Purpose of Review

People with headache usually experienced significantly lower health-related quality of life (HRQoL) than the healthy subjects. The goal of this systematic review was to evaluate the effectiveness of manual therapy on HRQoL in patients with tension-type headache (TTH), migraine (MH) or cervicogenic headache (CGH).

Recent Findings

We searched randomized controlled trials (RCTs) on MEDLINE, COCHRANE and PEDro databases. Treatment was manual therapy compared to usual care or placebo. The outcome was the HRQoL that could be measured by Headache Impact Test (HIT-6), Headache Disability Inventory (HDI), Migraine Disability Assessment Questionnaire (MIDAS) and Short Form Health Survey 12/36 (SF-12/36). For the RCT internal validity, we used the Cochrane risk of bias (RoB) tool. For the level of evidence, we used the Grading of Recommendations, Assessment, Development and Evaluation approach (GRADE). We identified a total of 10 RCTs, 7 of which were included into the meta-analysis. For HIT-6 scale, meta-analysis showed statistically significant differences in favour to manual therapy both after treatment (mean difference (MD) − 3.67; 95% CI from − 5.71 to − 1.63) and at follow-up (MD − 2.47; 95% CI from − 3.27 to − 1.68). For HDI scale, meta-analysis showed statistically significant differences in favour to manual therapy both after treatment (MD − 4.01; 95% CI from − 5.82 to − 2.20) and at follow-up (MD − 5.62; 95% CI from − 10.69 to − 0.54). Other scales provided inconclusive results.

Summary

Manual therapy should be considered as an effective approach in improving the quality of life in patients with TTH and MH, while in patients with CGH, the results were inconsistent. Those positive results should be considered with caution due to the very low level of evidence. Researchers should in future design primary studies using valid and reliable disease-specific outcome measures.

中文翻译：

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头痛患者的手动疗法和生活质量：随机对照试验的系统评价和荟萃分析。

审查目的

头痛患者通常经历的健康相关生活质量（HRQoL）明显低于健康受试者。该系统评价的目的是评估对紧张型头痛（TTH），偏头痛（MH）或宫颈源性头痛（CGH）的患者进行HRQoL手动治疗的有效性。

最近的发现

我们在MEDLINE，Cochrane和PEDro数据库中搜索了随机对照试验（RCT）。与常规护理或安慰剂相比，治疗是手动治疗。结果是可以通过头痛影响测试（HIT-6），头痛残疾清单（HDI），偏头痛残疾评估问卷（MIDAS）和简明健康调查12/36（SF-12 / 36）进行测量的HRQoL。对于RCT内部有效性，我们使用Cochrane偏倚风险（RoB）工具。对于证据水平，我们使用了建议分级，评估，发展和评估方法（GRADE）。我们确定了总共10个RCT，其中7个纳入了荟萃分析。对于HIT-6量表，荟萃分析显示在治疗后均支持人工疗法，差异具有统计学意义（均值差（MD）-3.67； 95％CI从-5.71至-1。63）和随访（MD-2.47; 95％CI从-3.27到-1.68）。对于HDI量表，荟萃分析显示在治疗后（MD-4.01； 95％CI从-5.82至-2.20）和随访（MD-5.62； 95％CI从-10.69）方面，对手动疗法的支持率有统计学显着差异。至-0.54）。其他量表没有得出结论性的结果。

概要

手工疗法应被认为是改善TTH和MH患者生活质量的有效方法，而CGH患者则结果不一致。由于证据水平非常低，应谨慎考虑那些积极的结果。研究人员应在未来设计中使用有效且可靠的针对疾病的结果指标进行基础研究。