Clinical variables associated with recovery in patients with chronic tension-type headache after treatment with manual therapy

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• 作者：René ; F. Castien^a ; ^b ; ^{r.castien@vumc.nl} ; Danië ; lle A.W.M. van der Windt^c ; Annette H. Blankenstein^b ; Martijn W. Heymans^d ; Joost Dekker^e
• 关键词：Chronic tension-type headache ; Course ; Prognostic factors ; Manual therapy ; Cohort study
• 刊名：Pain
• 出版年：2012
• 期刊代码：214_03043959
• 类别：med
• 出版时间：April, 2012
• 卷：153
• 期：4
• 页码：893-899
• 文件大小：164 K

摘要

The aims of this study were to describe the course of chronic tension-type headache (CTTH) in participants receiving manual therapy (MT), and to develop a prognostic model for predicting recovery in participants receiving MT. Outcomes in 145 adults with CTTH who received MT as participants in a previously published randomised clinical trial (n = 41) or in a prospective cohort study (n = 104) were evaluated. Assessments were made at baseline and at 8 and 26 weeks of follow-up. Recovery was defined as a 50%reduction in headache days in combination with a score of 鈥榤uch improved鈥?or 鈥榲ery much improved鈥?for global perceived improvement. Potential prognostic factors were analyzed by univariable and multivariable regression analysis. After 8 weeks 78%of the participants reported recovery after MT, and after 26 weeks the frequency of recovered participants was 73%. Prognostic factors related to recovery were co-existing migraine, absence of multiple-site pain, greater cervical range of motion and higher headache intensity. In participants classified as being likely to be recovered, the posterior probability for recovery at 8 weeks was 92%, whereas for those being classified at low probability of recovery this posterior probability was 61%. It is concluded that the course of CTTH is favourable in primary care patients receiving MT. The prognostic models provide additional information to improve prediction of outcome.