پديد آورندگان :
رضاييان، طاهره دانشگاه علوم بهزيستي و توانبخشي - گروه فيزيوتراپي، تهران , مصلي نژاد، زهرا دانشگاه علوم بهزيستي و توانبخشي - گروه فيزيوتراپي، تهران , احمدي، مهدي دانشگاه علوم بهزيستي و توانبخشي - گروه فيزيوتراپي، تهران , رستمي، محمد دانشگاه علوم بهزيستي و توانبخشي - گروه فيزيوتراپي، تهران , نوربخش، محمدرضا دانشگاه جورجيا - دانشكده توانبخشي - گروه فيزيوتراپي، آمريكا , نوروزي، مهدي مركز تحقيقات عوامل اجتماعي مؤثر بر سلامت - دانشگاه علوم بهزيستي و توانبخشي، تهران
چكيده لاتين :
Objective Subjects with migraine headache often have stiff posture, especially in the head and neck.
Also, these patients often have reduced cervical range of motion, faulty posture, forward head posture,
increased sensitivity on the cervical muscles, and myofascial pain syndrome. Myofascial Trigger
Points (MTrPs) are considered as the contributing factors to migraine headache. They produce
painful trigger points in the cervical muscles. There are different techniques for eliminating MTrPs
such as soft tissue (neck muscles) release technique, Ultrasound, and deep heat therapy, laser therapy,
and dry needling. The current study aimed to investigate the effects of selective neck muscle
release techniques on clinical indicators (frequency/intensity/duration of headache, medication,
functional disability, and pressure pain threshold) in patients with migraine headache.
Materials & Methods The current study is a randomized controlled trial was conducted in the physical
therapy research center of Shiraz University of Medical Sciences in Iran from August 2017 to
February 2018. The statistical population consisted of all patients with migraine headache. Of
these, 40 patients (aged 25-55 years) with trigger points in neck muscles including sternocleidomastoid,
upper trapezius, and suboccipital were selected and then randomly assigned into two groups
of release (mean age, 40.4±11.2 years) and control (mean age, 37.45±8.9 years). The subjects in the
release group received 6 sessions for 2 weeks (combined MTrP therapy and stretching movements),
while control group received placebo superficial massage. Headache frequency/intensity/duration,
medication, functional disability, and Pressure Pain Threshold (PPT) were assessed before, immediately
after intervention, and at 1-month follow-up period. For data analysis, the two-way mixed
design of ANOVA was used in SPSS v.23 software to evaluate the main effects of the two factors of
group and time on the dependent variables. If the group effect was significant, independent t-test
was performed to evaluate the differences in study variables between the two groups after the
treatment and at the follow-up period, and if the time effect was significant, the paired t-test was
carried out to assess the differences between the two groups before and after treatment and at the
follow-up period. The significance was considered at P<0.05.
Results All the variables had normal distribution (P˃0.05); therefore, parametric tests were used for
analyzing data. Based on the results, there were no significant differences between the two groups
in all quantitative and qualitative variables before treatment(P˃0.05). The release group showed improvement in the headache frequency, intensity, and duration, medication use, the functional
ability, and the PPT level in comparison with the control group (p<0.001). According to the paired
t-test results, the release group showed a significant reduction in headache parameters, medication
use and functional disability and increased PPT after the intervention and at the follow-up period
(P<0.001).
Conclusion The release techniques for selective neck muscles including MTrP therapy and stretching
movements were helpful in improving some clinical indicators such as headache parameters,
medication use, functional ability, and PPT in a short time. Therefore, these techniques can be
recommended for treating migraine headache patients with MTrPs in sternocleidomastoid, upper
trapezius, and suboccipital muscles.
