rojournalРоссийский остеопатический журналRussian Osteopathic Journal2220-09752949-3064All-Russian Public Organization «Russian Osteopathic Association» (ROsA)10.32885/2220-0975-2024-1-8-19rojournal-547Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESРоль мануальных методов коррекции и экстракорпоральной ударно-волновой терапии в профилактике хронической головной боли напряженияThe role of manual correction methods and extracorporeal shock wave therapy in the prevention of chronic tension headacheshttps://orcid.org/0000-0001-9844-9989ГусеваТ. С.GusevaT. S.

Гусева Татьяна Сергеевна - ассистент кафедры спортивной медицины и медицинской реабилитации.

119048, Москва, Трубецкая ул., 8, стр. 2

Tatiana S. Guseva - assistant of the Department of Sports Medicine and Medical Rehabilitation, I.M. Sechenov First Moscow State Medical University (Sechenov University).

bld. 8–2 ul. Trubetskaya, Moscow, 119048

guseva_t_s@mail.ruhttps://orcid.org/0000-0003-4204-2279НаприенкоМ. В.NaprienkoM. N.

Наприенко Маргарита Валентиновна - докт. мед. наук, профессор кафедры спортивной медицины и медицинской реабилитации.

119048, Москва, Трубецкая ул., 8, стр. 2

Margarita V. Naprienko - Doc. Sci. (Med.), Professor of the Department of Sports Medicine and Medical Rehabilitation, I.M. Sechenov First Moscow State Medical University (Sechenov University).

bld. 8–2 ul. Trubetskaya, Moscow, 119048

https://orcid.org/0000-0002-2219-9589СмекалкинаЛ. В.SmekalkinaL. V.

Смекалкина Лариса Викторовна - докт. мед. наук, профессор кафедры спортивной медицины и медицинской реабилитации.

119048, Москва, Трубецкая ул., 8, стр. 2

Larisa V. Smekalkina - Doc. Sci. (Med.), Professor of the Department of Sports Medicine and Medical Rehabilitation, I.M. Sechenov First Moscow State Medical University (Sechenov University).

bld. 8–2 ul. Trubetskaya, Moscow, 119048

Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation20242703202401819Copyright © Гусева Т.С., Наприенко М.В., Смекалкина Л.В., 20242024Гусева Т.С., Наприенко М.В., Смекалкина Л.В.Guseva T.S., Naprienko M.N., Smekalkina L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rojournal.elpub.ru/jour/article/view/547Введение

Введение. Головная боль напряжения является актуальной проблемой в современной медицине, так как имеет широкую распространенность и, несмотря на доброкачественную природу заболевания, сопровождается снижением качества жизни пациентов.

Цель исследования — разработать и научно обосновать методику комплексного применения экстракорпоральной ударно-волновой терапии (ЭУВТ) и мануальных методов лечения для профилактики хронической головной боли напряжения.

Материалы и методы

Материалы и методы. В проспективном рандомизированном исследовании приняли участие 90 пациентов 24–50 лет с диагнозом хронической головной боли напряженного типа (G44.2). Участники были распределены на три равные группы по 30 человек в каждой: I — пациенты получали фармакотерапию амитриптилином; II — мануальное лечение; III — комплексное лечение с применением мануальных методов воздействия и ЭУВТ. Дополнительно в исследование были включены 20 условно-здоровых пациентов 24–50 лет (IV группа). Для оценки эффективности применяемых методов использовали дневник головной боли, мануальное обследование, определение общего балла болезненности, балльную оценку боли по шкале NRS, шкалу тревоги и депрессии HADS.

Результаты

Результаты. Полученные данные продемонстрировали, что комплексное применение мануального лечения и ЭУВТ, а также моновоздействие мануальными методами лечения в большей степени, чем фармакотерапия, способствуют клиническому улучшению. Сравнительный анализ обследуемых групп в отдаленном периоде наблюдения (через 3 мес) показал более значимые результаты у пациентов III группы, получавших комплексную терапию, в виде статистически значимого снижения интенсивности боли, общего балла болезненности. Применяемые методы достоверно улучшали психоэмоциональный статус пациентов, однако фармакотерапия амитриптилином сопровождалась побочными эффектами.

Заключение

Заключение. Комплексное применение мануального метода лечения и экстракорпоральной ударно-волновой терапии приводит к существенному улучшению как клинической картины заболевания, так и психоэмоционального состояния у пациентов с головной болью напряжения.

Introduction

Introduction. Tension-type headache is an urgent problem in the modern medicine due to a significant decrease in the efficiency and quality of patient′s life, despite the benign nature of the disease.

The aim of the study is to develop and scientifically substantiate the comprehensive application of extracorporeal shock wave therapy and manual methods of preventive treatment of the chronic tension-type headache.

Materials and methods

Materials and methods. The prospective randomized study included 90 patients with tension-type headache (chronic), G44.2, and 20 healthy patients in the age from 24 to 50 years. Participants were divided into 3 equal groups with 30 participants in each one. In the I group the pharmacotherapy with amitriptyline was performed, in the II group — manual treatment, and in the III group — complex rehabilitation with manual methods of treatment and extracorporeal shockwave therapy. Additionally, 20 healthy patients were included in the study (group IV). To assess the treatment effectiveness the following methods were used: a headache diary, manual examination, NRS scale, HADS scale.

Results

Results. The data obtained demonstrated that the combined use of manual treatment and extracorporeal shock wave therapy, as well as single-impact manual treatment methods, contributes to clinical improvement to a greater extent than pharmacotherapy. A comparative analysis of the study groups in the long-term follow-up period (after 3 months) showed more significant results in the group with comprehensive rehabilitation, which is clearly reflected in the form of a significant decrease in pain intensity and overall pain score. The methods used significantly improved the psycho-emotional status of patients, however, pharmacotherapy with amitriptyline was accompanied by side effects.

Conclusion

Conclusion. The comprehensive application of extracorporeal shock wave therapy and manual methods of treatment leads to a significant improvement in both clinical and psycho-emotional states of patients with tension-type headache.

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The authors declare that there are no conflicts of interest present.