Tension Type Research Articles

COMORBID PRIMARY HEADACHE: OCCURANCE AND PREVALENCE IN PATIENTS WITH RELAPSING REMITTING MULTIPLE SCLEROSIS

COMORBID PRIMARY HEADACHE: OCCURANCE AND PREVALENCE IN PATIENTS WITH RELAPSING REMITTING MULTIPLE SCLEROSIS

Contribution of tension–torsion coupling effect on elastic properties of chiral and anti-chiral structures

Tension-induced rotation and rotation-induced tension are two types of tension–torsion coupling (TTC). The rotation deformation along with TTC effect is a major factor that can induce the planar porous structure to exhibit the auxetic behavior, but why do some structures have numerous rotations but do not exhibit the auxetic behavior? In this study, we propose an analytical framework to address this issue by quantitatively analyzing the independent effects of direct bending of ligaments and rotation of rigid rings on the mechanical properties of the chiral and antichiral honeycombs. The chirality and the angle between force and ligament mainly affect rotation of rigid rings and direct bending of ligaments, respectively. The analytical expressions of TTC coefficients, Poisson’s ratio and Young’s modulus of antichiral-4, antichiral-3 and chiral-3 honeycombs are derived. The effects of the eccentric distance, the rotation stiffness, the tension and bending stiffness of ligaments on the TTC coefficients, Poisson’s ratio and Young’s modulus are revealed via analytical expressions and numerical results. This work provides a guideline for tailoring Young’s modulus and Poisson’s ratio by tuning the TTC effect to alter the relative strength of direct and rotation-induced deformations in the porous structures from a theoretical point of view.

Path Analysis Models Integrating Psychological, Psycho-physical and Clinical Variables in Individuals With Tension-Type Headache

Tension type headache (TTH) is a prevalent but poorly understood pain disease. Current understanding supports the presence of multiple associations underlying its pathogenesis. Our aim was to compare competing multivariate pathway models that explains the complexity of TTH. Headache features (intensity, frequency, or duration - headache diary), headache-related disability (Headache Disability Inventory-HDI), anxiety/depression (Hospital Anxiety and Depression Scale), sleep quality (Pittsburgh Sleep Quality Index), widespread pressure pain thresholds (PPTs) and trigger points (TrPs) were collected in 208 individuals with TTH. Four latent variables were formed from the observed variables - Distress (anxiety, depression), Disability (HDI subscales), Severity (headache features), and Sensitivity (all PPTs). Structural equation modelling (SEM) and Bayesian network (BN) analyses were used to build and compare a theoretical (modeltheory) and a data-driven (modelBN) latent variable model. The modelBN (root mean square error of approximation [RMSEA] = 0.035) provided a better statistical fit than modeltheory (RMSEA = 0.094). The only path common between modelbn and modeltheory was the influence of years with pain on TrPs. The modelBN revealed that the largest coefficient magnitudes were between the latent variables of Distress and Disability (β=1.524, P = .006). Our theoretical model proposes a relationship whereby psycho-physical and psychological factors result in clinical features of headache and ultimately affect disability. Our data-driven model proposes a more complex relationship where poor sleep, psychological factors, and the number of years with pain takes more relevance at influencing disability. Our data-driven model could be leveraged in clinical trials investigating treatment approaches in TTH. PerspectiveA theoretical model proposes a relationship where psycho-physical and psychological factors result in clinical manifestations of headache and ultimately affect disability. A data-driven model proposes a more complex relationship where poor sleep, psychological factors, and number of years with pain takes more relevance at influencing disability.

