This study aims to investigate the effectiveness of manual therapy in women with tension-type headache and to compare treatment outcomes between menopausal and premenopausal women. Hormonal changes occurring during menopause may influence pain perception and headache characteristics. Participants diagnosed with tension-type headache will receive manual therapy interventions. Headache intensity, headache-related disability, pressure pain threshold, cervical range of motion, sleep quality, and quality of life will be evaluated before and after treatment using validated assessment tools. The results are expected to contribute to physiotherapy approaches in women experiencing tension-type headache during different hormonal periods.
Tension-type headache (TTH) is the most prevalent type of primary headache and is characterized by bilateral, pressing, or tightening pain of mild to moderate intensity. It has a considerable impact on daily activities, psychological status, sleep quality, and overall quality of life. Hormonal changes occurring during the menopausal transition may influence pain perception, musculoskeletal sensitivity, and headache characteristics. Therefore, investigating treatment responses in different hormonal periods may provide valuable clinical insights. The aim of this study is to investigate and compare the effectiveness of manual therapy applications in menopausal and premenopausal women with tension-type headache. The study will include women diagnosed with tension-type headache who meet the inclusion criteria. Participants will be evaluated before and after the intervention period. Manual therapy interventions including soft tissue techniques, cervical mobilization, and therapeutic exercises will be applied. Outcome measures will include headache intensity assessed with the Visual Analog Scale (VAS), headache-related disability evaluated using the Headache Impact Test (HIT-6), pressure pain threshold measured by algometer, cervical range of motion assessed using a goniometer, sleep quality evaluated with the Pittsburgh Sleep Quality Index (PSQI), and health-related quality of life measured with the Short Form-36 (SF-36). The results of this study are expected to provide evidence regarding the role of manual therapy in the management of tension-type headache and contribute to physiotherapy practices targeting women in different hormonal stages.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Participants diagnosed with tension-type headache will receive manual therapy interventions including cervical mobilization, soft tissue techniques, and suboccipital muscle relaxation. Treatments will be applied by a physiotherapist during the study period.
Necmettin Erbakan Univesity Faculty of Health Sciences
Konya, Konya, Turkey (Türkiye)
RECRUITINGPain İntensity (Visual Analog Scale - VAS)
Pain intensity will be assesed using the Visual Analog Scale (VAS). Participants will rate their pain on a 10 cm horizontal line ranging from 0 (no pain) to 10 (worst imaginable pain)
Time frame: Baseline and after 2 weeks of treatment
Headache İmpact (Headache İmpact Test - HİT-6)
Headache-related disability will be evaluted using the Headache İmpact Test (HİT-6). This questionnaire assesses the impact of headaches on daily functioning, social activities and overall quality of life.
Time frame: Baseline and after 2 weeks of treatment
Sleep Quality (Pittsburgh Sleep Quality Index - PSQI)
Sleep quality will be evaluated using the Pittsburgh Sleep Quality Index (PSQI), a self-reported questionnaire that assesses sleep quality and disturbances over the previous month. Higher scores indicate poorer sleep quality.
Time frame: Baseline and after 2 weeks of treatment
Quality of Life (SF-36)
Health-related quality of life will be assessed using the Short Form-36 Health Survey (SF-36), which evaluates physical and mental health across eight domains. Higher scores indicate better quality of life.
Time frame: Baseline and after 2 weeks of treatment
Pressure Pain Threshold
Pressure pain threshold will be measured using a digital algometer applied to the pericranial muscles. The minimum pressure that induces pain will be recorded.
Time frame: Baseline and after 2 weeks of treatment
Cervical Range of Motion
Cervical range of motion will be assessed using a universal goniometer to evaluate cervical flexion, extension, lateral flexion, and rotation movements.
Time frame: Baseline and after 2 weeks of treatment
Executive Function (Trail Making Test Part B)
Executive function and cognitive flexibility will be assessed using the Trail Making Test Part B (TMT-B). The test evaluates visual attention, processing speed, and task-switching ability. The time required to complete the test will be recorded.
Time frame: Baseline and after 2 weeks of treatment
Depression Severity (Beck Depression Inventory)
Depressive symptoms will be assessed using the Beck Depression Inventory (BDI), a 21-item self-report questionnaire designed to measure the severity of depressive symptoms.
Time frame: Baseline and after 2 weeks of treatment
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