RESUMO
Objetivos: Estudiar la eficacia de la terapia manual en el tratamiento de la cefalea tensional (CT) valorando los estudios controlados aleatorizados (ECA) publicados desde el año 2000 hasta abril del 2013. Métodos: Se realizó la búsqueda en las bases de datos MEDLINE, EBSCO, CINAHL, SCOPUS, PEDRO y OVID. Se incluyeron ECA que analizasen a pacientes con CT tratados con terapia manual y que recogiesen como variable de resultado la intensidad, frecuencia, duración del dolor de cabeza. La calidad metodológica fue valorada por 2 revisores independientes mediante la escala Jadad. Los datos de los ECA fueron extraídos por 2 revisores. Resultados: Se seleccionaron 14 ECA. Doce de ellos se consideraron de calidad aceptable (Jadad ≥ 3) y 2 de baja (Jadad = 2). Los estudios mostraron resultados positivos obteniendo disminución de la intensidad y/o frecuencia de cefaleas, reducción del consumo de medicamentos y mejora de la calidad de vida en pacientes con CT. Conclusiones: Debido a la heterogeneidad en diseños, instrumentos de medida y tratamientos de los estudios, no es posible obtener conclusiones definitivas sobre la eficacia de la terapia manual en pacientes con CT aunque se aprecien efectos beneficiosos. No obstante, el análisis de los estudios indica que, al recibir tratamiento con terapia manual, los pacientes con CT evolucionaron de forma más favorable respecto a aquellos que recibieron tratamiento habitual o un tratamiento placebo. Se requiere un mayor número de estudios con mayor calidad metodológica, así como mayor homogeneidad de los tratamientos y de los métodos de valoración de los resultados, para determinar la eficacia de la terapia manual en la CT
Objectives: To study the efficacy of manual therapy in the treatment of tension-type headache (TTH) by assessing the quality of randomized control trials (RCTs) published from the year 2000 to April 2013. Methods: A search was performed in the following databases: MEDLINE, EBSCO, CINAHL, SCOPUS, PEDRO and OVID. An analysis was made of RCT including patients with TTH receiving any manual therapy, and assessing outcome measures including the intensity, and frequency or duration of the headache. Two independent referees reviewed the methodological quality of RCTs using the Jadad scale. Data from the studies were extracted by two different reviewers. Results: A total of fourteen RCTs were selected. Twelve studies showed acceptable quality (Jadad scale ≥3), and the remaining 2 had low quality (Jadad = 2). The studies showed positive results, including reduction in headache intensity and/or frequency, reduction of medication consumption, and improvement in quality of life. Conclusions: The effectiveness of manual therapy for TTH cannot be completely assessed due to the heterogeneity in study design, outcome measures, and different treatments. Nevertheless, the results suggest patients with TTH receiving manual therapies showed better progress than those receiving conventional treatment or placebo. Further studies of high quality using manual therapy protocols, and also including standardized outcome measures, are now needed to clarify the efficacy of manual therapy in the management of TTH
Assuntos
Humanos , Masculino , Feminino , Cefaleia do Tipo Tensional/complicações , Cefaleia do Tipo Tensional/diagnóstico , Cefaleia do Tipo Tensional/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Qualidade de Vida , Modalidades de Fisioterapia/instrumentação , Modalidades de Fisioterapia/estatística & dados numéricos , Indicadores Básicos de Saúde , Avaliação de Eficácia-Efetividade de Intervenções , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , BibliometriaRESUMO
OBJECTIVES: To study the efficacy of manual therapy in the treatment of tension-type headache (TTH) by assessing the quality of randomized control trials (RCTs) published from the year 2000 to April 2013. METHODS: A search was performed in the following databases: MEDLINE, EBSCO, CINAHL, SCOPUS, PEDRO and OVID. An analysis was made of RCT including patients with TTH receiving any manual therapy, and assessing outcome measures including the intensity, and frequency or duration of the headache. Two independent referees reviewed the methodological quality of RCTs using the Jadad scale. Data from the studies were extracted by two different reviewers. RESULTS: A total of fourteen RCTs were selected. Twelve studies showed acceptable quality (Jadad scale ≥3), and the remaining 2 had low quality (Jadad=2). The studies showed positive results, including reduction in headache intensity and/or frequency, reduction of medication consumption, and improvement in quality of life. CONCLUSIONS: The effectiveness of manual therapy for TTH cannot be completely assessed due to the heterogeneity in study design, outcome measures, and different treatments. Nevertheless, the results suggest patients with TTH receiving manual therapies showed better progress than those receiving conventional treatment or placebo. Further studies of high quality using manual therapy protocols, and also including standardized outcome measures, are now needed to clarify the efficacy of manual therapy in the management of TTH.