Investigating Learners’ Changing Expectations on Learning Experience in a MOOC of Professional Translation and Interpreter Training

This study investigates the dynamic pattern of learners’ evaluation of their learning experiences on the MOOC platform at different stages. Data include 364 evaluative comments from the large MOOC in Consecutive Interpreting for a period of 15 weeks. The results of MANOVA test suggest that MOOC learners left significantly more comments on four areas at the later stage compared with those at the early stage: learning resources, learning community, learning opportunity, and student voice. It suggests that MOOC learners at a later stage are looking for a learning environment which supports self-assessment, peer feedback, and coaching to fulfil their personal needs and expectations. Moreover, qualitative thematic analysis suggests that learning resources addresses three areas: the design of the tasks, helpfulness, and diversity of the resources. Learning community largely refers to peer-feedback, co-instructions of peers, and instructors. Learning opportunities refers to the tasks which improve professional knowledge, self-regulated learning strategies, and language proficiency. Last, student voice indicates three types of tensions: the need for pre-existing knowledge to study MOOCs, learners’ diversified personal goals and teaching objectives of MOOCs, preferred learning strategies between MOOC designers and learners.

ASSOCIATION OF COMMON TYPES OF HEADACHES WITH VESTIBULAR IMPAIRMENT AND NECK PAIN IN ELDERLY

Headache(TTH). The headache is associated with vestibular impairment (VI) and neck pain, but this association has not been studied in elder population. Objective: To determine the association of common types of headaches with vestibular impairment and neck pain in elderly. Methods: A cross sectional study was conducted from February 2021 to June 2021 at District Headquarters Hospital Narowal using a non-probability convenience sampling technique on n=140 participants. The inclusion criteria include age above 50 years, able to ambulate independently, complaint history of common type of headache. Headache was assessed clinically based on diagnostic criteria. The head impulse test was used to assess the vestibular function. The neck pain presence was asked through close ended question with binary response. The chi-square (x2) test used for association between the variables. Results: The mean age of the participants was 58.17 ± 7.14 years. The tension type headache was seen in n=76 (54.2%), migraine in n=33 (23.5%) and cervicogenic headache in n=31 (22.1%) patients. Vertigo was seen in n=52 (37%) patients and neck pain in n=82 (58%) patients. A significant association of vestibular impairment with migraine (Chi square value= 7.79, p=0.02) and cervicogenic headache (Chi square value= 6.12, p=0.04). While no significant association with tension type headache (Chi square value= 0.97, p=0.04). All type of headache were significantly associated (p<0.05) with neck pain. Conclusion: The vestibular impairment and neck pain are associated with all type of headache, except tension type headache where vestibular impairments are not associated. There was an association between types of headaches and neck pain. Keywords: Cervicogenic headache, Migraine, Neck pain, Tension type headache, Vestibular impairment (VI).

Effect of Tension on Learner School Performance at Primary School Level at Bhakkar, Pakistan

Effect of tension on students' school performance at the primary school level is a title of study work. Exploring the tension effect on learner performance at school is one of the study's key goals. A major factor in students' school success is tension. This study was intended to highlight the detrimental effects on students' academic performance. The study's objectives were to identify the types of tension associated with student performance, assess how tension affected learners' school performances, and distinguish between how tension affected learners of each gender differently. The researcher can offer a workable solution for the effect of tension on students' school performance to meet the study mentioned earlier objectives. Every primary school in the district of Bhakkar has provided information about this topic. For this study, ten primary schools were chosen randomly (n=10). The researcher subsequently split the ten primary schools (n = 10) into two groups (n = 5) of males and (n = 5) of females. The learner's academic and performance level is better in the case of low stress and anxiety. The main results of this study demonstrate that the teacher can play a crucial part in easing students' school anxiety, and also, this home is a prominent place where this can decrease.

