ABSTRACT
INTRODUÇÃO: Cefaleias tensionais podem ser induzidas pela postura da cabeça para frente, e há uma grande quantidade de evidências disponíveis para o manejo de cefaleias crônicas. Os dados corroboram uso de abordagens de terapia manual para gerenciar dores de cabeça do tipo tensional. Devido à postura anterior da cabeça, a região do músculo suboccipital torna-se curta, resultando em aumento da lordose e dor no pescoço. Pacientes com uma postura de cabeça ainda mais para frente têm um ângulo craniovertebral menor, o que, por sua vez, causa cefaleia do tipo tensional. OBJETIVO: O objetivo deste estudo é comparar os efeitos da terapia de liberação miofascial (LMF) e da técnica de energia muscular (TEM) com exercícios gerais do pescoço no ângulo crânio-vertebral e na cefaleia em pacientes com cefaleia do tipo tensional. MÉTODOS: No total, 75 indivíduos com cefaleia tensional e sensibilidade muscular suboccipital foram recrutados e randomizados cegamente em três grupos: o grupo LMF, o grupo TEM e o grupo controle (25 indivíduos em cada grupo). Um ângulo pré-crânio vertebral foi obtido por método fotográfico e um questionário de índice de incapacidade pré-cefaleia foi preenchido. O grupo LMF recebeu liberação crânio-basal na região suboccipital com exercícios de pescoço; o grupo TEM recebeu relaxamento pós-isométrico na região suboccipital com exercícios, e o grupo controle recebeu apenas exercícios por 2 semanas. Após duas semanas, o ângulo pós-craniano e o questionário de cefaleia foram coletados e medidos. RESULTADOS: O ângulo crânio-vertebral e o índice de cefaleia mostraram melhora significativa nos grupos TEM e LMF. Não houve diferença significativa quando os grupos TEM e LMF foram comparados. Quando comparados com o grupo controle, tanto o TEM quanto o LMF apresentaram aumento significativo do ângulo crânio-vertebral. Houve melhora significativa no índice de cefaleia após TEM, LMF ou exercício de rotina no pescoço. CONCLUSÃO: Comparado ao grupo controle, o LMF apresenta melhores resultados do que o TEM no ângulo crânio-vertebral e cefaleia.
INTRODUCTION: Tension headaches can be induced by forward head posture, and there is a wealth of evidence available for managing chronic headaches. The data support the use of manual therapy approaches to manage tension-type headaches. Because of the forward head posture, the suboccipital muscle region becomes short, resulting in an increase in lordosis and neck pain. Patients with an even more forward head posture have a smaller craniovertebral angle, which in turn causes tension-type headache. OBJECTIVE: This study aims to compare the effects of Myofascial release therapy (MFR) and Muscle energy technique (MET) with general neck exercises on the craniovertebral angle and headache in tension-type headache patients. METHODS: In total, 75 subjects with tension-type headache and suboccipital muscle tenderness were recruited and randomized blindly into three groups: the MFR group, the MET group, and the control group (25 subjects in each group). A pre-craniovertebral angle was taken by photographic method, and a pre-headache disability index questionnaire was filled in. The MFR group receives cranio-basal release in the suboccipital region with neck exercises, the MET group receives postisometric relaxation in the suboccipital region with exercises, and the control group receives only exercises for two weeks. After two weeks, the postcranial angle and the headache questionnaire were taken and measured. RESULTS: Craniovertebral angle and headache index showed significant improvement in both the MET and MFR groups. There was no significant difference when MET and MFR groups were compared. When compared with the control group, both MET and MFR showed a significant increase in craniovertebral angle. There was a significant improvement in the headache index following MET, MFR, or routine neck exercise. CONCLUSION: Compared to the control group, MFR shows better results than MET on craniovertebral angle and headache.
