Spinal manipulation for the management of cervicogenic headache: A systematic review and meta‐analysis

颈源性头痛 医学 荟萃分析 物理疗法 严格标准化平均差 随机对照试验 脊柱推拿 腰痛 内科学 替代医学 病理 偏头痛
作者
Matthew Fernandez,Craig Moore,Jinghan Tan,Derrick Wen Quan Lian,Jeremy Nguyen,Andrew Bacon,Brie Christie,Isabella Shen,Thomas Waldie,Danielle Simonet,André Bussières
出处
期刊:European Journal of Pain [Wiley]
卷期号:24 (9): 1687-1702 被引量:39
标识
DOI:10.1002/ejp.1632
摘要

Abstract Background Spinal manipulative therapy (SMT) is frequently used to manage cervicogenic headache (CGHA). No meta‐analysis has investigated the effectiveness of SMT exclusively for CGHA. Objective To evaluate the effectiveness of SMT for CGHA. Databases and Data Treatment Five databases identified randomized controlled trials comparing SMT with other manual therapies. The PEDro scale assessed the risk‐of‐bias. Pain and disability data were extracted and converted to a common scale. A random effects model was used for several follow‐up periods. GRADE described the quality of evidence. Results Seven trials were eligible. At short‐term follow‐up, there was a significant, small effect favouring SMT for pain intensity (mean difference [MD] −10.88 [95% CI, −17.94, −3.82]) and small effects for pain frequency (standardized mean difference [SMD] −0.35 [95% CI, −0.66, −0.04]). There was no effect for pain duration (SMD − 0.08 [95% CI, −0.47, 0.32]). There was a significant, small effect favouring SMT for disability (MD − 13.31 [95% CI, −18.07, −8.56]). At intermediate follow‐up, there was no significant effects for pain intensity (MD − 9.77 [−24.21 to 4.68]) and a significant, small effect favouring SMT for pain frequency (SMD − 0.32 [−0.63 to − 0.00]). At long‐term follow‐up, there was no significant effects for pain intensity (MD − 0.76 [−5.89 to 4.37]) and for pain frequency (SMD − 0.37 [−0.84 to 0.10]). Conclusion For CGHA, SMT provides small, superior short‐term benefits for pain intensity, frequency and disability, but not pain duration, however, high‐quality evidence in this field is lacking. The long‐term impact is not significant. Significance CGHA are a common headache disorder. SMT can be considered an effective treatment modality, with this review suggesting it providing superior, small, short‐term effects for pain intensity, frequency and disability when compared with other manual therapies. These findings may help clinicians in practice better understand the treatment effects of SMT alone for CGHA.
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