Comparison of Genders in the Effectiveness of AcupunctureTherapy in Tension-TypeHeadache

Objective: Tension-type headache (TTH) with an average lifetime prevalence of 46% (12-78%) in adults is the most common primary headache type. Acupuncture treatment is one of the adjunctive therapy in tension type headache so we wanted to evaluate the response difference of acupuncture between genders.
 Material and Methods: In this retrospective study, the medical records of TTH patients, aged between 18 and 60, who did not receive conventional medical treatment (patient refusing medical treatment or intolerance due to drug side effects) and completed pre-determined sessions of acupuncture therapy in the outpatient clinics between 2017 and 2019 were evaluated. The monthly attack frequency, attack severity (Visual Analogue Scale), and the duration of attacks before and after acupuncture treatment between genders were documented.
 Results: A total of 17 patients meeting the study criteria were included in the study. No statistically significant difference in the frequency, the duration, and the severity of monthly attacks before and after the treatment were found between the genders. The monthly attack frequency and Visual Analogue Scale (VAS) score were found to be significantly decreased in women themselves before and after treatment in themselves. There was no statistically significant difference in the frequency, duration and severity of monthly attacks before and after the treatment among the men.
 Conclusion: Acupuncture should be considered as an alternative treatment option, especially in women with chronic TTH who do not want to use drugs or who have tolerability problems due to side effects or combination with medical therapy.

Frequency of primary headache disorders and association with body mass index; an ambispective study.

To determine the association of body mass index with various primary headache disorders. The ambispective study was conducted at the Department of Medicine, Shalamar Institute of Health Sciences, Lahore, Pakistan, from January 2020 to March 2021, and comprised data of patients who presented to outpatient departments of Neurology and Medicine with complaint of recurrent or persistent headaches. Body mass index of each subject at the time of latest headache visit was recorded. A control group of 200 individuals was also raised and the body mass index of its subjects was measured. Headache disorders were classified as per International Classification of Headache Disorders-3 beta criteria. Correlation of frequency of different types of primary headaches with body mass index was explored. Data was analysed using SPSS 20. Of the 400 subjects, 200(50%) each were cases and controls. There were 132(33%) males and 268(67%) females. The overall mean age was 37.4 ±14.7 years and mean body mass index was 27.3 ±5.87kg/m2. Migraine was found in 183(46%) subjects compared to tension-type headache 96(24%). Migraine was more common in subjects with high body mass index (p<0.05). Primary headaches constitute a significant health problem. Among various risk factors weight-gain is one that can predispose an individual to increased frequency of migraine.

Clinical Profile of Tension Type Headache in a Medical College with Special Emphasis on Triggering Factors.

Tension type headache is one of the costliest primary headaches which can cause a significant impact on an individual's life. Healthcare professionals are exposed to multiple trigger factors which give rise to an increase in headache frequency, most notable reasons being sleep disturbances, stress and untimely food habits. With this background, we conducted this study of detailed clinical profile and trigger factors among the 2050 subjects (MBBS students: 909, BDS students: 323, nursing students: 268, postgraduates students and staff: 550) in our medical institute. Subjects were given questionnaires on headache and were instructed to give the details of their clinical symptoms along with relevant questions on trigger factors. The assessment tools used were the Visual Analogue Scale (VAS) and Migraine Disability Assessment Scale (MIDAS). Out of 2050 subjects, 464 patients suffered from tension type headache. Overall prevalence of tension type headache was 22.6%. Prevalence was higher in females (57.9%) as compared to males (42.1%). Headache experienced by majority of the student population was unilateral (31.4%), pulsating type (51.6%) and of moderate intensity (77.1%). Common associated symptoms were nausea associated with other factors (40%) and photophobia and phonophobia (18.6%). Stress (72.1%) and decreased sleep (49.4%) were the most common triggering factors. Practice of self-medication was reported by 80.2% of subjects. Our study noted a high frequency of trigger factors in medical professionals, the most common triggering factors being stress and disturbed sleep. To our knowledge this is the first large study to evaluate headache and specifically tension type headache among medical professionals.

