Can muscle relaxation affect balance in patients with tension-type headache? A pre-post study

Zahra Rojhani-Shirazi, Ali Barzegar, Elham Nouraddini, Negar Ajdari, Marzieh Mohamadi

Abstract


Background: Proprioceptive inputs from the cervical region play an important role in balance. In patients with tension-type headache (TTH), proprioception is altered. The effect of treatment for TTH on balance is unclear. The aim of this study was to evaluate the effectiveness of post-isometric relaxation (PIR) in the neck muscles on pain, disability and balance in patients with TTH.

Methods: 30 patients with chronic TTH who had a trigger point and tenderness in the upper trapezius, sternocleidomastoid (SCM), suboccipitalor splenius muscles were enrolled in the study. The patients underwent PIR based on Liebenson’s method. Before and after treatment, balancewas evaluated with the Y balance test, time up and go test, functional reach test and single leg stance test. As clinical symptoms of TTH we considered the intensity and frequency of headaches,which were recorded along with neck disability index (NDI)assecondary outcomes. Paired t-tests were used to analyze the data.

Results:The results of the Y balance test, time up and go test, functional reach test and single leg stance test changed significantly after treatment (P< 0.001). Significant differences were also found forall secondary variables (P < 0.001).

Conclusions:The results of this study showed that the PIR technique for muscle relaxation in the upper trapezius, SCM, suboccipitalor splenius muscles may improve balance along with clinical symptoms such as pain and disabilityin patients with TTH.


Keywords


Balance; Tension-type headache; Muscle relaxation; Disability

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References


Massion J: Postural control system. Curr Opin Neurobiol 1994;4(6):877-887.

Brandt T: Cervical vertigo–reality or fiction? Audiol Neurotol 1996;1(4):187-196.

Gosselin G, Rassoulian H, Brown I: Effects of neck extensor muscles fatigue on balance. Clin Biomech 2004;19(5):473-479.

Revel M, Minguet M, Gergoy P, et al: Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. Arch Phys Med Rehabil 1994;75.

Elert J, Kendall SA, Larsson B, et al: Chronic pain and difficulty in relaxing postural muscles in patients with fibromyalgia and chronic whiplash associated disorders. J Rheumatol 2001;28(6):1361-1368.

Bendtsen L, Fernández-de-la-Peñas C: The role of muscles in tension-type headache. Curr Pain Headache Rep 2011;15(6):451-458.

Schoenen J, Gerard P, Pasqua V, et al: EMG activity in pericranial muscles during postural variation and mental activity in healthy volunteers and patients with chronic tension type headache. Headache 1991;31(5):321-324.

Jensen R, Bendtsen L, Olesen J: Muscular factors are of importance in tension‐type headache. Headache 1998;38(1):10-17.

Cobo JL, Sole-Magdalena A, Menendez I, et al: Connections between the facial and trigeminal nerves Anatomical basis for facial muscle proprioception. JPRAS Open 2017;12:9-18.

Giacomini P, Alessandrini M, Evangelista M, et al: Impaired postural control in patients affected by tension‐type headache. Eur J Pain 2004;8(6):579-583.

Wannaprom N, Treleaven J, Jull G, et al: Neck muscle vibration produces diverse responses in balance and gait speed between individuals with and without neck pain. Musculoskeletal Science and Practice 2018;35:25-29.

Ishizaki K, Mori N, Takeshima T, et al: Static stabilometry in patients with migraine and tension‐type headache during a headache‐free period. Psychiatry Clin Neurosci 2002;56(1):85-90.

Rossi C, Alberti A, Sarchielli P, et al: Balance disorders in headache patients: evaluation by computerized static stabilometry. Acta Neurol Scand 2005;111(6):407-413.

Kristijansson E, Treleaven K: Sensorimotor function and dizziness in neck pain: implications for assessment and management. J Orthop Sports Phys Ther 2009;39(5):364-77.

