Efectos de entrenamiento físico específico y técnicas de relajación sobre los parámetros dolorosos de la cefalea tensional en estudiantes universitarios: un ensayo clínico controlado y aleatorizado / Effects of physical therapy and relaxation techniques on the parameters of pain in university students with tension-type headache: A randomised controlled clinical trial

INTRODUCCIÓN: Los tratamientos no farmacológicos consiguen controlar la cefalea tensional, sin embargo, la evidencia es todavía limitada. Esta investigación estudia la eficacia de una intervención fisioterápica, basada en cinesiterapia cervical y pautas de higiene postural, que pretende mejorar los resultados obtenidos únicamente con técnicas de relajación (Entrenamiento Autógeno de Schultz [EA]). MÉTODOS: Se seleccionó a 152 estudiantes universitarios (sector poblacional entre quienes esta patología es muy frecuente), 84 mujeres (55,3%) y 68 hombres (44,7%), con edad media de 20,42 años (DT = 2,36), diagnosticados de cefalea tensional, según criterios de la International Headache Society. Se diseñó un ensayo clínico, no farmacológico, controlado y aleatorizado, con evaluación ciega de las variables respuesta. Se compararon los resultados de 2 muestras paralelas e independientes, aplicando a una el EA y a la otra la combinación de este con un programa de cinesiterapia cervical y educación postural. Se cuantificaron la mejoría en los parámetros dolorosos (frecuencia, intensidad y duración) y la reducción del consumo de fármacos, en diarios de cefaleas, antes de los tratamientos y después, a las 4 semanas y a los 3 meses. RESULTADOS: Los 2 grupos de intervención evolucionaron positivamente, consiguiéndose una reducción más significativa en la frecuencia e intensidad de las cefaleas con el tratamiento combinado (p < 0,01) (d = 0,4). CONCLUSIONES: Las terapias activas, no invasivas, como el EA y la cinesiterapia cervical, y especialmente la combinación de ambos, consiguen reducir la cefalea tensional, al prevenir y controlar las posibles causas psicofísicas de este trastorno. Como futuras líneas de investigación, sería interesante evaluar el mantenimiento de los beneficios a largo plazo

INTRODUCTION: Despite the impact of cerebrovascular disease (CVD) on global health, its morbidity and time trends in Spain are not precisely known. :Objective The purpose of our study was to characterise the epidemiology and trends pertaining to stroke in Aragon over the period 1998-2010. METHODS: We conducted a retrospective, descriptive study using the data of the Spanish health system's Minimum Data Set and included all stroke patients admitted to acute care hospitals in Aragon between 1 January 1998 and 31 December 2010. We present data globally and broken down by stroke subtype, sex, and age group. RESULTS: The number of cases increased by 13% whereas age- and sex-adjusted hospitalisation rates showed a significant decrease for all types of stroke (mean annual decrease of 1.6%). Men and women in younger age groups showed opposite trends in hospitalisation rates for ischaemic stroke. Case fatality rate at 28 days (17.9%) was higher in patients with intracerebral haemorrhage (35.8%) than in those with subarachnoid haemorrhage (26.2%) or ischaemic stroke (13%). CVD case fatality showed a mean annual decline of 2.8%, at the expense of the fatality rate of ischaemic stroke, and it was more pronounced in men than in women. DISCUSSION: Understanding stroke epidemiology and trends at the regional level will help establish an efficient monitoring system and design appropriate strategies for health planning

Effects of physical therapy and relaxation techniques on the parameters of pain in university students with tension-type headache: A randomised controlled clinical trial. / Efectos de entrenamiento físico específico y técnicas de relajación sobre los parámetros dolorosos de la cefalea tensional en estudiantes universitarios: un ensayo clínico controlado y aleatorizado.

INTRODUCTION: Non-pharmacological treatments help control tension-type headache; however, evidence about their effectiveness is still limited. This study evaluates the effectiveness of physical therapy based on cervical spine kinesiotherapy and posture correction exercises compared to a programme of relaxation techniques only (Schultz's Autogenic Training, AT). METHODS: Tension-type headache is very common among university students. We randomly selected 152 university students with a diagnosis of tension-type headache according to the criteria of the International Headache Society. Eighty-four were women (55.3%) and 68 were men (44.7%). Mean age was 20.42±2.36 years. The study design is a randomised controlled trial of a non-pharmacological intervention with a blinded evaluation of response variables. We compared the results of two independent samples: AT was used in one of the groups while the other group received AT plus cervical spine kinesiotherapy and posture correction training. Patients recorded any changes in the parameters of pain (frequency, intensity, and duration) and drug consumption in a headache diary before treatment, at 4 weeks, and at 3 months. RESULTS: Both interventions achieved a decrease in all the parameters of pain; however, decreases in frequency and intensity were more significant in the combined treatment group (P<0.01) (d=0.4). CONCLUSIONS: Such active, non-invasive therapies as AT and cervical spine kinesiotherapy, and especially the combination of both, effectively reduce tension-type headache by preventing and managing the potential psychophysical causes of this disorder. Future research should aim to assess the long-term effects of these interventions.