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Patricia Trott - One of the best experts on this subject based on the ideXlab platform.

  • cervical Headache an investigation of natural Head Posture and upper cervical flexor muscle performance
    Cephalalgia, 1993
    Co-Authors: Dean H Watson, Patricia Trott
    Abstract:

    In this study, 60 female subjects, aged between 25 and 40 years, were divided into two equal groups on the basis of absence or presence of Headache. A passive accessory intervertebral mobility (PAIVM) examination was performed to confirm an upper cervical articular cause of the subjects' Headache and a questionnaire was used to establish a profile of the Headache population. Measurements of cranio-cervic al Posture and isometric strength and endurance of the upper cervical flexor muscles were compared between the two groups of subjects. The Headache group was found to be significantly different from the non-Headache group in respect to Forward Head Posture (FHP) (t = -5.98, p < 0.00005), less isometric strength (t = 3.43, p < 0.001) and less endurance (t = 8.71, p < 0.0005) of the upper cervical flexors. A statistically significant relationship was also established between natural Head Posture and isometric endurance of the upper cervical flexor musculature which demonstrated that FHP corresponded with a low endurance capacity (c 2 = 13.2; p < 0.01). The outcome of this study highlights the need to screen for cervical etiology in patients who are suspected of suffering from common migraine.  Cervicogenic Headache, neck flexor muscle, tension Headache

  • cervical Headache an investigation of natural Head Posture and upper cervical flexor muscle performance
    Cephalalgia, 1993
    Co-Authors: Dean H Watson, Patricia Trott
    Abstract:

    In this study, 60 female subjects, aged between 25 and 40 years, were divided into two equal groups on the basis of absence or presence of Headache. A passive accessory intervertebral mobility (PAIVM) examination was performed to confirm an upper cervical articular cause of the subjects' Headache and a questionnaire was used to establish a profile of the Headache population. Measurements of cranio-cervical Posture and isometric strength and endurance of the upper cervical flexor muscles were compared between the two groups of subjects. The Headache group was found to be significantly different from the non-Headache group in respect to Forward Head Posture (FHP) (t = -5.98, p < 0.00005), less isometric strength (t = 3.43, p < 0.001) and less endurance (t = 8.71, p < 0.0005) of the upper cervical flexors. A statistically significant relationship was also established between natural Head Posture and isometric endurance of the upper cervical flexor musculature which demonstrated that FHP corresponded with a low endurance capacity (chi 2 = 13.2; p < 0.01). The outcome of this study highlights the need to screen for cervical etiology in patients who are suspected of suffering from common migraine.

Juan A Pareja - One of the best experts on this subject based on the ideXlab platform.

  • myofascial trigger points neck mobility and Forward Head Posture in episodic tension type Headache
    Headache, 2007
    Co-Authors: Cesar Fernandezdelaspenas, Maria Luz Cuadrado, Juan A Pareja
    Abstract:

