Effectiveness of Hands-Off Therapy in the Management of Primary Headache: A Systematic Review and Meta-Analysis. Issue 2 (June 2022)

• Record Type: Journal Article
• Authors: Mukhtar, Naziru Bashir; Meeus, Mira; Gursen, Ceren; Mohammed, Jibril; De Pauw, Robby; Cagnie, Barbara
• Is Part Of: Evaluation & the health professions. Volume 45:Issue 2(2022)
• Page Start: 183
• Page End: 203
• Publication Date: 2022-06
• Subjects: effectiveness -- hands-off -- therapy -- headache -- trials; Medical care -- Evaluation -- Periodicals; Medicine -- Ability testing -- Periodicals; 362.105
• DOI: 10.1177/0163278720983408
• Languages: English
• ISSNs: 0163-2787

Abstract

A number of hands-off therapies have been widely reported and are used in the management of headache. This systematic review and meta-analysis aimed to assess evidence supporting these therapies on selected headache outcomes. A systematic literature search for randomized clinical trials reporting on the effects of hands-off therapies for headache was performed in two electronic databases; PubMed and Web of Science (PROSPERO: CRD42018093559). Risk of bias was assessed using the Cochrane risk of bias tool. Meta-analysis was performed using Review Manager v5.4. Thirty-five studies, including 3, 403 patients with migraine, tension-type or chronic headaches were included in the review. Methodological quality of the studies ranged from poor to good. Result-synthesis revealed weak to moderate evidence for aerobic exercises, relaxation training and pain education for reducing disability. Other hands-off interventions were either weak or limited in evidence. Meta-analysis of 22 studies indicated that the effect of hands-off therapies significantly differed from one another for pain intensity, disability and quality of life (p < 0.05). Relaxation training, aerobic and active/stretching exercises had significant effect on pain intensity and disability (p < 0.05). To conclude, few hands-off therapies were effective on selected headache outcomes. Evidence to support other hands-off therapies is limited by paucity of studies.