徒手治療及運動治療介入對頸因性頭痛之效果: 系統性回顧與統合分析

Cervicogenic headache (CGH) is a secondary headache characterized by pain over the single side and related to the cervical spine. There is no consistent conclusion on the effect of manual therapy or exercise therapy on the cervicogenic headache. The purpose of this study was to investigate the effect of manual therapy and therapeutic exercise on intensity, frequency, duration of the headache, cervical mobility, and function of the neck. Methods: We searched PubMed, Medline and CINAHL databases for journal articles in English from1966 until April 2018. Original clinical trials which met the following criteria were included: (1) subjects with cervicogenic headache; (2) using either the manual therapy or therapeutic exercise as an intervention; (3) the control group received sham treatment, placebo, or no intervention; (4) outcome measures contained the intensity, frequency, duration of headache, cervical mobility, and neck function. Results: Seven articles met the inclusion criteria and were analyzed. The results of meta-analysis showed that both manual therapy and therapeutic exercise were significantly better than the control group on headache intensity, frequency, and duration (p ＜ 0.001). Manual therapy resulted in better improvement in neck mobility than the control group (p = 0.002). Manual therapy and therapeutic exercise demonstrated a significantly better effect than the controls on upper cervical rotation mobility (p ＜ 0.001). However, manual therapy showed no better effects on reducing neck pain in patients with CGH (p = 0.220). Conclusions: Good evidence has been found, supporting the clinical effects of manual therapy and exercise on improving the headache intensity, frequency, duration, and upper cervical rotation mobility. Manual therapy can also improve the gross range of cervical motion.