    Objective.—To assess the differences in the presence of trigger points (TrPs) in Head and neck muscles, Forward Head Posture (FHP) and neck mobility between episodic tension-type Headache (ETTH) subjects and healthy controls. In addition, we assess the relationship between these muscle TrPs, FHP, neck mobility, and several clinical variables concerning the intensity and the temporal profile of Headache. Background.—TTH is a Headache in which musculoskeletal disorders of the craniocervical region might play an important role in its pathogenesis. Design.—A blinded, controlled pilot study. Methods.—Fifteen ETTH subjects and 15 matched controls without Headache were studied. TrPs in both upper trapezius, both sternocleidomastoids, and both temporalis muscles were identified according to Simons and Gerwin diagnostic criteria (tenderness in a hypersensible spot within a palpable taut band, local twitch response elicited by snapping palpation, and elicited referred pain with palpation). Side-view pictures of each subject were taken in both sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. A cervical goniometer was employed to measure neck mobility. All measures were taken by a blinded assessor. A Headache diary was kept for 4 weeks in order to assess Headache intensity, frequency, and duration. Results.—The mean number of TrPs for each ETTH subject was 3.7 (SD: 1.3), of which 1.9 (SD: 0.9) were active, and 1.8 (SD: 0.9) were latent. Control subjects only had latent TrPs (mean: 1.5; SD: 1). TrP occurrence between the 2 groups was significantly different for active TrPs (P .05). Differences in the distribution of TrPs were significant for the right upper trapezius muscles (P= .04), the left sternocleidomastoid (P= .03), and both temporalis muscles (P < .001). Within the ETTH group, Headache intensity, frequency, and duration outcomes did not differ depending on TrP activity, whether the TrP was active or latent. The craniovertebral angle was smaller, ie, there was a greater FHP, in ETTH patients than in healthy controls for both sitting and standing positions (P < .05). ETTH subjects with active TrPs in the analyzed muscles had a greater FHP than those with latent TrPs in both sitting and standing positions, though differences were only significant for certain muscles. Finally, ETTH patients also showed lesser neck mobility than healthy controls in the total range of motion as well as in half-cycles (except for cervical extension), although neck mobility did not seem to influence Headache parameters. Conclusions.—Active TrPs in the upper trapezius, sternocleidomastoid, and temporalis muscles were more common in ETTH subjects than in healthy controls, although TrP activity was not related to any clinical variable concerning the intensity and the temporal profile of Headache. ETTH patients showed greater FHP and lesser neck mobility than healthy controls, although both disorders were not correlated with Headache parameters.

  • neck mobility and Forward Head Posture are not related to Headache parameters in chronic tension type Headache
    Cephalalgia, 2007
    Co-Authors: Cesar Fernandezdelaspenas, Cristina Alonsoblanco, Maria Luz Cuadrado, Juan A Pareja
    Abstract:

    The relationship between the changes in Forward Head Posture (FHP), neck mobility and Headache parameters was analysed in 25 patients with chronic tension-type Headache (CTTH) undergoing a physical therapy programme. Side-view pictures were taken to measure the cranio-vertebral angle in the sitting and standing positions. A cervical goniometer was employed to measure the range of all cervical motions. A Headache diary was kept to assess Headache intensity, frequency and duration. All patients received six sessions of physical therapy over 3 weeks. Outcomes were assessed at baseline, after treatment and 1 month later. Neck mobility and Headache parameters showed a significant improvement after the intervention, whereas Posture changes did not reach statistical significance. No correlations were found between FHP, neck mobility and Headache parameters at any stage. Changes in these outcomes throughout the study were not correlated either. FHP and neck mobility appear not to be related to Headache intensity, duration or frequency in patients suffering from CTTH. Although patients showed a reduction in the range of motion in the neck, it is uncertain whether this is consistent with TTH.

  • Forward Head Posture and neck mobility in chronic tension type Headache a blinded controlled study
    Cephalalgia, 2006
    Co-Authors: Cesar Fernandezdelaspenas, Cristina Alonsoblanco, Maria Luz Cuadrado, Juan A Pareja
    Abstract:

    Forward Head Posture (FHP) and neck mobility were objectively assessed in 25 patients with chronic tension-type Headache (CTTH) and 25 healthy controls. Side-view pictures were taken in a sitting position to measure the craniovertebral angle. A cervical goniometer was employed to measure the range of all cervical motions. Patients with CTTH showed a smaller cranio-vertebral angle (45.3° ± 7.6°) than controls (54.1° ± 6.3°), thus presenting a greater FHP (P < 0.001). Patients also had lesser neck mobility for all cervical movements, except for right lateral flexion (P < 0.01). There was a positive correlation between the craniovertebral angle and neck mobility. Within the CTTH group, a negative correlation was found between the cranio-vertebral angle and Headache frequency, but neck mobility did not correlate with Headache parameters. Further research is needed to define a potential role of FHP and restricted neck mobility in the origin or maintenance of TTH.

