Effects of High-frequency Diathermy Integrated into Suboccipital Release on Tenderness and Neck Mobility and Disability in People with Chronic Tension-type Headache

Hyoung-ryeol Lee; Jae-hun Shim; and Duck-won Oh

doi:10.12674/ptk.2017.24.2.037

pISSN 2288-6982
eISSN 2288-7105

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Phys Ther Korea 2017; 24(2): 37-47

Published online May 1, 2017

https://doi.org/10.12674/ptk.2017.24.2.037

뒤통수밑근 이완기법과 병행된 고주파 심부투열이 만성 긴장성 두통 환자들의 압통과 목 가동성 및 기능장애에 미치는 영향

이형렬¹, 심재훈², 오덕원³

¹새하늘정형외과의원 물리치료실,,
²백석대학교 보건학부 물리치료학과,,
³청주대학교 보건의료대학 물리치료학과

Effects of High-frequency Diathermy Integrated into Suboccipital Release on Tenderness and Neck Mobility and Disability in People with Chronic Tension-type Headache

Hyoung-ryeol Lee¹, Jae-hun Shim², and Duck-won Oh³

¹Dept. of Physical Therapy, Saehaneul Orthopedic Surgery Clinic,
²Dept. of Physical Therapy, Division of Health Science Baekseok University,
³Dept. of Physical Therapy, College of Health Science, Cheongju University

Correspondence to: Corresponding author: Jae-hun Shim clinicalpt@bu.ac.kr

Received: January 18, 2017; Revised: January 18, 2017; Accepted: February 25, 2017

Abstract

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Abstract

Background:

Active trigger points (TrPs) of the suboccipital muscles greatly contribute to the occurrence of chronic tension-type headache, with increased sensitivity of TrPs and facilitated referred pain.

Objects:

This study aimed to investigate whether the integration of high-frequency diathermy into suboccipital release is more beneficial than the use of suboccipital release alone.

Methods:

Thirty subjects were assigned to either experimental group-1 (EG-1) to undergo suboccipital release combined with high-frequency diathermy (frequency: 0.3 MHz, and electrode type: resistive electronic transfer), or EG-2 to undergo suboccipital release alone, or the control group (CG) with no intervention, with 10 subjects in each group. The assessment tools included the headache impact test 6 (HIT-6), perceived level of tenderness, neck disability index, and neck mobility. Intervention was performed for 10 minutes, twice per week, for 4 weeks, and measurements were performed before and after the interventions.

Results:

The between-group comparison of the post-test values and changes between pretest and post-test showed significant differences for all parameters at p<.05, except for the left-to-right lateral bending range. In the post hoc test, EG-1 showed significant differences for the parameters in comparison with the CG, while no significant differences in the perceived tenderness level, on both temporal regions, were found between EG-2 and CG. Furthermore, the HIT-6 score and perceived tenderness level, in the right temporal region, showed significant differences between EG-1 and EG-2. In the within-group comparison, EG-1 and EG-2 appeared to be significantly different between pretest and post-test (p<.05), except for the perceived tenderness level in the right temporal region, with significance for the EG-1 group only (p<.05).

Conclusion:

These findings suggest that the suboccipital release technique may be advantageous to improve headache, tenderness, and neck function and mobility, with more favorable effects with the incorporation of high-frequency diathermy.

Keywords: High-frequency diathermy, Neck function, Suboccipital release, Tension-type headache.

Article

ARTICLE

Phys Ther Korea 2017; 24(2): 37-47

Published online May 1, 2017 https://doi.org/10.12674/ptk.2017.24.2.037

뒤통수밑근 이완기법과 병행된 고주파 심부투열이 만성 긴장성 두통 환자들의 압통과 목 가동성 및 기능장애에 미치는 영향

이형렬¹, 심재훈², 오덕원³

¹새하늘정형외과의원 물리치료실,,
²백석대학교 보건학부 물리치료학과,,
³청주대학교 보건의료대학 물리치료학과

Received: January 18, 2017; Revised: January 18, 2017; Accepted: February 25, 2017

Effects of High-frequency Diathermy Integrated into Suboccipital Release on Tenderness and Neck Mobility and Disability in People with Chronic Tension-type Headache

Hyoung-ryeol Lee¹, Jae-hun Shim², and Duck-won Oh³

Correspondence to:Corresponding author: Jae-hun Shim clinicalpt@bu.ac.kr

Received: January 18, 2017; Revised: January 18, 2017; Accepted: February 25, 2017

Abstract

Background:

Active trigger points (TrPs) of the suboccipital muscles greatly contribute to the occurrence of chronic tension-type headache, with increased sensitivity of TrPs and facilitated referred pain.

