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Consensus among musculoskeletal experts for the management by physiotherapists in patients with headache? A Delphi study

Tijdschriftbijdrage - e-publicatie

Background Though a large amount of research on the management of headache has been conducted, the clinical effectiveness of these treatments remains questionable. Objectives To reach consensus among international musculoskeletal experts on what the most useful management and clinical indicators are in patients that suffer from headache. Design Expert group and Delphi-study. Methods A total of 11 experts participated in the expert panel groups, where the role of physiotherapy in the management of headache was discussed. Afterwards, 14 of the initial 25 participants in the field of headache completed the whole Delphi study, which was conducted over 4 rounds. The first round aimed to identify clinical indicators and treatments that are useful in patients with headache. These questions were then categorized and ranked during the second, third, and fourth rounds. Consensual agreement was set at ≥ 80%. Results After the final round, 9 interventions were rated as useful by the participants. In the final extra round, 14 clinical indicators were retrieved as important to decide whether or not to start one of the consensual treatments. The top 3 management strategies were (1) upper cervical spine mobilisations in cervivogenic headache, (2) active mobilisation exercises of the cervical spine in cervivogenic headache, and (3) lifestyle advice in tension-type headache and migraine. Conclusion International experts agreed that most scientifically established effective treatments are useful in cervicogenic headache. Consensual agreement on treatments for migraine and tension-type headache were only reached for specific treatments. Their recommendations provide a framework for further research and the clinical management of headache.
Tijdschrift: Musculoskeletal science & practice
ISSN: 2468-8630
Volume: 52
Jaar van publicatie:2021
Trefwoorden:A1 Journal article
Toegankelijkheid:Open