  • trigger points in the suboccipital muscles and Forward Head Posture in tension type Headache
    Headache, 2006
    Co-Authors: Cesar Fernandezdelaspenas, Cristina Alonsoblanco, Maria Luz Cuadrado, Robert D Gerwin, Juan A Pareja
    Abstract:

    Objective.—To assess the presence of trigger points (TrPs) in the suboccipital muscles and Forward Head Posture (FHP) in subjects with chronic tension-type Headache (CTTH) and in healthy subjects, and to evaluate the relationship of TrPs and FHP with Headache intensity, duration, and frequency. Background.—Tension-type Headache (TTH) is a prototypical Headache in which myofascial TrPs in the cervical and pericranial musculature can play an important role. Design.—A blinded, controlled pilot study. Methods.—Twenty CTTH subjects and 20 matched controls without Headache participated. TrPs were identified by eliciting referred pain with palpation, and increased referred pain with muscle contraction. Side-view pictures of each subject were taken in sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. Both measures were taken by a blinded assessor. A Headache diary was kept for 4 weeks in order to assess Headache intensity, frequency, and duration. Results.—Sixty-five percent (13/20) CTTH subjects showed active TrPs and 35% (7/20) had latent TrPs in the suboccipital muscles. Six (30%) controls also had latent TrPs. Differences in the presence of suboccipital muscle TrPs between both the groups were significant for active TrPs (P .5). CTTH subjects with active TrPs reported a greater Headache intensity and frequency than those with latent TrPs (P < .05). The degree of FHP was greater in CTTH subjects than in controls in both sitting and standing positions (P < .01). Within the CTTH group, there was a negative correlation between the craniovertebral angle and the frequency of Headache (rs=−0.6, P < .01, in sitting position; rs=−0.5, P < .05, in standing position). CTTH subjects with active TrPs had a greater FHP than those with latent TrPs, though this difference was not significant. Conclusions.—Suboccipital active TrPs and FHP were associated with CTTH. CCTH subjects with active TrPs reported a greater Headache intensity and frequency than those with latent TrPs. The degree of FHP correlated positively with Headache duration, Headache frequency, and the presence of suboccipital active TrPs.

Dean H Watson - One of the best experts on this subject based on the ideXlab platform.

  • cervical Headache an investigation of natural Head Posture and upper cervical flexor muscle performance
    Cephalalgia, 1993
    Co-Authors: Dean H Watson, Patricia Trott
    Abstract:

    In this study, 60 female subjects, aged between 25 and 40 years, were divided into two equal groups on the basis of absence or presence of Headache. A passive accessory intervertebral mobility (PAIVM) examination was performed to confirm an upper cervical articular cause of the subjects' Headache and a questionnaire was used to establish a profile of the Headache population. Measurements of cranio-cervic al Posture and isometric strength and endurance of the upper cervical flexor muscles were compared between the two groups of subjects. The Headache group was found to be significantly different from the non-Headache group in respect to Forward Head Posture (FHP) (t = -5.98, p < 0.00005), less isometric strength (t = 3.43, p < 0.001) and less endurance (t = 8.71, p < 0.0005) of the upper cervical flexors. A statistically significant relationship was also established between natural Head Posture and isometric endurance of the upper cervical flexor musculature which demonstrated that FHP corresponded with a low endurance capacity (c 2 = 13.2; p < 0.01). The outcome of this study highlights the need to screen for cervical etiology in patients who are suspected of suffering from common migraine.  Cervicogenic Headache, neck flexor muscle, tension Headache

  • cervical Headache an investigation of natural Head Posture and upper cervical flexor muscle performance
    Cephalalgia, 1993
    Co-Authors: Dean H Watson, Patricia Trott
    Abstract:

