Headache Clinical Trial
Official title:
Effects of Cervical and Thoracic Manipulative Techniques Combined With OnabotulinumtoxinA Prophylaxis in the Management of Chronic Migraine: a Pilot Single-blind Randomized Controlled Trial
Chronic migraine (CM) is a very disabling disorder with grave socioeconomic consequences. Pharmacological approaches can affect mechanisms of pain production, while rehabilitation such as Transcutaneous Electrical Nerve Stimulation and Manual Therapy may reduce the neuromuscular contributing factors. The main aim of the study is to evaluate the effects of cervical and thoracic manipulative techniques combined with OnabotulinumtoxinA prophylaxis on headache frequency in patients with Chronic Migraine (CM). The second aim is to evaluate the training effects on the intensity of headache attacks, analgesic consumption, cervical range of motion, TrPs sensitivity and disability. The hypothesis is that the manipulative treatment would alleviate CM symptoms and, in turn, decrease the analgesic consumption.
The present study is a single-blind randomized controlled trial conducted according to the
Declaration of Helsinki, the guidelines for Good Clinical Practice, and the Consolidated
Standards of reporting Trials (CONSORT) Statement guidelines. The examiner will be blinded
to group assignment. If eligible, patients will be allocated to the experimental group (EG)
or the control group (CG) using an automated randomization system (Allocation ratio 1:1).
The group allocation will be kept concealed by means of sealed numbered envelopes. The
randomization list was locked in a desk drawer accessible only to the main investigator. All
the treatments and assessment will be performed in the Neurorehabilitation Unit of Azienda
Ospedaliera Universitaria Integrata of Verona (Italy).
Patients will be asked to complete a daily headache diary, which is routinely administered
to all patients with CM admitted at our Unit for OnabotulinumtoxinA prophylaxis. In the
context of this study, daily headache diaries during 1 month pre-treatment (T0), during the
treatment (treatment phase) and 1 month post-treatment (T1) will be considered.
Moreover, at T0 a questionnaire concerning clinical and demographic data as well as some
habits like consumption of coffee and alcohol, and smoking will be administered. According
to the nature of the study feasibility and efficacy outcomes will be defined. Feasibility
outcomes were the patients' compliance during treatments, any adverse events (i.e. pain,
discomfort) occurred during the treatment, and the number of training session performed.
Primary and secondary outcome measures will be categorized as efficacy outcomes.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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