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ABSTRACT
Purposes
To compare the effectiveness of instrument-assisted soft tissue mobilization (IASTM) and pressure algometry with sham ultrasound (control group) on the clinical measures of headache, pressure pain threshold (PPT) of upper trapezius and suboccipital muscles and cervical alignment in patients with tension type headache (TTH).
Methods
Seventy-two patients with TTH of both genders were randomly allocated to 3 experimental groups: a) the IASTM group (n=24), b) pressure algometry group (n=24), and c) sham ultrasound control group (n=24). Headache frequency and disability, pressure pain threshold of upper trapezius and suboccipital muscles, cervical lordosis angle (CA) and anterior head translation (AHT) were measured four weeks before and after intervention. Moreover, headache frequency was followed up for two more weeks after intervention.
Results
Statistically significant improvements (P <0.05; effect size ranges 1.1-1.9) were observed in all outcome measures following IASTM compared to the other two intervention methods. In the IASTM group, the headache frequency decreased from 15 to 2 days/month. Also, headache disability decreased from 19 to 10. Further, CA increased from 17.5° to 31.4° and AHT decreased from 24.1 to 15.5 mm. The pressure algometry group showed significantly lower headache frequency at the follow-up (P < 0.01) than the sham ultrasound control group. However, Similar findings in the other evaluated outcomes were found between the pressure algometry and sham ultrasound control groups (P ˃ 0.05).
Conclusion
The results of the present study indicate the effectiveness of IASTM in improving headache symptoms and cervical alignment in patients with TTH.
Acknowledgments
The authors would like to thank Dr Asmaa Sayed Ali, Dr Sheriff Ahmed Sayed and Dr Sami Mohamed Salaman, El Gomhorya Hospital for their assistance in data collection. Further, the authors are grateful to Prof. Dr Abeer Abd el-rahman, Cairo University for her advices and support.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Additional information
Funding
Notes on contributors
Sherif Moustafa Ramadan
Sherif Moustafa Ramadan is a PhD candidate at the Faculty of Physical Therapy, Cairo University. He earned a Bachelor degree (2005) and a MSc in Physical Therapy (2013) from Cairo University, Egypt. His Master thesis examined the Efficacy of Cranial Base Release in Chronic Tension-type Headache.
Hussein Awad El Gharieb
Dr. Hussein Awad El gharieb received a Bachelor degree (excellent with honors) in Medicine (1999) and a MSc in Neuropsychiatry (2004) from Al Azhar University, Egypt. Then he received his MD in Neurology (2010) from Al Azhar University. He is an assistant professor of Neurology at the Faculty of Medicine, Al Azhar University.
Awatef Mohamed Labib
Prof. Dr. Awatef Mohamed Labib is a Professor of Physical Therapy at the Department of Basic Science, Cairo University. She was appointed a Chairman of the Department of Basic Science (1983-1994). Also, she was appointed a Chairman of the Promotions Committee (2006-2012). She taught courses and published research on manual therapy, pain management and exercise physiology.
Eman Ahmed Embaby
Dr. Eman Ahmed Embaby PhD, PT is an associate professor of Physical Therapy at Cairo University since 2016. She is experienced in Biostatistics. In addition, she earned a certificate in Medical Education. She is a managing editor of the “Bulletin of Faculty of Physical Therapy Cairo University”. Her research interest includes posture correction, electromyography, lumbo-pelvic motor control and psychometric properties of measurements.