    In this study, 60 female subjects, aged between 25 and 40 years, were divided into two equal groups on the basis of absence or presence of Headache. A passive accessory intervertebral mobility (PAIVM) examination was performed to confirm an upper cervical articular cause of the subjects' Headache and a questionnaire was used to establish a profile of the Headache population. Measurements of cranio-cervical Posture and isometric strength and endurance of the upper cervical flexor muscles were compared between the two groups of subjects. The Headache group was found to be significantly different from the non-Headache group in respect to Forward Head Posture (FHP) (t = -5.98, p < 0.00005), less isometric strength (t = 3.43, p < 0.001) and less endurance (t = 8.71, p < 0.0005) of the upper cervical flexors. A statistically significant relationship was also established between natural Head Posture and isometric endurance of the upper cervical flexor musculature which demonstrated that FHP corresponded with a low endurance capacity (chi 2 = 13.2; p < 0.01). The outcome of this study highlights the need to screen for cervical etiology in patients who are suspected of suffering from common migraine.

Cesar Fernandezdelaspenas - One of the best experts on this subject based on the ideXlab platform.

  • myofascial trigger points neck mobility and Forward Head Posture in episodic tension type Headache
    Headache, 2007
    Co-Authors: Cesar Fernandezdelaspenas, Maria Luz Cuadrado, Juan A Pareja
    Abstract:

    Objective.—To assess the differences in the presence of trigger points (TrPs) in Head and neck muscles, Forward Head Posture (FHP) and neck mobility between episodic tension-type Headache (ETTH) subjects and healthy controls. In addition, we assess the relationship between these muscle TrPs, FHP, neck mobility, and several clinical variables concerning the intensity and the temporal profile of Headache. Background.—TTH is a Headache in which musculoskeletal disorders of the craniocervical region might play an important role in its pathogenesis. Design.—A blinded, controlled pilot study. Methods.—Fifteen ETTH subjects and 15 matched controls without Headache were studied. TrPs in both upper trapezius, both sternocleidomastoids, and both temporalis muscles were identified according to Simons and Gerwin diagnostic criteria (tenderness in a hypersensible spot within a palpable taut band, local twitch response elicited by snapping palpation, and elicited referred pain with palpation). Side-view pictures of each subject were taken in both sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. A cervical goniometer was employed to measure neck mobility. All measures were taken by a blinded assessor. A Headache diary was kept for 4 weeks in order to assess Headache intensity, frequency, and duration. Results.—The mean number of TrPs for each ETTH subject was 3.7 (SD: 1.3), of which 1.9 (SD: 0.9) were active, and 1.8 (SD: 0.9) were latent. Control subjects only had latent TrPs (mean: 1.5; SD: 1). TrP occurrence between the 2 groups was significantly different for active TrPs (P .05). Differences in the distribution of TrPs were significant for the right upper trapezius muscles (P= .04), the left sternocleidomastoid (P= .03), and both temporalis muscles (P < .001). Within the ETTH group, Headache intensity, frequency, and duration outcomes did not differ depending on TrP activity, whether the TrP was active or latent. The craniovertebral angle was smaller, ie, there was a greater FHP, in ETTH patients than in healthy controls for both sitting and standing positions (P < .05). ETTH subjects with active TrPs in the analyzed muscles had a greater FHP than those with latent TrPs in both sitting and standing positions, though differences were only significant for certain muscles. Finally, ETTH patients also showed lesser neck mobility than healthy controls in the total range of motion as well as in half-cycles (except for cervical extension), although neck mobility did not seem to influence Headache parameters. Conclusions.—Active TrPs in the upper trapezius, sternocleidomastoid, and temporalis muscles were more common in ETTH subjects than in healthy controls, although TrP activity was not related to any clinical variable concerning the intensity and the temporal profile of Headache. ETTH patients showed greater FHP and lesser neck mobility than healthy controls, although both disorders were not correlated with Headache parameters.

