Investigation of the efficacy of structured exercise program in tension-type headache

Introduction: Tension-type headache (TTH) is one of the most common primary headaches, with various mechanisms in its pathogenesis, affecting the patients' quality of life and causing disability. In addition to pharmacological methods, non-pharmacological physiotherapy approaches such as exercise play an important role in its treatment. Objective:The aim of our study is to investigate the effects of structured exercise program and aerobic exercise program in TTH on quality of life, pain, disability, pressure pain threshold (PPT), proprioception, muscle strength, posture, exercise capacity, anxiety, and depression, and to compare the effects of the two exercise programs. Methods: In our study, 54 female participants between the ages of 18-55 were randomised to receive a 12-week exercise programme for 45 minutes, 2 days a week. While the structured exercise programme consisted of aerobic exercise, strengthening and stretching exercises, in the aerobic exercise group the aerobic exercises were performed with stepping boards and accompanied by music. While pre- and post-treatment evaluations were conducted, an interim evaluation was conducted at the end of week 8. Participants' quality of life (Headache Impact Test), pain (Visual Analog Scale, pain diary), disability level (Pain Disability Index), PPT (dolorimeter), proprioception (Cervical-Range of Motion), muscle strength (stabilizer), cervical posture (craniovertebral angle, mobile application), exercise capacity (Six Minute Walk Test), anxiety and depression (Hospital Anxiety and Depression Scale) were evaluated. Results: As a result of our study, a statistically significant improvement was achieved in both groups in terms of quality of life, pain intensity, disability, anxiety, depression, and functional capacity at the end of the 8th and 12th weeks. It was observed that significant improvement in terms of PPT and proprioception started in the 8th week in both groups and progressed increasingly.While there was an improvement in muscle strength and craniovertebral angle in the structured exercise program, the improvement in craniovertebral angle in the aerobic exercise group reached significance in the 12th week. Structured exercise program was found to be superior to aerobic exercises in terms of quality of life, PPT, proprioception, muscle strength and posture. Conclusion: The two exercise programmes appear to be similarly effective in terms of pain, activity and participation parameters. But we recommend adding strengthening and stretching exercises to the treatment program due to its superiority in PPT, proprioception, muscle strength and posture parameters.