Cephalalgia ( IF 4.9 ) Pub Date : 2021-08-18 , DOI: 10.1177/03331024211034489 Dagmar Beier 1 , Henriette E Callesen 2 , Louise N Carlsen 3, 4 , Kirsten Birkefoss 5 , Hanna Tómasdóttir 6 , Hanne Wűrtzen 7 , Henrik W Christensen 8 , Lotte S Krøll 3 , Mette Jensen 9 , Christel V Høst 4 , Jakob M Hansen 1
Background
Many people suffering from migraine combine pharmacological and non-pharmacological treatments. The purpose of this systematic review is to provide an updated guideline for some widely used non-pharmacological treatment options for migraine.
Methods
We conducted a systematic literature review of randomized studies of adults with migraine treated with manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture and patient education. The main outcomes measured were days with headache and quality of life. Recommendations were formulated based on the Grade of Recommendation, Assessment, Development and Evaluation (GRADE) approach including patient preferences based on expert opinion and questionnaire data.
Results
The overall level of certainty of the evidence was low to very low. Manual therapy techniques and psychological treatment did not change the studied outcomes. Supervised physical activity might have a positive impact on quality of life, acupuncture on headache frequency, intensity, quality of life and the use of attack-medicine. Patient education might improve self-rated health and quality of life and increase the number of well-informed patients.
Conclusion
Based on observed effects, the lack of serious adverse events, and patients’ preferences, we make weak recommendations for considering the investigated interventions as a supplement to standard treatment.
Protocol registration: Prospero CRD42020220132.
中文翻译:
偏头痛治疗中的手动关节活动技术、有监督的身体活动、心理治疗、针灸和患者教育。系统评价和荟萃分析
背景
许多患有偏头痛的人结合了药物和非药物治疗。本系统评价的目的是为一些广泛使用的偏头痛非药物治疗方案提供更新指南。
方法
我们对采用手动关节松动技术、有监督的体力活动、心理治疗、针灸和患者教育治疗成人偏头痛的随机研究进行了系统的文献回顾。测量的主要结果是头痛天数和生活质量。建议是根据推荐、评估、发展和评价 (GRADE) 方法制定的,包括基于专家意见和问卷数据的患者偏好。
结果
证据的总体确定性水平从低到非常低。手法治疗技术和心理治疗并未改变研究结果。有监督的体力活动可能对生活质量、针灸对头痛频率、强度、生活质量和攻击药物的使用产生积极影响。患者教育可能会改善自评健康和生活质量,并增加知情患者的数量。
结论
基于观察到的效果、没有严重不良事件和患者的偏好,我们提出了弱建议,将所调查的干预措施作为标准治疗的补充。
协议注册: Prospero CRD42020220132。