Functional improvement in children and adolescents with primary headache after an interdisciplinary multimodal therapy program: the DreKiP study

BackgroundMore than 2/3 of children and adolescents in Germany regularly suffer from headaches. Headache-related limitations in everyday life, school drop-out and educational impairment are common. Structured therapy programs for young headache patients are widely missing.MethodsOne hundred eleven patients with frequent migraine and/or tension type headache were treated in a 15 hour group program in afternoons, parallel with school, parents received 7 hours of therapy. At the beginning of the program (T0), 6 (T1) and 12 months (T2) after completion, data on headache related disability (PedMidas), headache frequency, intensity, and pediatric pain disability score (PPDI) were prospectively collected to investigate the effects of the therapy.ResultsSeventy-five patients (9-19 years, median = 14; 66.7% female) and their parents provided patient reported outcome measures showing at T1 (65 patients) and T2 (47 patients) reduced headache frequency (last 3 months headache days median T0: 30 days; T1: 18 days, reduction of median 12 days since T0; T2: 13 days, reduction of median 17 days since T0). Linear mixed models revealed significant reduction (T0/T1 p = 0,002; T0/T2 p = 0,001). Reduced headache disability has been reported at T1 and T2 (PedMidas median T0 = 30, T1 = 15, T2 = 7; p < 0,001, p < 0,001 respectively). Follow up data of a subgroup of patients 24 months after the treatment point to sustainable effects.ConclusionsThe interdisciplinary multimodal headache therapy program DreKiP reduces headache frequency and headache related disability significantly 6-12 months following its completion.Trial registrationDRKS00027523, retrospectively registered.

Primary headaches increase the risk of dementias: An 8-year nationwide cohort study.

BackgroundHeadache, a highly prevalent neurological disorder, has consistently been linked with an elevated risk of dementia. However, most studies are focused on the relationship with migraine in limited age groups. Therefore, the objective of this research was to look at the link between various type of headaches and dementias based on longitudinal population-based data.Methods and resultsParticipants diagnosed with headache from 2002 to 2005 were selected and major covariates were collected. The diagnoses of Alzheimer’s disease, vascular dementia, and other dementias were observed from 2006 until 2013. The adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of dementias according to headache type were calculated by Cox proportional hazards regression. A number of 470,652 participants were observed for a mean of 7.6 years (standard deviation: 1.2), for approximately 3.6 million person-years. Both tension type headache (TTH) and migraine elevated the risk of all-cause dementias (TTH, aHR 1.18, 95% CI 1.13–2.24; migraine, aHR 1.18, 95% CI 1.13–2.24). Headaches had a greater influence in females and non-smokers as a risk factor of dementias. Patients with migraine who consumed alcohol had a higher risk of dementia, however this was not true with TTH patients. Among participants without comorbidities, TTH patients were more susceptible to dementia than migraine patients. Headache patients had a higher proportion of females regardless of headache type and approximately 1.5 times more individuals had three or more comorbidities compared to those without headache.ConclusionsHeadache could be an independent predictor for subsequent dementia risk. Future studies should focus on clarifying pathogenic pathways and possible dementia-related preventive measures in headache populations.

Comparing the effect of myofascial release and muscle energy technique on craniovertebral angle and headache in tension type headache patients

INTRODUCTION: Tension headaches can be induced by forward head posture, and there is a wealth of evidence available for managing chronic headaches. The data supports the use of manual therapy approaches to manage tension type headaches. Because of the forward head posture, the suboccipital muscle region becomes short, resulting in an increase in lordosis and neck pain. Patients with an even more forward head posture have a smaller cranio-vertebral angle, which in turn causes tension type headache. OBJECTIVE: The aim of this study is to compare the effects of Myofascial release therapy(MFR) and Muscle energy technique(MET) with general neck exercises on the cranio-vertebral angle and headache in tension type headache patients. METHODS: In total, 75 subjects with tension type headache and suboccipital muscle tenderness were recruited and randomized blindly into three groups: the MFR group, the MET group, and the control group (25 subjects in each group). A pre-craniovertebral angle was taken by photographic method, and a pre-headache disability index questionnaire was filled in. The MFR group receives cranio-basal release in the suboccipital region with neck exercises, the MET group receives post–isometric relaxation in the suboccipital region with exercises, and the control group receives only exercises for 2 weeks. After two weeks, the postcranial angle and the headache questionnaire were taken and measured. RESULTS: Craniovertebral angle and headache index showed significant improvement in both the MET and MFR groups. There was no significant difference when MET and MFR groups were compared. When compared with the control group, both MET and MFR showed a significant increase in craniovertebral angle. There was significant improvement in the headache index following MET, MFR, or routine neck exercise. CONCLUSION: Compared to the control group, MFR shows better results than MET on craniovertebral angle and headache.