Objects:

This study aimed to investigate whether the integration of high-frequency diathermy into suboccipital release is more beneficial than the use of suboccipital release alone.

Methods:

Results:

Conclusion:

Keywords: High-frequency diathermy, Neck function, Suboccipital release, Tension-type headache.

Abstract

Fig 1.

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Figure 1.

Use of suboccipital release technique. (A) palpation of subocciptal region and application of sustained pressure, and (B) distaction of subocciptal region.

Physical Therapy Korea 2017; 24: 37-47https://doi.org/10.12674/ptk.2017.24.2.037

Fig 2.

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Figure 2.

Equipment of high-frequency diathermy (radio frequence therapeutique).

Physical Therapy Korea 2017; 24: 37-47https://doi.org/10.12674/ptk.2017.24.2.037

Fig 3.

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Figure 3.

Application of high- frequency diathermy during suboccipital release. Physical therapist weared the strap-typed electrode in the middle of forearm (circle) and return-pad plate was positioned under patients’ upper back (square in dot line).

Physical Therapy Korea 2017; 24: 37-47https://doi.org/10.12674/ptk.2017.24.2.037

Fig 4.

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Figure 4.

Diagram of the study (EG-1: integration of high-frequency diathermy into suboccipital release technique, EG-2: suboccipital release technique alone, CG: control group, HIT-6: Head impact Test-6, NDI: Neck Disability Index).

Physical Therapy Korea 2017; 24: 37-47https://doi.org/10.12674/ptk.2017.24.2.037

Table 1 .. General characteristics of subjects (N=30).

	EG-1a (n₁=10)	EG-2b (n₂=10)	CGc (n₃=10)	F(p)

Gender (male/female)	3/7	2/8	1/9	.5(.5)
Age (year)	34.7±7.8d	32.20±6.1	28.80±2.9	2.4(.1)
Height (cm²)	165.7±5.2	164.6±8.0	167.50±6.2	.5(.6)
Weight (kg)	64.6±9.1	65.6±13.8	60.0±9.1	.7(.5)
HIT-6e (scores)	63.9±4.3	62.3±5.9	62.0±2.0	.5(.6)

^aexperimental group-1: integration of high-frequency heat therapy into suboccipital release

^bexperimental group-2: suboccipital release alone

^ccontrol group

^dmean±standard deviation

^ehead impact test-6.

Table 2 .. Comparison of the outcome of tenderness in pre and post-test among three groups (Unit: lb/cm²).

		EG-1a (n₁=10)	EG-2b (n₂=10)	CGc (n₃=10)	F(p)

HIT-6e	Pre-test	63.90±4.30d	62.30±5.94	62.00±2.00	.54(.58)
	Post-test	46.30±7.45†	51.00±6.81†	60.80±2.44	15.20(<.001)
	Difff	17.60±7.10†‡	11.30±5.10†	1.20±3.04	23.93(<.001)
	t(p)	7.83(<.001)	7.00(<.001)	1.24(.25)

Left temporal region	Pre-test	4.85±1.48	5.02±1.47	5.70±1.98	.74(.48)
	Post-test	7.05±2.01	5.95±1.75	5.40±1.80	2.04(.15)
	Diff	-2.20±2.12†	-.94±.92	.30±.68	9.72(<.001)
	t(p)	-3.71(.01)	-3.23(.01)	1.40(.20)

Right temporal region	Pre-test	5.30±.93	5.35±2.09	5.85±2.51	.24(.80)
	Post-test	7.45±1.67†	5.88±1.70	5.38±1.82	3.91(.03)
	Diff	-2.15±1.30†‡	-.53±1.26	.47±1.18	11.26(<.001)
	t(p)	-5.23(<.001)	-1.32(.22)	1.26(.24)

