Upper Extremity Function and Neuromuscular Parameters in Primary Headaches: A Cross-Sectional Study

Year 2024, Volume: 11 Issue: 2, 417 - 431, 02.08.2024

Taşkın Özkan , Ülkü Kezban Şahin , Sevim Acaröz Candan , Zeynep Ünlütürk

Abstract

Objectives: To investigate the upper extremity function, muscle strength, endurance, and proprioception in patients with primary headache compared to healthy controls.
Materials and Methods: The study was completed with 37 patients with primary headache (22 patients with tension-type headache and 15 patients with migraine) and 36 healthy controls with matched age and gender. Headache severity was evaluated with the Visual Analog Scale (VAS); upper extremity function with Nine-Hole Peg Test (9-HPT); upper extremity isometric muscle strength of shoulder flexor, extensor, and elbow flexor with a hand-held dynamometer; upper extremity endurance with 6-Minute Pegboard and Ring Test (6PBRT); and upper extremity proprioception with shoulder reposition tests using Dualer IQTM digital inclinometer. Intergroup differences were examined using the Mann-Whitney U Test, and the Spearman correlation analysis was used to ascertain the relationship between the variables in headache groups.
Results: There was a significant difference between the results for the 9-HPT, some upper extremity isometric muscle strength tests, 6PBRT, and shoulder reposition tests between patients with tension-type headache, migraine, and healthy controls (p<0.05). Except for the 9-HPT and 6PBRT (r between -0.518 and -0.645; p<0.05 for all), there was no significant relationship between the results for patients with tension type and migraine (p>0.05).
Conclusion: Upper extremity function, some upper extremity muscle strength parameters, endurance, and proprioception were decreased in patients with tension-type headache and migraine compared to healthy controls, and upper extremity function was found to be associated with upper extremity endurance in these patients.

Keywords

upper extremity, function, strength, endurance, proprioception

Ethical Statement

Written ethical approval was obtained from Ordu University Clinical Research Ethics Committee on 03.06.2022. (Decision Number: 141).

Supporting Institution

There isn't.

Thanks

The authors thank everyone who took part in the study.

