偏头痛和紧张性头痛的颈椎肌肉骨骼损伤及其与疼痛相关因素的关系：一项最新的系统综述和荟萃分析。

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice Pub Date : 2024-12-24 DOI:10.1016/j.msksp.2024.103251

Chalomjai Pensri, Zhiqi Liang, Julia Treleaven, Gwendolen Jull, Lucy Thomas

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引用次数: 0

摘要

背景：需要对偏头痛和紧张性头痛患者的颈椎肌肉骨骼功能障碍进行最新的系统综述。影响因素（疼痛过敏与颈椎肌肉骨骼测试，活动触发点和压痛）尚未调查。目的：i)更新偏头痛和紧张性头痛中颈椎肌肉骨骼损伤的证据ii)报告头痛中伴随的疼痛、活动触发点和压痛；Iii)确定这些敏感性特征与头痛患者颈椎肌肉骨骼损伤之间的关系。方法：检索5个数据库进行观察性研究。采用JBI关键评价法评估研究质量。采用随机效应模型进行meta分析。使用GRADE评估证据的确定性。结果：纳入77项研究，包括2551名受试者。偏头痛的新发现是站立时头部前倾增加（MD = -2.51°[-4.94°，-0.09°]），屈曲/旋转范围减小（MD = -9.47°[-15.78°，-3.16°]），屈肌强度（MD = -0.34[-0.57, -0.10]）和耐力（MD = -14.37[-28.15, -0.58]）和伸肌强度降低（MD = -0.34[-0.60, -0.08]）。紧张性头痛的伸肌强度降低（Std. MD = -0.45[-0.85, -0.04]）。由于异质性和较小的效应量，所有研究结果的确定性都很低。活跃的触发点和压痛是常见的，特别是在慢性头痛。在77项研究中，有2项研究发现，颈椎肌肉骨骼功能与活动触发点和压痛之间存在负相关(r结论：偏头痛和紧张性头痛中存在几种颈椎肌肉骨骼损伤，其确定性非常低。由于很少有研究考虑到可能影响检测的因素，因此需要谨慎。

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Cervical musculoskeletal impairments in migraine and tension-type headache and relationship to pain related factors: An updated systematic review and meta-analysis.

Background: An updated systematic review of cervical musculoskeletal dysfunction in migraine and tension-type headache is needed. Influencing factors (pain hypersensitivity with cervical musculoskeletal testing, active trigger points and tenderness) have not been investigated.

Objectives: To i) update evidence for cervical musculoskeletal impairments in migraine and tension-type headache ii) report on accompanying pain associated with testing, active trigger points and tenderness in headache; iii) determine relationships between these sensitivity features and cervical musculoskeletal impairments in headache.

Methods: Five databases were searched for observational studies. Quality of studies was assessed with JBI Critical Appraisal. Meta-analysis was performed using random effect models. Certainty of the evidence was assessed using GRADE.

Results: Seventy-seven studies were included comprising 2551 participants. New findings in migraine were increased forward head posture in standing (MD = -2.51°[-4.94°, -0.09°]), reduced flexion/rotation range (MD = -9.47°[-15.78°, -3.16°]), reduced flexor strength (Std. MD = -0.34[-0.57, -0.10]) and endurance (MD = -14.37[-28.15, -0.58]), and reduced extensor strength (Std. MD = -0.34[-0.60, -0.08]) in migraine. Tension-type headache had reduced extensor strength (Std. MD = -0.45[-0.85, -0.04]). Certainty was very low for all findings due to heterogeneity and small effect size. Active trigger points and tenderness were common, particularly, in chronic headache. A negative relationship between cervical musculoskeletal performance and active trigger points and tenderness was found in 2 from 77 studies (r < - 0.47).

Conclusions: Several cervical musculoskeletal impairments are present in migraine and tension-type headache with very low certainty. Caution is needed since few studies considered factors that would influence testing.

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来源期刊

Musculoskeletal Science and Practice Health Professions-Physical Therapy, Sports Therapy and Rehabilitation

CiteScore

4.10

自引率

8.70%

发文量

152

审稿时长

48 days

期刊介绍： Musculoskeletal Science & Practice, international journal of musculoskeletal physiotherapy, is a peer-reviewed international journal (previously Manual Therapy), publishing high quality original research, review and Masterclass articles that contribute to improving the clinical understanding of appropriate care processes for musculoskeletal disorders. The journal publishes articles that influence or add to the body of evidence on diagnostic and therapeutic processes, patient centered care, guidelines for musculoskeletal therapeutics and theoretical models that support developments in assessment, diagnosis, clinical reasoning and interventions.