title: Clinical variables associated with recovery in patients with chronic tension-type headache after treatment with manual therapy.
abstract: The aims of this study were to describe the course of chronic tension-type headache (CTTH) in participants receiving manual therapy (MT), and to develop a prognostic model for predicting recovery in participants receiving MT. Outcomes in 145 adults with CTTH who received MT as participants in a previously published randomised clinical trial (n=41) or in a prospective cohort study (n=104) were evaluated. Assessments were made at baseline and at 8 and 26 weeks of follow-up. Recovery was defined as a 50% reduction in headache days in combination with a score of 'much improved' or 'very much improved' for global perceived improvement. Potential prognostic factors were analyzed by univariable and multivariable regression analysis. After 8 weeks 78% of the participants reported recovery after MT, and after 26 weeks the frequency of recovered participants was 73%. Prognostic factors related to recovery were co-existing migraine, absence of multiple-site pain, greater cervical range of motion and higher headache intensity. In participants classified as being likely to be recovered, the posterior probability for recovery at 8 weeks was 92%, whereas for those being classified at low probability of recovery this posterior probability was 61%. It is concluded that the course of CTTH is favourable in primary care patients receiving MT. The prognostic models provide additional information to improve prediction of outcome.
authors.affiliation: Health Care Center Haarlemmermeer, Hoofddorp, The Netherlands Department of General Practice, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands Arthritis Research UK Primary Care Centre, Keele University, UK Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands Department of Rehabilitation Medicine and Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: René F
authors.initials: RF
authors.lastname: Castien
authors.forename: Daniëlle A W M
authors.initials: DAWM
authors.lastname: van der Windt
authors.forename: Annette H
authors.initials: AH
authors.lastname: Blankenstein
authors.forename: Martijn W
authors.initials: MW
authors.lastname: Heymans
authors.forename: Joost
authors.initials: J
authors.lastname: Dekker
mesh_terms: D000293:Adolescent; D000328:Adult; D059350:Chronic Pain / Q000175:diagnosis / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D020773:Headache Disorders / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology; D018781:Tension-Type Headache / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult