Multimodal compared to pharmacologic treatments for chronic tension-type headache in adolescents
Summary Chronic tension-type headache (CTTH) in children and adolescents is a serious medical condition, with considerable morbidity and few effective, evidence-based treatments. We performed a chart review of 83 adolescents (age range = 13–18 years; 67 girls and 16 boys) diagnosed with CTTH. Two tr...
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| Veröffentlicht in: | Journal of bodywork and movement therapies 2016-10, Vol.20 (4), p.715-721 |
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| creator | Przekop, Peter, D.O., Ph.D Przekop, Allison, D.O Haviland, Mark G., Ph.D |
| description | Summary Chronic tension-type headache (CTTH) in children and adolescents is a serious medical condition, with considerable morbidity and few effective, evidence-based treatments. We performed a chart review of 83 adolescents (age range = 13–18 years; 67 girls and 16 boys) diagnosed with CTTH. Two treatment protocols were compared: multimodal (osteopathic manipulative treatments, mindfulness, and qi gong) and pharmacologic (amitriptyline or gabapentin). Four outcomes (headache frequency, pain intensity, general health, and health interference) were assessed at three time points (baseline, 3 months, and 6 months). A fifth outcome, number of bilateral tender points, was recorded at baseline and 6 months. All five were evaluated statistically with a linear mixed model. Although both multimodal and pharmacologic treatments were effective for CTTH (time effects for all measures were significant at p |
| doi_str_mv | 10.1016/j.jbmt.2015.02.003 |
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We performed a chart review of 83 adolescents (age range = 13–18 years; 67 girls and 16 boys) diagnosed with CTTH. Two treatment protocols were compared: multimodal (osteopathic manipulative treatments, mindfulness, and qi gong) and pharmacologic (amitriptyline or gabapentin). Four outcomes (headache frequency, pain intensity, general health, and health interference) were assessed at three time points (baseline, 3 months, and 6 months). A fifth outcome, number of bilateral tender points, was recorded at baseline and 6 months. All five were evaluated statistically with a linear mixed model. Although both multimodal and pharmacologic treatments were effective for CTTH (time effects for all measures were significant at p < .001), results from each analysis favored multimodal treatment (the five group by time interaction effects were significant at or below the p < .001 level). Headache frequency in the pharmacologic group, for example, reduced from a monthly average (95% Confidence Interval shown in parentheses) of 23.9 (21.8, 26.0) to 16.4 (14.3, 18.6) and in the multimodal group from 22.3 (20.1, 24.5) to 4.9 (2.6, 7.2) (a substantial group difference). Pain intensity (worst in the last 24 hours, 0-10 scale) was reduced in the pharmacologic group from 6.2 (5.6, 6.9) to 3.4 (2.7, 4.1) and from 6.1 (5.4, 6.8) to 2.0 (1.2, 2.7) in the multimodal group (a less substantial difference). Across the other three assessments, group differences were larger for general health and number of tender points and less so for pain restriction. Multimodal treatment for adolescent CTTH appears to be effective. Randomized controlled trials are needed to confirm these promising results.</description><identifier>ISSN: 1360-8592</identifier><identifier>EISSN: 1532-9283</identifier><identifier>DOI: 10.1016/j.jbmt.2015.02.003</identifier><identifier>PMID: 27814849</identifier><language>eng</language><publisher>United States: Elsevier Ltd</publisher><subject>Adolescent ; Analgesics, Non-Narcotic - therapeutic use ; Chronic tension-type headache ; Combined Modality Therapy ; Female ; Humans ; Male ; Manipulation, Osteopathic - methods ; Mindfulness ; Mindfulness - methods ; Musculoskeletal Pain - therapy ; Pain Measurement ; Physical Medicine and Rehabilitation ; Qi gong ; Qigong - methods ; Stress ; Tension-Type Headache - therapy ; Treatment</subject><ispartof>Journal of bodywork and movement therapies, 2016-10, Vol.20 (4), p.715-721</ispartof><rights>Elsevier Ltd</rights><rights>2015 Elsevier