Effectiveness of Suboccipital Soft Tissue Inhibition Technique Versus Neurodynamics On Tension Type Headache for Female Physiotherapy Students

The intent of the study is to establish the effectiveness of suboccipital soft tissue inhibition technique versus neurodynamics on tension type headache for female physiotherapy students. Tension-Type Headache (TTH) is a symptom with a greater impact on quality of life and with a significant socioeconomic impact. Tension-Type Headache and stress are common in student. Long term headache can progress to chronic headache, which has a great impact on the daily life of patients, for instance; aspects of emotions, daily work, and general life activities and so on. Suboccipital Soft tissue mobilization reduces muscle tension and neural tension in tension type headache. The purpose of this study was to explore the application of sub-occipital soft tissue inhibition technique and neurodynamics to compare its effect on Tension-Type Headache. This experimental study included 30 female subjects with headache for more than 1 month and divided into three groups. Group A received suboccipital soft tissue inhibition. Group B received neurodynamics technique, Group C Received both suboccipital soft tissue inhibition and neurodynamic technique. Pre and Post test were taken using VAS, NDI, HDI, Cervical ROM after 4 weeks. On comparing mean values of Group A, Group B &amp; Group C on Visual Analogue Scale score for pain intensity, it showed a significant decrease in the post test Mean values, but Suboccipital soft tissue inhibition and Neurodynamic Techniques (Group C) showed 2.63 which has a lower mean value and is more effective than Suboccipital soft tissue inhibition Technique (Group A) 3.61 and followed by Neurodynamic Technique (Group B) 3.86 at P = 0.001. Hence Null Hypothesis is rejected. This study and our study concludes that both suboccipital soft tissue inhibition and neurodynamics showed a positive impact on headache and quality of life among adults. Although results showed a clinical improvement, there is no clear evidence that one technique is superior to another, combination of both techniques is the most effective treatment.Â

Local Experience of Global CSR in Cocoa Value Chain: Critical Perspective

This paper explores the implementation of corporate social responsibility (CSR) initiatives aimed at community development of Ivorian cocoa growing communities from the perspective of its intended beneficiaries. While the majority of studies on CSR in developing countries focuses on the global dimension of CSR and its role within global governance arrangements, we seek to bring new empirical insights by shifting the focus to the receiving end of CSR and bringing to the fore the contextualised lived experience of local marginalised actors intended to benefit from the CSR initiatives. Drawing on unique qualitative empirical data and building on critical perspective on CSR, we reveal different types of tensions emerging at multiple levels. We contribute to the critical CSR research by developing a conceptual process model, which theorises the relationship between different types of tensions and shows how unresponded tensions lead to the abandon and failure of the CSR initiative.

Tension type headaches: Whether they are primary or secondary headaches?

