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Physical Treatments Reduce Pain in Children with Tension-Type Headache: A Systematic Review and Meta-Analysis
Insights
Physical treatments effectively reduce pain in children with tension-type headaches (TTH). Relaxation training and occlusal appliances show significant benefits for TTH management in pediatric populations.
Area of Science:
- Pediatric Neurology
- Physical Therapy
- Evidence-Based Medicine
Background:
- Tension-type headache (TTH) is a common neurological disorder in children.
- Effective management strategies for pediatric TTH are crucial for improving quality of life.
- Physical treatments offer a non-pharmacological approach to TTH management.
Purpose of the Study:
- To evaluate the efficacy of various physical interventions for managing TTH in children.
- To synthesize evidence from controlled trials on physical treatments for pediatric TTH.
- To assess the impact of these treatments on pain, functioning, and quality of life.
Main Methods:
- Systematic review and meta-analysis of randomized and non-randomized controlled trials.
- Studies included interventions with a physical component for TTH in children.
- Evidence quality assessed using GRADE criteria; bias assessed using PEDro criteria.
Main Results:
- Seventeen trials involving 1,815 children were included, with moderate overall evidence quality.
- Physical treatments demonstrated a significant effect in reducing TTH pain (RR: 2.37).
- Relaxation training (RR: 3.00) and occlusal appliances for TTH with temporomandibular disorders (RR: 2.58) were particularly effective.
Conclusions:
- Physical treatments are a supported and effective approach for reducing pain in children with TTH.
- Specific interventions like relaxation training show strong efficacy.
- Further research may refine optimal physical therapy protocols for pediatric TTH.
Aims:
To assess the effectiveness of a variety of physical treatments in the management of tension-type headache (TTH) in children.
Methods:
This review is reported in accordance with the PRISMA guidelines and was registered in the PROSPERO database (CRD42014015290). Randomized and nonrandomized controlled trials that examined the effects of all treatments with a physical component in the management of TTH in children and compared these treatments to a placebo intervention, no intervention, or a controlled comparison intervention were included. The Physiotherapy Evidence Database (PEDro) criteria for bias assessment and the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) Working Group criteria were used to assess the quality of the body of evidence. The outcome measures were pain, functioning, and quality of life. Only RCTs were included in the meta-analyses.
Results:
An initial search produced 10,464 published articles. Of these, 17 were relevant trials, including 1,815 participants. The overall GRADE rating of the included studies was moderate, and 11 of the 17 studies could be used in the meta-analyses. The effectiveness of physical treatments in terms of a reduction of pain of 50% or more showed a risk ratio (RR) of 2.37 (95% CI: 1.69 to 3.33). Relaxation training was the most evaluated intervention and proved to be significantly effective (RR: 3.00 [95% CI: 1.94 to 4.63]). In children having TTH combined with temporomandibular disorders, occlusal appliances were effective (RR: 2.58 [95% CI: 1.37 to 4.85]).
Conclusion:
This review supports the use of physical treatments to reduce pain in children with TTH.
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