Ltd</rights><rights>Copyright © 2015 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-d5718f4cbaf18260e8492177f8c054d2f93ba6c17e4717e470c09e92609d9f333</citedby><cites>FETCH-LOGICAL-c411t-d5718f4cbaf18260e8492177f8c054d2f93ba6c17e4717e470c09e92609d9f333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jbmt.2015.02.003$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27814849$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Przekop, Peter, D.O., Ph.D</creatorcontrib><creatorcontrib>Przekop, Allison, D.O</creatorcontrib><creatorcontrib>Haviland, Mark G., Ph.D</creatorcontrib><title>Multimodal compared to pharmacologic treatments for chronic tension-type headache in adolescents</title><title>Journal of bodywork and movement therapies</title><addtitle>J Bodyw Mov Ther</addtitle><description>Summary Chronic tension-type headache (CTTH) in children and adolescents is a serious medical condition, with considerable morbidity and few effective, evidence-based treatments. We performed a chart review of 83 adolescents (age range = 13–18 years; 67 girls and 16 boys) diagnosed with CTTH. Two treatment protocols were compared: multimodal (osteopathic manipulative treatments, mindfulness, and qi gong) and pharmacologic (amitriptyline or gabapentin). Four outcomes (headache frequency, pain intensity, general health, and health interference) were assessed at three time points (baseline, 3 months, and 6 months). A fifth outcome, number of bilateral tender points, was recorded at baseline and 6 months. All five were evaluated statistically with a linear mixed model. Although both multimodal and pharmacologic treatments were effective for CTTH (time effects for all measures were significant at p < .001), results from each analysis favored multimodal treatment (the five group by time interaction effects were significant at or below the p < .001 level). Headache frequency in the pharmacologic group, for example, reduced from a monthly average (95% Confidence Interval shown in parentheses) of 23.9 (21.8, 26.0) to 16.4 (14.3, 18.6) and in the multimodal group from 22.3 (20.1, 24.5) to 4.9 (2.6, 7.2) (a substantial group difference). Pain intensity (worst in the last 24 hours, 0-10 scale) was reduced in the pharmacologic group from 6.2 (5.6, 6.9) to 3.4 (2.7, 4.1) and from 6.1 (5.4, 6.8) to 2.0 (1.2, 2.7) in the multimodal group (a less substantial difference). Across the other three assessments, group differences were larger for general health and number of tender points and less so for pain restriction. Multimodal treatment for adolescent CTTH appears to be effective. Randomized controlled trials are needed to confirm these promising results.</description><subject>Adolescent</subject><subject>Analgesics, Non-Narcotic - therapeutic use</subject><subject>Chronic tension-type headache</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Manipulation, Osteopathic - methods</subject><subject>Mindfulness</subject><subject>Mindfulness - methods</subject><subject>Musculoskeletal Pain - therapy</subject><subject>Pain Measurement</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Qi gong</subject><subject>Qigong - methods</subject><subject>Stress</subject><subject>Tension-Type Headache - therapy</subject><subject>Treatment</subject><issn>1360-8592</issn><issn>1532-9283</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2r1DAYhYMoznX0D7iQLN205qNfAbkgg18w4kJdxzR566SmTU3SC_PvTZ3xLly4SUI45_C-z0HoOSUlJbR5NZZjP6WSEVqXhJWE8AfohtacFYJ1_GF-84YUXS3YDj2JcSSEiIqJx2jH2o5WXSVu0PdPq0t28kY5rP20qAAGJ4-XkwqT0t75H1bjFEClCeYU8eAD1qfg5-0b5mj9XKTzAvgEyih9AmxnrIx3EPVmeIoeDcpFeHa99-jbu7dfDx-K4-f3Hw9vjoWuKE2FqVvaDZXu1UA71hDI0zHatkOnSV0ZNgjeq0bTFqr2z0E0ESCyUhgxcM736OUldwn-1woxycnmCZxTM_g1StrxpuUsx2Ypu0h18DEGGOQS7KTCWVIiN7JylBtZuZGVhMlMNpteXPPXfgJzb_mLMgteXwSQt7yzEGTUFmYNxgbQSRpv_59_-49dO5shK_cTzhBHv4Y585NUxmyQX7Zut2ppnWvNrPhvYoafqw</recordid><startdate>20161001</startdate><enddate>20161001</enddate><creator>Przekop, Peter, D.O., Ph.D</creator><creator>Przekop, Allison, D.O</creator><creator>Haviland, Mark G., Ph.D</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20161001</creationdate><title>Multimodal compared to pharmacologic treatments for chronic tension-type headache in adolescents</title><author>Przekop, Peter, D.O., Ph.D ; Przekop, Allison, D.O ; Haviland, Mark G., Ph.