医学 物理疗法 颈源性头痛 随机对照试验 置信区间 手法治疗 荟萃分析 心理干预 可视模拟标度 梅德林 科克伦图书馆 分级(工程) 内科学 替代医学 偏头痛 病理 精神科 政治学 法学 土木工程 工程类
作者
Anthony Demont,Simon Lafrance,Clément Gaska,Amélie Kechichian,Aurélie Bourmaud,François Desmeules
出处
期刊:Pm&r [Wiley]
卷期号:15 (5): 613-628 被引量:6
标识
DOI:10.1002/pmrj.12856
摘要

Abstract Objective To update and appraise the efficacy of physiotherapy for adults with cervicogenic headache. Literature Survey Bibliographic searches were conducted up to October 2021 for randomized controlled trials (RCTs), assessing the efficacy of physiotherapy interventions for adults with cervicogenic headache, in five databases: CINAHL, Physiotherapy Evidence Database (PEDro), PubMed, Sage Journals, and Wiley Online Library. Methodology Data extraction of included trials was conducted by two reviewers according to a standardized extraction form. The PEDro tool and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach were used for grading evidence. Results from trials with similar interventions and with similar outcome measures were pooled into separate meta‐analyses. A qualitative synthesis was performed for studies that were not pooled into meta‐analyses. Synthesis Fourteen trials were included. Moderate‐certainty evidence indicates that manual therapy significantly reduces headache frequency (mean difference [MD]: −0.93 episodes/week; 95% confidence interval [CI]: −1.40 to −0.46; 2 RCTs; n = 265) compared to sham manual therapy, and headache frequency (MD: −1.23 episodes/week; 95% CI: −1.55 to −0.91; 3 RCTs; n = 126) and intensity (MD: −1.63/10; 95% CI: −2.15 to −1.10; 4 RCTs; n = 208) compared to no treatment in the short term. At 12‐month follow‐up, moderate‐certainty evidence indicates that manual therapy did not lead to greater reduction in headache intensity (MD Visual Analog Scale 0‐10: ‐0.12; 95% CI: −0.49 to 0.26; 2 RCTs; n = 265) or frequency (MD: −0.32 episodes/week; 95% CI: −0.91 to 0.28; 2 RCTs; n = 265) when compared to a sham manual therapy. In the long‐term, in one high quality trial, neck exercise significantly reduced headache intensity compared to no treatment (MD: −1.51/10; 95% CI: −2.52 to −0.50; n = 100) or to aerobic exercises in another trial of moderate quality (MD: −1.15/10; 95% CI: −2.1 to −0.20; n = 180). Conclusions Manual therapy in the short term and neck exercise in the long term may be efficacious to treat adults with cervicogenic headache. More high‐quality evidence is needed and future results may change the current conclusions. Trial Registration Prospero : #CRD42019135858.
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