Efficacy of Pulsed Ultrasonic Therapy Combined with Manual Therapy on Pain, Sleep Quality and Neck Disability in Patients with Chronic Tension-Type Headaches

Abstract

Tension-type headache is the most common headache type worldwide with significant socioeconomic and psychological impacts on the affected  persons. This study examined the therapeutic efficacy of pulsed ultrasonic therapy combined with manual therapy (MT) in the management of  chronic tension-type headache (CTTH) symptoms of pain, sleep disorders and neck disability. Twelve patients (11F, 1M) aged 36 to 72 years,   diagnosed with CTTH and presented with its symptoms were managed with physiotherapy techniques (pulsed ultrasonic therapy [frequency = 1  MHz, intensity = 1.5 Wcm^-2, mark-to-space ratio = 2:8], manual stretching and kneading massage). All participants were treated daily for four  consecutive days in the first week and thrice weekly during the second week making a total of seven treatment sessions per participant. Outcome  measures including the Numeric Pain Rating Scale, the Pittsburgh Sleep Quality Index and the Neck Disability Index were used to assess  participants’ pain severity, sleep quality and how pain affected the performance of their daily activities respectively. Data obtained were subjected to  descriptive and inferential statistical analyses with significance level set at 0.05. The paired samples t-test was used to test the efficacy of the  interventions. Results showed a significant difference between participants’ pre- and post-treatment pain severity (p < 0.05), sleep quality (p < 0.05)  and performance of daily activities (p < 0.05). This shows that a combination of pulsed ultrasound and MT was effective in the management of  patients with CTTH. Healthcare professionals, especially physicians and GPs, should employ this nonpharmacological option in the management of  CTTH patients by timely referral in order to improve their quality of life.