Armstrong B, McNair P, Taylor D: Head and neck position sense. Sports Med 2008;38:101-117.

Myers TW: Anatomy trains: Myofascial meridians for manual and movement therapists. 1st ed. Edinburgh: Churchill Livingstone Elsevier; 2001.

Willard FH, Vleeming A, Schuenke MD, et al: The thoracolumbar fascia: anatomy, function and clinical considerartion. J Anat 2012;221:507-536.

Vernon H, Mior S: The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther 1991;14(7):409-415.

Podsiadlo D, Richardson S: The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39(2):142-148.

Duncan PW, Weiner DK, Chandler J, et al: Functional reach: a new clinical measure of balance. J Gerontol 1990;45(6):M192-M197.

Mann GC, Whitney SL, Redfern MS, et al: Functional reach and single leg stance in patients with peripheral vestibular disorders. J Vestib Res 1996;6(5):343-353.

Coughlan GF, Fullam K, Delahunt E, et al: A comparison between performance on selected directions of the star excursion balance test and the Y balance test. J Athl Train 2012;47(4):366.

Fullam K, Caulfield B, Coughlan GF, et al: Kinematic analysis of selected reach directions of the Star Excursion Balance Test compared with the Y-Balance Test. J Sport Rehabil 2014;23(1):27-35.

Gribble PA, Hertel J, Plisky PJ: Using the Star Excursion Balance Test to Assess Dynamic Postural Control Deficits and Outcomes in Lower Extremity Injury – A Literature and Systematic Review. J Athl Train 2012;47(3):339-57.

Liebenson C: Rehabilitation of the spine: a practitioner's manual. Lippincott Williams & Wilkins; 2007.

Penzien DB, Rains JC, Lipchik GL, et al: Behavioral interventions for tension-type headache: overview of current therapies and recommendation for a self-management model for chronic headache. Curr Pain Headache Rep 2004;8(6):489-499.

Söderberg E, Carlsson J, Stener‐Victorin E: Chronic tension‐type headache treated with acupuncture, physical training and relaxation training. Between‐group differences. Cephalalgia 2006;26(11):1320-1329.

Jensen R, Olesen J: Initiating mechanisms of experimentally induced tension-type headache. Cephalalgia 1996;16(3):175-182.

Fernández‐de‐las‐Peñas C, Cuadrado M, Arendt‐Nielsen L, et al: Myofascial trigger points and sensitization: an updated pain model for tension‐type headache. Cephalalgia 2007;27(5):383-393.

Poole E, Treleaven J, Jull G: The influence of neck pain on balance and gait parameters in community-dwelling elders. Man Ther 2008;13(4):317-324.

Gosselin G, Fagan MJ: The effects of cervical muscle fatigue on balance–a study with elite amateur rugby league players. J Sports Sci Med 2014;13(2):329-337.

Lee M-Y, Lee H-Y, Yong M-S: Characteristics of cervical position sense in subjects with forward head posture. J Phys Ther Sci 2014;26(11):1741-1743.

Ashina M: neurobiology of chronic tension-type headache. Cephalalgia 2004;24:161-172.

Horak FB: Postural orientation and equilibrium: What do we need to know about neural control of balance to prevent falls? Age Ageing 2006;35:Suppl 2:ii7-ii11.

Beinert K, Taube W: The effect of balance training on cervical sensorimotor function and neck pain. J Mot Behav 2013;45(3):271-8.

Reddy RS, Maiya AG, Rao SK: Effect of dorsal neck muscle fatigue on cervicocephalic kinaesthetic sensibility. Hong Kong Physiother J 2012;30(2):105-109.

Shirazi ZR, Jahromi FN: Comparison of the effect of selected muscle groups fatigue on postural control during bipedal stance in healthy young women. Niger Med J 2013;54(5):306.

Akdal G, Dönmez B, Öztürk V, et al: Is balance normal in migraineurs without history of vertigo? Headache 2009;49(3):419-425.


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