Subject(s)
Tension-Type Headache , Patients , HeadacheABSTRACT
To evaluate the application of outcome indicators in randomized controlled trials(RCTs) concerning the treatment of tension-type headache(TTH) with traditional Chinese medicine(TCM) in recent five years, so as to provide a basis for the study of core outcome set(COS) for TCM intervention in TTH. The RCTs on TCM treatment of TTH in recent five years were systematically retrieved from CNKI, Wanfang, VIP, CBM, EMbase, PubMed, Cochrane Library, Web of Science, ClinicalTrials.gov and China Clinical Trial Registry. After literature screening, data extraction and evaluation of the risk of bias, the outcome indicators in the included RCTs were subjected to qualitative analysis. The preliminary search yielded 19 042 articles, and 10 983 were left after the elimination of duplication. Finally, 52 RCTs(48 in Chinese and 4 in English) were included for qualitative analysis. The outcome indicators of RCTs included in this study were classified into seven domains: TCM syndrome, symptom and sign, physical and chemical detection, quality of life, long-term prognosis, economic evaluation, and safety event. The findings demonstrated that headache characteristic index in the symptom and sign domain was the index with the highest reporting frequency and reporting rate. Seventeen RCTs used TCM syndrome score as the outcome indicator. Further analysis revealed that there existed such problems in research design as non-distinction between primary and secondary outcome indicators, great difference in the adopted measurement tools for outcome indicators, and the neglect of measurement time of outcome indicators. Moreover, the syndrome indicators reflecting TCM advantages, objective evaluation indicators, safety and health-economic indicators were lacking. These limitations have affected the quality and reliability of RCTs on TTH treatment with TCM. It is suggested that the efficacy and characteristics of TCM should be combined into current clinical research, and the COS in RCTs regarding TCM treatment of TTH should be established according to internationally recognized standard procedures.
Subject(s)
Humans , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Quality of Life , Randomized Controlled Trials as Topic , Reproducibility of Results , Tension-Type Headache/drug therapyABSTRACT
Siddha system is an ancient system of medicine which is popularly practised around south India particularly in Tamilnadu. Siddhars were considered as the pioneer of Siddha system, this system of medicine mainly encompasses for a healthy life for human beings. Among the broad spectrum of treatment aspects in Siddha system Siddhars classify the forms of internal medicines into 32 types which are all unique by its preparations. Choornam is one of the forms of internal medicine which can be used as single as well as poly herbal formulations. In this case report a poly-herbal formulation in Siddha system was used to treat tension type of headache (TTH). A 30 years old male patient visited out-patient department of Ayothidoss Pandither Hospital in National Institute of Siddha, Chennai. Patient reported with the complaints of episodic and chronic headache which is band like around the head, the intensity becomes mild to moderate, pain increased during working hours for past 2 years. Patient advised to follow the internal medicine Chundai vatral choornam it relives the TTH immediately when he got those symptoms.
ABSTRACT
Objective To determine the protein and mRNA levels ofinterleukin-17 (IL-17) and the proportion of Th17 cells in the peripheral blood of patients with systemic lupus erythematosus (SLE) and their clinical significance is analyzed. Methods Twenty-five hospitalized SLE patients were recruited and twentytwo healthy volunteers were enrolled as normal controls. Plasma protein and mRNA of IL-17 in the peripheral blood were measured by enzyme-linked immunosorbent assay and real time-PCR respectively. Flow cytometric assay was used to analyze the percentage of Th17 cells in SLE patients. The relationship between IL-17/Th17 cells and clinical or laboratory parameters of SLE patients was explored. Students' t-test and Spearman's correlation was used to evaluate the relationship between mRNA level and inflammatory parameters. Results The plasma concentration and mRNA level of IL-17 was significantly elevated in SLE patients as compared to the normal controls (P＜0.05). The percentage of Th17 cells in patients with SLE was higher than that of normal controls and was significantly increased in more active SLE patients and SLE with nephritis than less active SLE and SLE without nephritis (P＜0.05). Both plasma levels of IL-17 and the proportion of Th17 cells were positively correlated with SLEDAI (r=0.681, P＜0.01; r=0.426, P=0.034). Conclusion Plasma IL-17 protein and mRNA expression level and the percentage of Th17 cells in SLE patients are all significantly elevated and the close relationship between IL-17/Th17 cells and disease activity suggests that IL-17/Th17 may play an important role in the pathogenesis of SLE.
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TTH and DNP-BSA delayed hyper-sensitivity(DH)were transfered tononimmune human recipients withGoose derived transfer factor(TF-G)prepared from blood and spleen ofGoose immunized with TTH or DNP-BSA.Only human recipients injec—ted with immune TF-G showed DHskin reactivity by skin test.TTHDH response were only transferedby TTH specific TF-G but not DNPBSA specific TF-G and the DNP-BSAdermal reactivity could only be ob-served when DNP-BSA specific TF-G were employed.The fact that TF-G was able to tranfer donor specificDTH to human recipients suggestedthat there may be no absolute speciesbarriers for DTH transfer with TF.