EFFECTIVENESS OF MANUAL THERAPY

TECHNIQUES COMPARED TO
CONVENTIONAL PHYSICAL THERAPY IN
TENSION-TYPE HEADACHE

 Caballero Calixto L, Anton Puescas PE, Bravo Cucci SD

 Carrera de Terapia Física Universidad Peruana de Ciencias Aplicadas, Lima Peru
 Unidad Domiciliara Sociedades Operadoras Callao y Villa María del Triunfo Salud
 Universidad Nacional Mayor de San Marcos
 Lima-Perú
 46% Adult world 50% Europe population
population has has headache >60% has
headache 42% TTH (2)
Tension-type headache
TTH(1)

MINSA: 2015 -> Ranked

14 th (3)
Instituto Nacional de
Ciencias Neurológicas
(INCN): TTH 2018 ->
Ranked 5 th (4)

(1) Stovner L, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, et al. The global burden of headache: a documentation of
headache prevalence and disability worldwide. Cephalalgia Int J Headache. marzo de 2007;27(3):193-210.
(2) Stovner, L. J., & Andree, C. (2010). Prevalence of headache in Europe: a review for the Eurolight project. The Journal of
Headache and Pain, 11(4), 289–299. doi:10.1007/s10194-010-0217-0
(3) http://www.minsa.gob.pe/estadisticas/estadisticas/morbilidad/cemacros.asp?00
(4) http://www.incn.gob.pe/images/ESTADISTICAS/2018/2018%20MORBIMORTALIDAD%202018%20%20.pdf
 60 patients with TTH
METHODS
 Randomized controlled trial - single EXPERIMENTAL GROUP
blind CONTROL GROUP
Conventional physical therapy +
Conventional physical therapy (hot Upper trapezious TrP inactivation technique +
 OUTCOMES: pack therapy + TENS + massage +
Sub occipital inhibitory distraction technique +
active self-stretching)
✓ Visual Analogue Scale VAS Deep cervical flexor training

✓ Headache Impact Test HIT6

✓ Neck Disability Index NDI
INITIAL (VAS+HIT-6+NDI)
 THE ASSESMENTS :

✓ Before the Treatment

✓ Intermediate INTERMEDIATE (VAS+HIT-
6+NDI)
✓ After The Treatment

FINAL (VAS+HIT-6+NDI)
 VAS, HIT-6 and NDI
Final vs Initial Evaluation
30,
EG decreased 26,33
29.1% compared EG
to the CG with decreased
22,5 11.5% (p < 0.001) 75.7%
EG decreased
by 78.9%
18,67 compared to
compared to CG with
15,
the CG with 23.4% (p <
43.1% (p < 0.001) 0.001)

7,26 6,6
7,5
5,22
3,09

0,
VAS HIT 6 NDI
Experimental Control

RESULTS
VAS EG vs CG 2.14 Both groups showed significant differences before and after the treatment in VAS,
HIT-6 EG vs CG 15.65 HIT-6 and NDI (p< 0.001)
NDI EG vs CG 19.73 Both groups reported a lower frequency of headache.
Comparing between groups (EG and CG) at the end of the treatment, differences
were shown statistically significant in favor of EG:
 CONCLUSIONS

 Both interventions have positive results for the treatment of

tension-type headache, but the treatment with application of the
upper trapezius (TrP) inactivation techniques and sub occipital
inhibitory distraction (SID) associated with deep cervical flexor
training (DCF) was the most effective.
 It is suggested to investigate new treatment schemes that
include techniques of manual therapy, exercise and muscle
inactivation techniques.
 The intervention of physical therapy should be integrated into the
treatment of tension headache as first-line treatment,
conventional schemes can integrate the techniques described in
this study to get better benefits.
 THANKS !!!
 Finally, we want to thank God for giving us life and for the opportunity to be
here and live this wonderful academic experience.
 To our families for all their support and understanding, especially in the
moments of absence for following our dream, our passion ... Our
profession!

lily.caballero6@gmail.com
patynadora@hotmail.com
prof.sbravo@gmail.com