Tension-type headache is the most common type of headache affecting the population. Due to unclear etiology TTH is categorized as primary. However, it is quentionable if this categorisation is correct. Existing studies on TTH lack evidence that would connect it to primary headaches. Research shows that TTH has close connections with other conditions, meanwhile other primary headaches do not. Moreover, when comparing TTH to other primary headaches, phenotypical differences can be identified. TTH truly can impair a person’s social, physical and occupational activity. Due to the uncertainty about the origin and pathophysiology of this obscure disease there are diminished possibilities in treatment. For this reason, many people are still suffering from it. The name „Tension Type Headache“ has not been changed since the release of ICHD-I in 1988, in hopes for more comprehensive studies about its pathogenesis and etiology in the future. Though, it is evident that TTH is the least studied type of headache. The only unanimous opinion stands for the broad classification and diagnostic criteria. Criteria are based on moderate, bilateral, blunt pain, absence of typical migraine symptoms and lack of clear explanation. It is possible to group the provoking factors which include muscle related (muscle tension theory), environmental (stress, sleep disorders, depression and anxiety), genetic (this predisposition is not fully confirmed) and nutritional (correlation between vitamin D deficiency and TTH was found). TTH pathogenesis is most likely multifactorial, but no concrete mechanisms are clarified. Based on the history, etiology, and pathophysiology of TTH, as well as clinically applied treatment aimed at eliminating causal factors and alleviating pain as a symptom, it can be said that TTH is more likely to be of secondary origin, manifesting as an expression of other somatic, psychological, and affective disorders. For these reasons, TTH should be regarded as one of the symptoms or a component of a syndrome.The hypothesis: Tension-type headache is a headache of secondary rather than primary origin. ObjectiveTo demonstrate that tension-type headache is not idiopathic primary headache.

Coopetitive tensions across project phases: A paradox perspective

Coopetition is a paradoxical phenomenon that encapsulates the dynamic interplay between cooperation and competition. Management of tensions, inherent in coopetitive relationships, is a success factor for this type of collaboration. Previous research has extensively examined management of tensions in the implementation phase of coopetitive innovation projects but has paid little attention to the dynamics of these tensions across different project phases. This gap is disconcerting since the innovation management literature recognizes the fuzziness and uncertainty of the pre-project phase as critical to the continuity of an innovation project. We argue that differences between project phases are likely to affect tensions, and qualitatively investigate their nature and management in the pre-project and implementation phases. The findings indicate that companies in mature industries often experience strong intra-organizational tensions during the pre-project phase due to performing and organizing paradoxes. These tensions may harm companies' participation in projects and need to be handled by a working-through strategy at the company level. In contrast, inter-organizational tensions are identified as the dominant type of tensions during the project implementation phase due to performing, organizing and learning paradoxes. Inter-organizational tensions need to be addressed by working-through strategy, splitting-and-integration strategy or a combination of the two strategies, respectively.

Pediatric vestibular migraine: Diagnosis according to ICHD-3 criteria and the effectiveness of short-term CH prophylaxis.

Vestibular migraine (VM) is a rare migraine variant with limited information about its treatment in children. This study, it was aimed to evaluate the diagnostic characteristics of VM in children and the effectiveness of cyproheptadine hydrochloride (CH) prophylaxis. Patients aged 6-18 years who were diagnosed with VM and other primary headaches (OPHs) according to ICHD-3 diagnostic criteria and given oral CH prophylaxis for at least 3 months were included in the study. Response to CH prophylaxis was defined by the change in symptoms (worsening, no change, and improvement) monthly. A total of 64 cases diagnosed with primary headache and given CH prophylaxis were identified. 40.6% (29) migraine without aura of patients, 34.4% (22) VM, 14.1% (9) tension type headache, 4.7% (3) benign paroxysmal vertigo, 3.1% (2) migraine with aura and 3.1% (2) were diagnosed with abdominal migraine. Compared to OPHs, it was found that the duration of headache attack was shorter (p .013) and vomiting, which is one of the associated symptoms, was observed less in pediatric VM (p .032). The positive response of the whole study population to CH prophylaxis was 85.9%. However, CH prophylaxis responses were higher in VM compared to OPHs at the end of 1 month (63.6%) and 2 months (86.3%). In the pediatric population, the migrainous characters of VM may show differences, but its response to short-term CH prophylaxis is quite good.

