Consensus among musculoskeletal experts for the management of patients with headache by physiotherapists? A delphi study

Pauw, Robby De; Dewitte, Vincent; Hertogh, Willem De; Cnockaert, Elise; Chys, Marjolein; Cagnie, Barbara

doi:10.1016/j.msksp.2021.102325

Cited by 15 publications

(15 citation statements)

References 45 publications

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“…Although it is generally accepted to adopt a BPSL-approach in the management of pain, a recent Delphi-study on managing patients with headache by physiotherapists proposed active mobilisation exercises, upper cervical spine mobilisations, work-related ergonomic training, and active and passive mobilisations with movement as useful in the treatment of CeH. Lifestyle advice, pain education, and cognitive therapy were not considered to be relevant 61 , 62 . Though, based on our new approach, and previous findings 42 , 43 , 63 , further research is needed to determine which patient is likely to benefit from which type of intervention(s) based on the patient’s BPSL-profile 61 .…”

Section: Discussionmentioning

confidence: 99%

Inter-individual variability in mechanical pain sensation in patients with cervicogenic headache: an explorative study

Mingels

Dankaerts

Bruckers

et al. 2022

Sci Rep

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Currently, evidence for effective physiotherapy interventions in patients with cervicogenic headache (CeH) is inconsistent. Although inter-individual variability in pain response is predictive for successful physiotherapy interventions, it was never explored in patients with CeH. Therefore the objective of the current study was to explore inter-individual variability in mechanical pain sensation, and its association with biopsychosocial-lifestyle (BPSL) characteristics in patients with CeH. A cross-sectional explorative analysis of inter-individual variability in mechanical pain sensation in 18 participants with CeH (29–51 years) was conducted. Inter-individual variability in mechanical pain sensation (standard deviations (SDs), F-statistics, Measurement System Analysis) was deducted from bilateral pressure pain thresholds of the suboccipitals, erector spine, tibialis anterior. BPSL-characteristics depression, anxiety, stress (Depression Anxiety Stress Scale-21), quality of life (Headache Impact Test-6), sleep-quality (Pittsburgh Sleep Quality Index), and sedentary time (hours/week) were questioned. Inter-individual variability in mechanical pain sensation explained 69.2% (suboccipital left), 86.8% (suboccipital right), 94.6% (erector spine left), 93.2% (erector spine right), 91.7% (tibialis anterior left), and 82% (tibialis anterior right) of the total variability in patients with CeH. The significant p-values and large F-statistic values indicate inter-individual differences in SDs. Significant associations between (1) lower quality of life and lower SDs of the suboccipital left PPT (p .005), and (2) longer sedentary time and higher SDs of the suboccipital left PPT (p .001) were observed. Results from our explorative study could suggest inter-individual variability in mechanical pain sensation at the left suboccipitals which associates with quality of life and sedentary time. These novel findings should be considered when phenotyping patients and ‘individually’ match interventions.

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Section: Discussionmentioning

confidence: 99%

Inter-individual variability in mechanical pain sensation in patients with cervicogenic headache: an explorative study

Mingels

Dankaerts

Bruckers

et al. 2022

Sci Rep

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“…Pandemic COVID-19 is shown to be a potential factor in the development, worsening, or persistence of TTH and/or orofacial pain. [5,9,10,12,13]…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 ] This kind of pain is described as a pressure with mild to moderate intensity, bilateral. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

“…[3] This kind of pain is described as a pressure with mild to moderate intensity, bilateral. [5] TTH is the most prevalent type worldwide, and the stiffness in the myofascial tissue in the cervical and cranial region strongly connects with the frequency and intensity of the discomfort. Genetic, emotional, and peripheral factors, such as nociception and central factors (central sensitization), are noted as etiological for orofacial pain.…”

