title: Effectiveness of physiotherapy for seniors with recurrent headaches associated with neck pain and dysfunction: a randomized controlled trial.
abstract: A previous study demonstrated that in seniors, the presence of cervical musculoskeletal impairment was not specific to cervicogenic headache but was present in various recurrent headache types. Physiotherapy treatment is indicated in those seniors diagnosed with cervicogenic headache but could also be adjunct treatment for those with cervical musculoskeletal signs who are suspected of having transitional headaches.
  
  
  
  This study aimed to determine the effectiveness of a physiotherapy program for seniors with recurrent headaches associated with neck pain and cervical musculoskeletal dysfunction, irrespective of the headache classification.
  
  
  
  This is a prospective, stratified, randomized controlled trial with blinded outcome assessment.
  
  
  
  Sixty-five participants with recurrent headache, aged 50-75 years, were randomly assigned to either a physiotherapy (n=33) or a usual care group (n=32).
  
  
  
  The primary outcome was headache frequency. Secondary outcomes were headache intensity and duration, neck pain and disability, cervical range of motion, quality of life, participant satisfaction, and medication intake.
  
  
  
  Participants in the physiotherapy group received 14 treatment sessions. Participants in the usual care group continued with their usual care. Outcome measures were recorded at baseline, 11 weeks, 6 months, and 9 months. This study was funded by a government research fund of $6,850. No conflict of interest is declared.
  
  
  
  There was no loss to follow-up for the primary outcome measure. Compared with usual care, participants receiving physiotherapy reported significant reductions in headache frequency immediately after treatment (mean difference -1.6 days, 95% confidence interval [CI] -2.5 to -0.6), at 6-month follow-up (-1.7 days, 95% CI -2.6 to -0.8), and at 9-month follow-up (-2.4 days, 95% CI -3.2 to -1.5), and significant improvements in all secondary outcomes immediately posttreatment and at 6- and 9-month follow-ups, (p<.05 for all). No adverse events were reported.
  
  
  
  Physiotherapy treatment provided benefits over usual care for seniors with recurrent headache associated with neck pain and dysfunction.
authors: Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, 110 Intawaroroj Rd, Sripoom, Chiang Mai, Thailand 50200; Research Center in Back, Neck and Other Joint Pain and Human Performance, Khon Kaen University, 123 Moo 16 Mittraphap Rd, Khon Kaen, Thailand 40002. Electronic address: sureeporn.uthaikhup@cmu.ac.th.
authors: Sureeporn
authors: S
authors: Uthaikhup
authors: Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, 110 Intawaroroj Rd, Sripoom, Chiang Mai, Thailand 50200.
authors: Jenjira
authors: J
authors: Assapun
authors: Department of Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroroj Rd, Sripoom, Chiang Mai, Thailand 50200.
authors: Kanokwan
authors: K
authors: Watcharasaksilp
authors: Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Australia 4072.
authors: Gwendolen
authors: G
authors: Jull
mesh_terms: D000368:Aged; D005260:Female; D006261:Headache / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000150:complications / Q000628:therapy*; D026741:Physical Therapy Modalities / Q000009:adverse effects*; D011788:Quality of Life; D016059:Range of Motion, Articular
keywords: Cervical disorder; Cervical musculoskeletal dysfunction; Headache; Neck pain; Physiotherapy; Seniors