Efficiency of ionic liquid/polymer flooding combined with smart water injection on oil recovery through secondary and tertiary patterns using Iranian carbonate rock

The current investigation utilizes direct injection of modified smart water (SW) after oil flooding stage (secondary oil recovery process) instead of injecting the solution after water flooding (tertiary oil flooding). Before performing these types of core flooding experiments, viscosity, interfacial tension (IFT), and wettability alteration besides the effect of ionic liquids (ILs) on the IFT reduction are investigated at the presence of hydrolyzed polyacrylamide (HPAM) dissolved in SW. The results show the oil recovery of 63.5% by injecting SW/polymer while individual injection of water leading the oil recovery of 23.9% based on original oil in place (OOIP). Besides, further core-flooding experiments reveal that injecting SW/polymer solution modified by IL-based surfactants (SWPIL) enhances the recovery to 69.8 and 73.9% based on OOIP for 1-dodecyl-3-methylimidazolium chloride ([C12mim][Cl])) and 1-octadecyl-3-methylimidazolium chloride ([C18mim][Cl])) during the secondary stage. Finally, performing core-flooding experiments with a soaking time of 21 days reveal 87.0 and 89.3% of ultimate oil recovery which can be correlated to IFT reduction while the remained portions (13 and 10.7%) belong to the wettability alteration effect.

Short-term effects of instrument-assisted soft tissue mobilization compared to algometry pressure release in tension-type headache: a randomized placebo-controlled trial

ABSTRACT Purposes To compare the effectiveness of instrument-assisted soft tissue mobilization (IASTM) and pressure algometry with sham ultrasound (control group) on the clinical measures of headache, pressure pain threshold (PPT) of upper trapezius and suboccipital muscles and cervical alignment in patients with tension type headache (TTH). Methods Seventy-two patients with TTH of both genders were randomly allocated to 3 experimental groups: a) the IASTM group (n=24), b) pressure algometry group (n=24), and c) sham ultrasound control group (n=24). Headache frequency and disability, pressure pain threshold of upper trapezius and suboccipital muscles, cervical lordosis angle (CA) and anterior head translation (AHT) were measured four weeks before and after intervention. Moreover, headache frequency was followed up for two more weeks after intervention. Results Statistically significant improvements (P <0.05; effect size ranges 1.1-1.9) were observed in all outcome measures following IASTM compared to the other two intervention methods. In the IASTM group, the headache frequency decreased from 15 to 2 days/month. Also, headache disability decreased from 19 to 10. Further, CA increased from 17.5° to 31.4° and AHT decreased from 24.1 to 15.5 mm. The pressure algometry group showed significantly lower headache frequency at the follow-up (P < 0.01) than the sham ultrasound control group. However, Similar findings in the other evaluated outcomes were found between the pressure algometry and sham ultrasound control groups (P ˃ 0.05). Conclusion The results of the present study indicate the effectiveness of IASTM in improving headache symptoms and cervical alignment in patients with TTH.

Influence of Sheet Metal Pre-forming on Edge Crack Sensitivity using an AHSS Steel Grade

Especially in the automotive sector, high-strength sheet materials are processed in the manufacturing industry. These steels often show a pronounced sensitivity to edge cracks. Because of this, many edge crack testing methods for a wide variety of stress conditions have been developed to describe the edge crack sensitivity of a material. Only the hole expansion test according to ISO 16630 has been standardized. However, the standardization has some gaps in the process description, which has resulted in test modifications. Another disadvantage is the dependence of the results on the machine operator. In the past, the influence of the shear cutting parameters die clearance, cutting edge geometry, and type of cutting line on the edge crack sensitivity was only calculated for undeformed sheet materials. Not only are shear cutting operations carried out on undeformed sheet blanks in the context of the manufacturing of sheet metal components, but more and more pre-formed sheets are mechanically separated and subsequently further formed. Therefore, it is essential to consider the influence of the type and amount of pre-forming introduced on the sensitivity of a material to edge cracks. The discrete types of pre-forming, uniaxial tension, plane strain, and equi-biaxial stretch forming were introduced to sheet metal blanks using dual-phase steel. The Edge-Fracture-Tensile-Test was used to identify the residual formability of the undeformed and pre-formed specimens. The Edge-Crack-Sensitivity-Factor{K}_{mathrm{ec}}, which can be used to predict edge cracks in a finite element forming simulation, was determined from the recorded major strains for selected parameter configurations.