Section: Introductionmentioning

confidence: 99%

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The effect of systemic versus local transcutaneous laser therapy on tension-type cephalea and orofacial pain in post-COVID-19 patients: A pragmatic randomized clinical trial

et al. 2022

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Introduction: Orofacial pain and tensional cephalea were symptoms commonly reported in COVID-19 patients, even after recovery, and were considered chronic pain in these cases. The aim of this research is to evaluate the effect of the application of photobiomodulation with red and infrared lasers applied locally and systemically.Methods and analysis: For this purpose, individuals who have been diagnosed with COVID-19 and have had a tension headache and/or orofacial pain for more than 3 months will be selected by convenience. The participants will be divided into two different groups: G1-photobiomodulation with red and infrared laser with local application on the pain points (808 nm and 660 nm, 100 mW, 6 J per point) and G2-photobiomodulation with red laser with transcutaneous application on the radial artery (660 nm, 100 mW, 30 minutes). All participants will be treated for a period of 4 weeks, with 8 application sessions. The effects will be measured by means of blood lactate level, Brief Pain Inventory, Visual Analog Scale (VAS), and Cephalea Impact Test. The data will be collected weekly before and after the treatment, and the following tests will be applied: Analysis of variance (ANOVA), Tukey paired t test, Kruskal-Wallis, or Wilcoxon, according to data distribution. α = 0.05 will be considered as the level of statistical significance.Ethics and dissemination: This study was approved by the Research Projects Committee of the Nove de Julho University (approval number 4.673.963). Results will be disseminated through peer-reviewed journals and events for the scientific and clinical community, and the general public. It is registered in the ClinicalTrials.gov database with the number NCT05430776.

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“…As cervicogenic headache with an underlying articular joint dysfunction is considered as an indication for OMT intervention, the therapist must then weigh all included factors within a risk- benefit analysis and propose the most adequate and suitable treatment for this patient. In this scenario, the initial proposed treatment was education regarding pain and posture combined with passive high and low-velocity mobilizations of the cervical and thoracic spine, home-exercises and myofascial release techniques [ 15 , 16 , 17 , 18 ]. According to the shared decision-making process, the therapist explained and discussed the indication, expected benefits, treatment options and potential risks with the patient.…”

Section: A Case Studymentioning

confidence: 99%

Translating the new International IFOMPT Cervical Framework into a framework flowchart for clinical practice and education

Cagnie

Castien

Scholten-Peeters

2023

BMR

Self Cite

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BACKGROUND: In 2020, a revised version of the International IFOMPT Cervical Framework was published. This framework provides both physical therapists and educators the necessary information to guide the assessment of the cervical spine region for potential vascular pathologies of the neck in advance of planned Orthopaedic Manual Therapy (OMT) interventions. OBJECTIVE: The objective was to develop a framework flowchart which is useful in clinical practice and education to assist physical therapists to improve the safety of OMT, and apply this in a case report. METHODS: The framework was developed in co-creation with manual therapy experts, researchers, educators in manual therapy, patients, medical specialists and the Manual Therapy Association in The Netherlands and Belgium. Manual therapists and patients tested the framework for intelligibility and usefulness. RESULTS: A framework flowchart is developed and presented, that is easy to use in both clinical practice and education. It is a visual representation of the sequence of steps and decisions needed during the process. A case description of a patient with neck pain and headache is added to illustrate the clinical usefulness of the framework flowchart. CONCLUSION: The framework flowchart helps physical therapists in their clinical reasoning to provide safe OMT interventions.

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Consensus among musculoskeletal experts for the management of patients with headache by physiotherapists? A delphi study

Cited by 15 publications

References 45 publications

Inter-individual variability in mechanical pain sensation in patients with cervicogenic headache: an explorative study

Inter-individual variability in mechanical pain sensation in patients with cervicogenic headache: an explorative study

The effect of systemic versus local transcutaneous laser therapy on tension-type cephalea and orofacial pain in post-COVID-19 patients: A pragmatic randomized clinical trial

Translating the new International IFOMPT Cervical Framework into a framework flowchart for clinical practice and education

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