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Spinal manipulation for the management of cervicogenic headache: A systematic review and meta-analysis

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Sistematic Review

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Structural and chiropractic

Eur J Pain.2020 Oct;24(9):1687-1702.

Authors:

M Fernandez, C Moore, J Tan, D Lian, J Nguyen, A Bacon, B Christie, I Shen, T Waldie, D Simonet, A Bussières

Abstract.

Background: Spinal manipulative therapy (SMT) is frequently used to manage cervicogenic headache (CGHA). No meta-analysis has investigated the effectiveness of SMT exclusively for CGHA. Objective: To evaluate the effectiveness of SMT for CGHA. Databases and data treatment: Five databases identified randomized controlled trials comparing SMT with other manual therapies. The PEDro scale assessed the risk-of-bias. Pain and disability data were extracted and converted to a common scale. A random effects model was used for several follow-up periods. GRADE described the quality of evidence. Results: Seven trials were eligible. At short-term follow-up, there was a significant, small effect favouring SMT for pain intensity (mean difference [MD] -10.88 [95% CI, -17.94, -3.82]) and small effects for pain frequency (standardized mean difference [SMD] -0.35 [95% CI, -0.66, -0.04]). There was no effect for pain duration (SMD - 0.08 [95% CI, -0.47, 0.32]). There was a significant, small effect favouring SMT for disability (MD - 13.31 [95% CI, -18.07, -8.56]). At intermediate follow-up, there was no significant effects for pain intensity (MD - 9.77 [-24.21 to 4.68]) and a significant, small effect favouring SMT for pain frequency (SMD - 0.32 [-0.63 to - 0.00]). At long-term follow-up, there was no significant effects for pain intensity (MD - 0.76 [-5.89 to 4.37]) and for pain frequency (SMD - 0.37 [-0.84 to 0.10]). Conclusion: For CGHA, SMT provides small, superior short-term benefits for pain intensity, frequency and disability, but not pain duration, however, high-quality evidence in this field is lacking. The long-term impact is not significant.

Publication Date: 

2020 Oct

OEID: 

6053

Fernandez, M., Moore, C., Tan, J., Lian, D., Nguyen, J., Bacon, A., Christie, B., Shen, I., Waldie, T., Simonet, D., Bussières, A. (2020) 'Spinal manipulation for the management of cervicogenic headache: A systematic review and meta-analysis', Eur J Pain.2020 Oct;24(9):1687-1702.

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