title: Efficacy of manual therapy in the treatment of tension-type headache. A systematic review from 2000-2013.
abstract: OBJECTIVE
  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.
authors.affiliation: Máster en Dolor Orofacial y Disfunción Craneomandibular, Facultad de Medicina, Departamento de Fisioterapia, Universidad CEU San Pablo, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Lozano López
authors.affiliation: Máster en Dolor Orofacial y Disfunción Craneomandibular, Facultad de Medicina, Departamento de Fisioterapia, Universidad CEU San Pablo, Madrid, España. Electronic address: jmesaj@ceu.es.
authors.forename: J
authors.initials: J
authors.lastname: Mesa Jiménez
authors.affiliation: Máster en Dolor Orofacial y Disfunción Craneomandibular, Facultad de Medicina, Departamento de Fisioterapia, Universidad CEU San Pablo, Madrid, España.
authors.forename: J L
authors.initials: JL
authors.lastname: de la Hoz Aizpurúa
authors.affiliation: Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Pareja Grande
authors.affiliation: Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Fernández de Las Peñas
mesh_terms: D006801:Humans; D026201:Musculoskeletal Manipulations; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D018781:Tension-Type Headache / Q000628:therapy*
keywords: Cefalea tensional; Fisioterapia; Manual therapy; Physical therapy; Tension-type headache; Terapia manual