Left suboccipital region	Pre-test	5.40±2.10	5.55±2.72	6.96±2.00	1.40(.26)
	Post-test	9.65±2.02	9.40±2.93	6.80±2.28	.31(.02)
	Diff	-2.25±1.49†	-1.84±0.73†	.16±1.26	11.38(<.001)
	t(p)	-4.75(<.001)	-7.93(<.001)	.40(.70)

Right suboccipital region	Pre-test	5.91±1.91	5.44±2.56	6.78±2.28	.90(.41)
	Post-test	9.72±2.08	9.25±3.05	6.84±2.37	.30(.03)
	Diff	-1.81±1.54†	-1.81±1.02†	-.06±1.62	5.04(.01)
	t(p)	-3.71(<.001)	-5.57(<.001)	-.11(.91)

^aexperimental group-1: integration of high-frequency heat therapy into suboccipital release

^bexperimental group-2: suboccipital release alone

^ccontrol group

^dmean±standard deviation

^ehead impact test-6

^fdifference between pre- and post-test

^†significant difference in a comparison with the control group (p<.05)

^‡significant difference in a comparison with the EG-2 group (p<.05).

Table 3 .. Comparison of the outcome of NDI (neck disability index) and neck mobility in pre and post-test among three groups (Unit: degree).

		EG-1a (n₁=10)	EG-2b (n₂=10)	CGc (n₃=10)	F(p)

NDIe	Pre-test	16.70±3.59d	17.60±5.92	14.60±4.32	1.06(.35)
	Post-test	8.50±4.08†	11.20±4.15	13.70±4.00	4.05(.02)
	Difff	8.20±4.34†	6.40±2.83†	.90±1.96	14.10(<.001)
	t(p)	5.97(<.001)	7.13(<.001)	1.44(.25)

Flexion-extension range	Pre-test	91.55±12.47	94.7±9.84	95.2±7.52	.38(.68)
	Post-test	112.35±10.08†	112.8±9.08†	96.1±10.96	8.90(<.001)
	Diff	-20.80±8.44†	-18.1±6.08†	-.90±4.6	27.00(<.001)
	t(p)	-7.79(<.001)	-9.41(<.001)	-.61(.55)

Left-right rotation range	Pre-test	112.90±15.36	112.00±18.57	116.2±13.48	.19(.82)
	Post-test	128.20±10.67†	128.10±9.36†	115.3±11.17	5.05(.01)
	Diff	-15.30±9.85†	-16.10±14.73†	.90±6.64	7.70(<.001)
	t(p)	-4.90(<.001)	-3.45(.01)	.42(.68)

Left-right lateral bending range	Pre-test	77.10±11.25	84.5±4.97	82.9±5.19	2.54(.09)
	Post-test	83.40±7.57	87.7±5.29	84.2±7.59	1.09(.34)
	Diff	-6.30±7.08	-3.2±4.39	-1.30±7.1	1.59(.22)
	t(p)	-2.81(.02)	-2.30(.05)	-.57(.58)

^aexperimental group-1: integration of high-frequency heat therapy into suboccipital release

^bexperimental group-2: suboccipital release alone

^ccontrol group

^dmean±standard deviation

^eneck disability index

^fdifference between pre- and post-test

^†significant difference in a comparison with the control group (p<.05)

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뒤통수밑근 이완기법과 병행된 고주파 심부투열이 만성 긴장성 두통 환자들의 압통과 목 가동성 및 기능장애에 미치는 영향

Effects of High-frequency Diathermy Integrated into Suboccipital Release on Tenderness and Neck Mobility and Disability in People with Chronic Tension-type Headache

Abstract

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뒤통수밑근 이완기법과 병행된 고주파 심부투열이 만성 긴장성 두통 환자들의 압통과 목 가동성 및 기능장애에 미치는 영향

Effects of High-frequency Diathermy Integrated into Suboccipital Release on Tenderness and Neck Mobility and Disability in People with Chronic Tension-type Headache

Abstract

Background:

Objects:

Methods:

Results:

Conclusion:

Fig 1.

Fig 2.

Fig 3.

Fig 4.

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