References

• Anttila, P., Metsähonkala, L., Aromaa, M., Sourander, A., Salminen, J., Helenius, H., ... & Sillanpää, M. (2002). Determinants of tension-type headache in children. Cephalalgia, 22(5), 401-408. https://doi.org/10.1046/j.1468-2982.2002.00381
• Anttila, P., Metsähonkala, L., Mikkelsson, M., Aromaa, M., Kautiainen, H., Salminen, J., ... & Sillanpää, M. (2002). Muscle tenderness in pericranial and neck-shoulder region in children with headache. A controlled study. Cephalalgia, 22(5), 340-344. https://doi.org/10.1046/j.1468-2982.2002.003
• Barton PM, Hayes KC 1996 Neck flexor muscle strength, efficiency, and relaxation times in normal subjects and subjects with unilateral neck pain and headache. Archives of physical medicine and rehabilitation, 77(7): 680-687. https://doi.org/10.1016/S0003-9993(96)90008-8
• Bohannon, R. W. (1986). Test-retest reliability of hand-held dynamometry during a single session of strength assessment. Physical therapy, 66(2), 206-209. https://doi.org/10.1093/ptj/66.2.206
• Christensen, R. H., & Amin, F. M. (2023). Measuring Pain Intensity in Headache Trials. In Clinical Scales for Headache Disorders (pp. 73-79). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-031-25938-8_5
• Dos Santos, G. L., Salazar, L. F. G., Lazarin, A. C., & De Russo, T. L. (2015). Joint position sense is bilaterally reduced for shoulder abduction and flexion in chronic hemiparetic individuals. Topics in stroke rehabilitation, 22(4), 271-280. https://doi.org/10.1179/1074935714Z.0000000014
• Ertas, M., Baykan, B., Kocasoy Orhan, E., Zarifoglu, M., Karli, N., Saip, S., ... & Siva, A. (2012). One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. The journal of headache and pain, 13(2), 147-157. https://doi.org/10.1007/s10194-011-0414-5
• Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods, 39(2), 175-191. https://doi.org/10.3758/BF03193146
• Fernández-de-Las-Peñas, C., Ge, H. Y., Arendt-Nielsen, L., Cuadrado, M. L., & Pareja, J. A. (2007). Referred pain from trapezius muscle trigger points shares similar characteristics with chronic tension type headache. European Journal of Pain, 11(4), 475-482. https://doi.org/10.1016/j.ejpain.2006.07.005
• Fernández‐de‐las‐Peñas, C., Alonso‐Blanco, C., Cuadrado, M. L., Gerwin, R. D., & Pareja, J. A. (2006). Myofascial trigger points and their relationship to headache clinical parameters in chronic tension‐type headache. Headache: The Journal of Head and Face Pain, 46(8), 1264-1272. https://doi.org/10.1111/j.1526-4610.2006.00440.x
• Fernández‐de‐las‐Peñas, C., Alonso‐Blanco, C., Cuadrado, M. L., Gerwin, R. D., & Pareja, J. A. (2006). Trigger points in the suboccipital muscles and forward head posture in tension‐type headache. Headache: The Journal of Head and Face Pain, 46(3), 454-460. https://doi.org/10.1111/j.1526-4610.2006.00288.x
• Feys, P., Lamers, I., Francis, G., Benedict, R., Phillips, G., LaRocca, N., ... & Multiple Sclerosis Outcome Assessments Consortium. (2017). The Nine-Hole Peg Test as a manual dexterity performance measure for multiple sclerosis. Multiple Sclerosis Journal, 23(5), 711-720. https://doi.org/10.1177/1352458517690824
• Gillen, G., & Nilsen, D. M. (2020). Stroke Rehabilitation E-Book: A Function-Based Approach (5th Edition). Elsevier Health Sciences.
• Hagen, K., Einarsen, C., Zwart, J. A., Svebak, S., & Bovim, G. (2002). The co‐occurrence of headache and musculoskeletal symptoms amongst 51 050 adults in Norway. European journal of Neurology, 9(5), 527-533. https://doi.org/10.1046/j.1468-1331.2002.00451.x
• Headache Classification Subcommittee of the International Headache Society. (2004) The international classification of headache disorders. 2nd ed. Cephalalgia, 24(suppl 1), 1-159. https://doi.org/10.1111/j.1468-2982.2003.00824.x.
• Jensen, R., Bendtsen, L., & Olesen, J. (1998). Muscular factors are of importance in tension‐type headache. Headache: The Journal of Head and Face Pain, 38(1), 10-17. https://doi.org/10.1046/j.1526-4610.1998.3801010.x
• Lima, V. P., Velloso, M., Almeida, F. D., Carmona, B., Ribeiro-Samora, G. A., & Janaudis-Ferreira, T. (2018). Test–retest reliability of the unsupported upper-limb exercise test (UULEX) and 6-min peg board ring test (6PBRT) in healthy adult individuals. Physiotherapy Theory and Practice, 34(10), 806-812. https://doi.org/10.1080/09593985.2018.1425786
• Luedtke, K., Starke, W., & May, A. (2018). Musculoskeletal dysfunction in migraine patients. Cephalalgia, 38(5), 865-875. https://doi.org/10.1177/0333102417716
• Madsen, B. K., Søgaard, K., Andersen, L. L., Skotte, J., Tornøe, B., & Jensen, R. H. (2018). Neck/shoulder function in tension-type headache patients and the effect of strength training. Journal of Pain Research, 445-454. https://doi.org/10.2147/JPR.S146050
• Madsen, B. K., Søgaard, K., Andersen, L. L., Skotte, J. H., & Jensen, R. H. (2016). Neck and shoulder muscle strength in patients with tension-type headache: A case-control study. Cephalalgia, 36(1), 29-36. https://doi.org/10.1177/033310241557
• Mendoza-Sánchez, S., Molina-Rueda, F., Florencio, L. L., Carratalá-Tejada, M., & Cuesta-Gómez, A. (2022). Reliability and agreement of the Nine Hole Peg Test in patients with unilateral spastic cerebral palsy. European Journal of Pediatrics, 181(6), 2283-2290. https://doi.org/10.1007/s00431-022-04423-w
• Muceli, S., Farina, D., Kirkesola, G., Katch, F., & Falla, D. (2011). Reduced force steadiness in women with neck pain and the effect of short term vibration. Journal of Electromyography and Kinesiology, 21(2), 283-290. https://doi.org/10.1016/j.jelekin.2010.11.011
• Oksanen, A. (2008). Neck muscle function and adolescent headache. Publications of the university of turku annales universitatis turkuensis.
• Oksanen, A., Metsähonkala, L., Viander, S., Jäppilä, E., Aromaa, M., Anttila, P., ... & Sillanpää, M. (2006). Strength and mobility of the neck-shoulder region in adolescent headache. Physiotherapy Theory and Practice, 22(4), 163-174. https://doi.org/10.1080/09593980600822800
• Oksanen, A., Pöyhönen, T., Ylinen, J. J., Metsähonkala, L., Anttila, P., Laimi, K., ... & Sillanpää, M. (2008). Force production and EMG activity of neck muscles in adolescent headache. Disability and rehabilitation, 30(3), 231-239. https://doi.org/10.1080/09638280701265430
• Robbins, M. S., & Lipton, R. B. (2010). The epidemiology of primary headache disorders. Seminars in Neurology - Thieme E-Books & E-Journals, 30(2), 107-119. https://doi.org/10.1055/s-0030-1249220
• Silberstein, S. D., Lipton R. B., Goadsby P. J. (2018). Headache in clinical practice (2. Edition). Routledge.
• Sohn, J. H., Choi, H. C., & Jun, A. Y. (2013). Differential patterns of muscle modification in women with episodic and chronic tension-type headache revealed using surface electromyographic analysis. Journal of Electromyography and Kinesiology, 23(1), 110-117. https://doi.org/10.1016/j.jelekin.2012.08.001
• Ünlüer, N. Ö., Ozkan, T., Yaşa, M. E., Ateş, Y., & Anlar, Ö. (2019). An investigation of upper extremity function in patients with multiple sclerosis, and its relation with shoulder position sense and disability level. Somatosensory & motor research, 36(3), 189-194. https://doi.org/10.1080/08990220.2019.1644998
• Van Harlinger, W., Blalock, L., & Merritt, J. L. (2015). Upper limb strength: study providing normative data for a clinical handheld dynamometer. PM&R, 7(2), 135-140. https://doi.org/10.1016/j.pmrj.2014.09.007
• Varangot-Reille, C., Suso-Martí, L., Romero-Palau, M., Suárez-Pastor, P., & Cuenca-Martínez, F. (2022). Effects of different therapeutic exercise modalities on migraine or tension-type headache: a systematic review and meta-analysis with a replicability analysis. The Journal of Pain, 23(7), 1099-1122. https://doi.org/10.1016/j.jpain.2021.12.003
• Watson, D. H., & Trott, P. H. (1993). Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia, 13(4), 272-284. https://doi.org/10.1046/j.1468-2982.1993.13042