Abstract
The aim of the study was to perform a mapping and umbrella review with meta-meta-analysis (MMA) to synthesise and critically evaluate the effectiveness of manual therapy (MT) and aerobic exercise (AE) in relation to pain intensity, frequency, disability and quality of life in patients with migraines, tension-type headaches (TTH) and cervicogenic headaches (CGH). A systematic search was conducted in PubMed, PEDro, Scielo and Google Scholar up to December 2020. A total of 18 articles met the inclusion criteria, and only 8 were included in the quantitative analysis. The MMA showed results in favour of the interventions in terms of pain intensity and quality of life in migraine, TTH and CCH. Data were also in favour of the intervention in terms of pain frequency in migraine and in terms of disability in TTH. However, there were no significant effects on pain frequency in TTH and CGH. The results showed moderate evidence to suggest that AE reduces pain intensity in patients with migraine. In addition, the evidence in favour of MT or a mixed intervention (including therapeutic exercise) was also moderate in terms of reducing pain intensity in patients with TTH.
Highlights
Headaches are categorised worldwide into 2 groups: primary and secondary [1].Among the primary headaches, migraine and tension-type headaches (TTH) are the most prevalent [2]
The analysis showed a significant difference in favour of the Intervention group at the post-treatment (MD = −4.01; 95% confidence interval (CI) −5.82 to −2.20) and at the follow-up
The results showed that therapeutic exercise on the craneocervical and shoulder region significantly improved the frequency of symptoms in the medium term, with a strong level of evidence
Summary
Headaches are categorised worldwide into 2 groups: primary and secondary [1]. Migraine and tension-type headaches (TTH) are the most prevalent [2]. Secondary headaches include cervicogenic headaches (CGHs), among others [1]. Headache disorders were the third-leading cause of disability in 2016 [2]. Pharmacological treatment appears to be efficient for some acute cases and for prophylaxis [3]. This treatment is not effective in all cases, and they can become chronic disorders. Chronic headaches generate an increase in the number of medical consultations at the cost of the health system and can even generate medication-overuse headache [4,5,6]
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