Exercise in patients with tension-type headache : a systematic review and meta-analysis

Abstract: Abstract: Objective: This meta-analysis reviews the evidence for training in patients with tension-type headache on pain intensity and headache frequency. Method: Electronic databases were searched for randomized controlled trials evaluating training on patients with tension-type headache. Data was extracted by the reviewer. Methodological quality was assessed using risk of bias two and a meta-analysis was made using Revman 5. The quality of the evidence was calculated using GRADEproGDT. Results: Regarding pain intensity four studies were included (n = 330 participants). The meta-analysis indicates that training is effective in reducing pain intensity in patients with tension-type headache. This result does not reach a clinical important difference. The quality of evidence is moderate. For headache frequency three studies were included in the meta-analysis (n = 290 participants). The meta-analysis showed that training is effective in reducing headache frequency in patients with tension-type headache. This change does not reach a clinical important difference. The quality of evidence for this result is high. Conclusion: There is moderate quality of evidence that exercise reduces pain intensity in patients with tension-type headache. There is high quality evidence that exercise reduces headache frequency in patients with tension-type headache. Neither of these results reach a clinically important difference. This may be due to the active control groups and needs to be researched further.