  • performance of the craniocervical flexion test Forward Head Posture and Headache clinical parameters in patients with chronic tension type Headache a pilot study
    Journal of Orthopaedic & Sports Physical Therapy, 2007
    Co-Authors: Cesar Fernandezdelaspenas, Marta Perezdeheredia, Alberto Molerosanchez, Juan Carlos Miangolarrapage
    Abstract:

    Design Case-control, descriptive pilot study. Objective To describe the differences in the performance of the craniocervical flexion test (CCFT) between individuals with chronic tension-type Headache (CTTH) and healthy controls. To assess the relationship between the CCFT, Forward Head Posture, and several clinical variables related to the intensity and temporal profile of Headache. Background Musculoskeletal impairments of the craniocervical region might play an important role on the pathogenesis of CTTH. Deficits in the performance of the CCFT have been reported in patients with cervicogenic Headache, nonspecific neck pain, and whiplash injury, but not in individuals with CTTH. Material and Methods Ten patients with CTTH and 10 comparable controls without Headache were studied. A Headache diary was kept for 4 weeks to substantiate the diagnosis and to record the pain history. The CCFT was performed with the subject supine and required performing a gentle Head-nodding action of craniocervical flexion. Th...

  • neck mobility and Forward Head Posture are not related to Headache parameters in chronic tension type Headache
    Cephalalgia, 2007
    Co-Authors: Cesar Fernandezdelaspenas, Cristina Alonsoblanco, Maria Luz Cuadrado, Juan A Pareja
    Abstract:

    The relationship between the changes in Forward Head Posture (FHP), neck mobility and Headache parameters was analysed in 25 patients with chronic tension-type Headache (CTTH) undergoing a physical therapy programme. Side-view pictures were taken to measure the cranio-vertebral angle in the sitting and standing positions. A cervical goniometer was employed to measure the range of all cervical motions. A Headache diary was kept to assess Headache intensity, frequency and duration. All patients received six sessions of physical therapy over 3 weeks. Outcomes were assessed at baseline, after treatment and 1 month later. Neck mobility and Headache parameters showed a significant improvement after the intervention, whereas Posture changes did not reach statistical significance. No correlations were found between FHP, neck mobility and Headache parameters at any stage. Changes in these outcomes throughout the study were not correlated either. FHP and neck mobility appear not to be related to Headache intensity, duration or frequency in patients suffering from CTTH. Although patients showed a reduction in the range of motion in the neck, it is uncertain whether this is consistent with TTH.

  • Forward Head Posture and neck mobility in chronic tension type Headache a blinded controlled study
    Cephalalgia, 2006
    Co-Authors: Cesar Fernandezdelaspenas, Cristina Alonsoblanco, Maria Luz Cuadrado, Juan A Pareja
    Abstract:

    Forward Head Posture (FHP) and neck mobility were objectively assessed in 25 patients with chronic tension-type Headache (CTTH) and 25 healthy controls. Side-view pictures were taken in a sitting position to measure the craniovertebral angle. A cervical goniometer was employed to measure the range of all cervical motions. Patients with CTTH showed a smaller cranio-vertebral angle (45.3° ± 7.6°) than controls (54.1° ± 6.3°), thus presenting a greater FHP (P < 0.001). Patients also had lesser neck mobility for all cervical movements, except for right lateral flexion (P < 0.01). There was a positive correlation between the craniovertebral angle and neck mobility. Within the CTTH group, a negative correlation was found between the cranio-vertebral angle and Headache frequency, but neck mobility did not correlate with Headache parameters. Further research is needed to define a potential role of FHP and restricted neck mobility in the origin or maintenance of TTH.

