Neck-Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial.

Physical therapists were not blinded when assessing outcomes, which can bias measures such as neck endurance and range of motion. The primary outcome was headache intensity because that was the best evidence at design, but more recent work proposes headache frequency as the primary outcome; the positive finding is therefore a secondary outcome. The control group received placebo nerve stimulation plus the same stretching exercises from the third session, so stretching, therapist attention, and the exercise program cannot be cleanly separated. Participants had mixed headache diagnoses, including tension-type headache, cervicocranial syndrome, cervical spondylosis with headache, migraine, and migraine with cervical pain, so the result may not apply to one specific headache type. Eighteen participants (16%) were lost before the end. Home exercise completion averaged 4.1 of six prescribed sessions weekly during the first 3 months and 2.8 of four during the latter 3 months in the exercise group; control stretching averaged 2.2 weekly during the first 3 months and 0.5 during the latter 3 months.

The authors declared no potential conflicts of interest. The article states financial support was disclosed, but the supplied text does not name the funding source.

Do not conclude that neck-shoulder exercise reduces headache intensity more than placebo. The primary outcome was headache intensity, and it showed no significant between-group difference (p = 0.66). The positive finding was fewer weekly headache days.