Strength training vs interdisciplinary counseling for tension-type headache in girls
Frequent episodic and chronic childhood tension-type headache (TTH) is a prevalent and debilitating situation for the child and family. Low cost non-pharmacological treatments were usually preferred as the first choice of professionals and parents.
Passive acupunctural laser therapy has also shown positive effects in a controlled trial on headache frequency. Relaxation therapy showed better compliance and acceptance by parents. Even though these effects are supported by evidence, use in practice is more limited than expected. In one of our previous studies, we found reduced neck–shoulder muscle strength and aerobic power together with increased pericranial tenderness, especially in the trapezius descendens, to be associated with TTH in girls. To examine the outcomes of specific strength training for girls with tension-type headache, a study was conducted.
In the conducted study, 49 girls aged 9-18 years with TTH were selected randomly for patient education programs to 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 whereas 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. Further, health-related quality of life questionnaires was also assessed at baseline and after 24 months.
After the analyses, both group showed decreased headache frequency significantly. The odds of having headache on a random day decreased over 22 weeks by 0.65. For both groups, neck extension strength decreased significantly with a decrease in cervico thoracic extension/flexion ratios to 1.7 which indicated a positive change in muscle balance. A 24-month follow-up on health related quality of life for the pooled sample revealed statistically significant improvements. However, 55% of the girls reported little to none disability.
After the analyses, results indicated that both physical health and health-related quality of life could be influenced significantly by physical exercise and nurse counseling. Whereas, more research is needed to examine the relationship between physical exercise and tension-type headache in girls. Thus, empowering patient education to promote maximum possible outcomes for all children needs more attention.