title: Effects of physical therapy and relaxation techniques on the parameters of pain in university students with tension-type headache: A randomised controlled clinical trial.
abstract: BACKGROUND
  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.
authors.affiliation: Departamento de Medicina Física y Rehabilitación-Hidrología Médica, Universidad Complutense de Madrid, Madrid, España. Electronic address: angela.alvarez@ucm.es.
authors.forename: A C
authors.initials: AC
authors.lastname: Álvarez-Melcón
authors.affiliation: Departamento de Medicina Física y Rehabilitación-Hidrología Médica, Universidad Complutense de Madrid, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Valero-Alcaide
authors.affiliation: Departamento de Medicina Física y Rehabilitación-Hidrología Médica, Universidad Complutense de Madrid, Madrid, España.
authors.forename: M A
authors.initials: MA
authors.lastname: Atín-Arratibel
authors.affiliation: Departamento de Psicobiología, Universidad Complutense de Madrid, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Melcón-Álvarez
authors.affiliation: Departamento de Enfermería, Universidad Complutense de Madrid, Madrid, España.
authors.forename: J V
authors.initials: JV
authors.lastname: Beneit-Montesinos
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D026201:Musculoskeletal Manipulations / Q000706:statistics & numerical data; D010146:Pain / Q000517:prevention & control*; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D012064:Relaxation Therapy; D018781:Tension-Type Headache / Q000628:therapy*; D055815:Young Adult
keywords: Autogenic training; Cefalea tensional; Cervical spine kinesiotherapy; Cinesiterapia cervical; Entrenamiento autógeno; Higiene postural; Physical therapy; Posture correction; Relaxation techniques; Tension-type headache; Terapia física; Técnicas relajación