  • trigger points in the suboccipital muscles and Forward Head Posture in tension type Headache
    Headache, 2006
    Co-Authors: Cesar Fernandezdelaspenas, Cristina Alonsoblanco, Maria Luz Cuadrado, Robert D Gerwin, Juan A Pareja
    Abstract:

    Objective.—To assess the presence of trigger points (TrPs) in the suboccipital muscles and Forward Head Posture (FHP) in subjects with chronic tension-type Headache (CTTH) and in healthy subjects, and to evaluate the relationship of TrPs and FHP with Headache intensity, duration, and frequency. Background.—Tension-type Headache (TTH) is a prototypical Headache in which myofascial TrPs in the cervical and pericranial musculature can play an important role. Design.—A blinded, controlled pilot study. Methods.—Twenty CTTH subjects and 20 matched controls without Headache participated. TrPs were identified by eliciting referred pain with palpation, and increased referred pain with muscle contraction. Side-view pictures of each subject were taken in sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. Both measures were taken by a blinded assessor. A Headache diary was kept for 4 weeks in order to assess Headache intensity, frequency, and duration. Results.—Sixty-five percent (13/20) CTTH subjects showed active TrPs and 35% (7/20) had latent TrPs in the suboccipital muscles. Six (30%) controls also had latent TrPs. Differences in the presence of suboccipital muscle TrPs between both the groups were significant for active TrPs (P .5). CTTH subjects with active TrPs reported a greater Headache intensity and frequency than those with latent TrPs (P < .05). The degree of FHP was greater in CTTH subjects than in controls in both sitting and standing positions (P < .01). Within the CTTH group, there was a negative correlation between the craniovertebral angle and the frequency of Headache (rs=−0.6, P < .01, in sitting position; rs=−0.5, P < .05, in standing position). CTTH subjects with active TrPs had a greater FHP than those with latent TrPs, though this difference was not significant. Conclusions.—Suboccipital active TrPs and FHP were associated with CTTH. CCTH subjects with active TrPs reported a greater Headache intensity and frequency than those with latent TrPs. The degree of FHP correlated positively with Headache duration, Headache frequency, and the presence of suboccipital active TrPs.

Mark I Johnson - One of the best experts on this subject based on the ideXlab platform.

  • Head Posture and neck pain of chronic nontraumatic origin a comparison between patients and pain free persons
    Archives of Physical Medicine and Rehabilitation, 2009
    Co-Authors: Anabela G Silva, David T Punt, P Sharples, Joao Paulo Vilasboas, Mark I Johnson
    Abstract:

    Abstract Silva AG, Punt TD, Sharples P, Vilas-Boas JP, Johnson MI. Head Posture and neck pain of chronic nontraumatic origin: a comparison between patients and pain-free persons. Objective To compare standing Head Posture measurements between patients with nontraumatic neck pain (NP) and pain-free individuals. Design Single-blind (assessor) cross-sectional study. Setting Hospital and general community. Participants Consecutive patients (n=40) with chronic nontraumatic NP and age- and sex-matched pain-free participants (n=40). Interventions Not applicable. Main Outcome Measures Three angular measurements: the angle between C7, the tragus of the ear, and the horizontal; the angle between the tragus of the ear, the eye, and the horizontal; and the angle between the inferior margins of the right and the left ear and the horizontal were calculated through the digitization of video images. Results NP patients were found to have a significantly smaller angle between C7, the tragus, and the horizontal, resulting in a more Forward Head Posture than pain-free participants (NP, mean ± SD, 45.4°±6.8°; pain-free, mean ± SD, 48.6°±7.1°; P 50y) revealed an interaction, with a statistically significant difference in Head Posture for younger participants with NP compared with younger pain-free participants (NP, mean ± SD, 46.1°±6.7°; pain-free, mean ± SD, 51.8°±5.9°; P P >.05; CI for the difference between groups, –4.9°–4.2°). No other differences were found between patients and pain-free participants. Conclusions Younger patients with chronic nontraumatic NP were shown to have a more Forward Head Posture in standing than matched pain-free participants. However, the difference, although statistically significant, was perhaps too small to be clinically meaningful.