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-d5718f4cbaf18260e8492177f8c054d2f93ba6c17e4717e470c09e92609d9f333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Analgesics, Non-Narcotic - therapeutic use</topic><topic>Chronic tension-type headache</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Manipulation, Osteopathic - methods</topic><topic>Mindfulness</topic><topic>Mindfulness - methods</topic><topic>Musculoskeletal Pain - therapy</topic><topic>Pain Measurement</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Qi gong</topic><topic>Qigong - methods</topic><topic>Stress</topic><topic>Tension-Type Headache - therapy</topic><topic>Treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Przekop, Peter, D.O., Ph.D</creatorcontrib><creatorcontrib>Przekop, Allison, D.O</creatorcontrib><creatorcontrib>Haviland, Mark G., Ph.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of bodywork and movement therapies</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Przekop, Peter, D.O., Ph.D</au><au>Przekop, Allison, D.O</au><au>Haviland, Mark G., Ph.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multimodal compared to pharmacologic treatments for chronic tension-type headache in adolescents</atitle><jtitle>Journal of bodywork and movement therapies</jtitle><addtitle>J Bodyw Mov Ther</addtitle><date>2016-10-01</date><risdate>2016</risdate><volume>20</volume><issue>4</issue><spage>715</spage><epage>721</epage><pages>715-721</pages><issn>1360-8592</issn><eissn>1532-9283</eissn><abstract>Summary Chronic tension-type headache (CTTH) in children and adolescents is a serious medical condition, with considerable morbidity and few effective, evidence-based treatments. We performed a chart review of 83 adolescents (age range = 13–18 years; 67 girls and 16 boys) diagnosed with CTTH. Two treatment protocols were compared: multimodal (osteopathic manipulative treatments, mindfulness, and qi gong) and pharmacologic (amitriptyline or gabapentin). Four outcomes (headache frequency, pain intensity, general health, and health interference) were assessed at three time points (baseline, 3 months, and 6 months). A fifth outcome, number of bilateral tender points, was recorded at baseline and 6 months. All five were evaluated statistically with a linear mixed model. Although both multimodal and pharmacologic treatments were effective for CTTH (time effects for all measures were significant at p < .001), results from each analysis favored multimodal treatment (the five group by time interaction effects were significant at or below the p < .001 level). Headache frequency in the pharmacologic group, for example, reduced from a monthly average (95% Confidence Interval shown in parentheses) of 23.9 (21.8, 26.0) to 16.4 (14.3, 18.6) and in the multimodal group from 22.3 (20.1, 24.5) to 4.9 (2.6, 7.2) (a substantial group difference). Pain intensity (worst in the last 24 hours, 0-10 scale) was reduced in the pharmacologic group from 6.2 (5.6, 6.9) to 3.4 (2.7, 4.1) and from 6.1 (5.4, 6.8) to 2.0 (1.2, 2.7) in the multimodal group (a less substantial difference). Across the other three assessments, group differences were larger for general health and number of tender points and less so for pain restriction. Multimodal treatment for adolescent CTTH appears to be effective. Randomized controlled trials are needed to confirm these promising results.</abstract><cop>United States</cop><pub>Elsevier Ltd</pub><pmid>27814849</pmid><doi>10.1016/j.jbmt.2015.02.003</doi><tpages>7</tpages></addata></record> |
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| subjects | Adolescent Analgesics, Non-Narcotic - therapeutic use Chronic tension-type headache Combined Modality Therapy Female Humans Male Manipulation, Osteopathic - methods Mindfulness Mindfulness - methods Musculoskeletal Pain - therapy Pain Measurement Physical Medicine and Rehabilitation Qi gong Qigong - methods Stress Tension-Type Headache - therapy Treatment |
| title | Multimodal compared to pharmacologic treatments for chronic tension-type headache in adolescents |
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