• Journal of Pharmacopuncture
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• v.12 no.2
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• pp.41-50
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• 2009

Although Chronic tension-type headache(CTTH) is one of the most common symptom in primary headache, there is no definite mechanisms. But muscular factors and psychological factors is supposed to be related with CTTH according to many other studies and pressure pain threshold(PPT) is used to measure muscular factors. Methods 1. We performed this study with 63 patients fulfilling the International Headache Societ criteria for chronic tension-type headache and 20 healthy control group and measured the PPT of temporal muscle and trapezius muscle. 2. We investigated the correlation between clinical characteristic and PPT. 3. Each of the CTTH groups and Control group is divided to four group again - HNP, Spondylosis, Sprain, Normal according to Cervical spine X-ray. Results 1. The PPT of temporal muscle and trapezius muscle in the CTTH is significantly lower than that of Control. 2. In CTTH group, the PPT has significant positive relation with duration of headache and continued time of headache. And the PPT has significant inverse relation with Frequency of headache and Level of headache. 3. In CTTH group, spondylosis group has the highest PPT and normal group is second. And there are significant difference between spondylosis group and the others. Conclusion : We found that PPT is strongly significant to measure muscular factor in CTTH.

• Journal of Acupuncture Research
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• v.26 no.5
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• pp.127-135
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• 2009

Objectives : The purpose of this research is to analyze demographic characteristics and symptoms distribution in CTTH. Methods : This research was carried out on 100 patient with CTTH. CTTH patients answered demographic characteristics and checked symptoms score by six point Likert scale in headache symptoms and associated symptoms questionnaire. Results & Conclusions : Over 50% of tension headache patients from this research answered 'yes' to 23 questions of headache symptoms and associated symptoms questionnaire. Among the 23 syptoms, two were appealed by more than 80% of the patients. The two symptoms are related to physical and mental fatigue.

• The Journal of Korean Physical Therapy
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• v.21 no.2
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• pp.71-77
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• 2009

Purpose: This study assessed the differences in the forward head posture (FHP), cervical range of motion, and headache clinical parameters in episodic tension-type headache (ETTH) subjects, chronic tension-type headache (CTTH) subjects, and healthy controls (university students). Methods: Fifteen CTTH subjects, 15 ETTH subjects and 15 controls without headache were examined. Side-view images of each group were taken in both the sitting and standing positions, in order to assess the FHP by measuring the craniovertebral angle. The CROM was used to measure the cervical range of motion. A headache diary was kept for 4 weeks to assess the headache intensity, frequency, and duration. Results: The craniovertebral angle was smaller, ie, there was a greater FHP, in the CTTH and ETTH subjects than in the healthy controls in both the sitting and standing positions (p<0.05). The CTTH and ETTH subjects showed a lower cervical range of motion than the healthy controls in the total range of motion as well as in the half-cycles (p<0.05). Conclusion: The increased FHP and decreased cervical range of motion might be a contributing factor in the initiation of tension-type headache.

• Journal of Acupuncture Research
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• v.26 no.2
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• pp.59-70
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• 2009

Objectives : Although CTTH is one of the most common symptom in primary headache, the mechanism and treatment is not definite. The purpose of this study is to research about clinical characteristic and roentgenographic finding of the cervical spine in CTTH to determine relationship between the cervical spine and headache. Methods : This study was carried out on 93 patients with CTTH. By roentgenographic finding, they were classified into four groups - HNP, Spondylosis, Sprain, Normal. Then the HNP group was divided again into two groups - singer type and multiple type. Results: 1. Among 93 patients with CTTH, 69(74.19%) patients had abnormal cervical spine by roentgenographic finding. 2. There were HNP, spondylosis, sprain in abnormal roentgenographic finding. And a great majority of the patients were diagnosed as cervical sprain. 3. There were no significant difference between four groups on sex, weight, height, blood pressure, pulse, respiratory rate. But on ages, the HNP group showed the highest average while the sprain group showed the lowest. 4. The patients in HNP group had more frequent, severe pain, longer onset and higher onset-age than those of the other three group. 5. The patients in Multiple-type HNP group had severe pain, longer pain-duration, longer onset, more pre-symptoms and younger onset-age than those of the Single-type HNP group. Conclusions : A great majority of the patients with CTTH had abnormal cervical spines. Also, we found out that the worse the grade of HNP, heavier the level of headache.

• The Journal of Korean Medicine
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• v.31 no.5
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• pp.41-59
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• 2010

Objective: Headache is one of the most common symptoms in primary medical care. The purpose of this study was to support medical treatment by consideration of a new CTTH (chronic tension-type headache) oriental medical diagnosis index. Methods: An Oriental medical diagnosis questionnaire was administered to a CTTH group, migraine group and normal group. The result was classified by using LDA, CART, factor diagnosis and tested in comparison with the original diagnosis. Also, weighting method based on expert opinions was done. Results: 1. The result analyzed by using LDA has an accuracy of 93.9% in comparison with the original diagnosis. 2. High accuracy showed when the test was performed with about 35 significant questions and four questions selected based on SPSS Wilks' lambda. 3. There was accuracy of 90.9% when differentiation was performed by using CART compared with original diagnosis. 4. 10 factors has a high initial value after factor analysis, consisting of questions to the similar differentiation. 5. Diagnosis formula of headache was made by using weighting method based on expert opinions. Conclusion: Oriental medical diagnosis questionnaires make it possible to classify headaches significantly. The study about weighting method of CTTH can make it possible to classify symptoms more accurately.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.4
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• pp.1897-1902
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• 2019

Background: Tension-type headaches, which make up the highest proportion of headaches, are prone to develop into chronic tension-type headaches (CTTH). The characteristic of CTTH in patients is that the active myofascial trigger point (ATrP) which causes pain in the muscles of the back of the head is increased, compared to the normal headache and moves the head position forward. Objective: The aim of this study was to investigate the effects of myofascial release (MFR) and posture correction in effectively improving neck function and sleep quality in the symptoms of CTTH patients. Design: Observer-blind study Methods: To reduce ATrP, MFR was applied and exercise was also applied to correct posture. The subjects of this study were 48 individuals randomly divided into three groups; The MFR group using the MFR technique; The MFR with exercise group subject to both the MFR technique and forward head position correction exercises (MFREx), and the control group. MFR and MFREx groups were given the relevant interventions twice a week for four consecutive weeks, and went through the number ATrPs, range of motion (ROM) of neck, Neck Disability Index (NDI) and the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. A physical therapist, who was fully familiar with the measuring methods of the equipment, was the measurer and not aware of the target's condition was blinded to take measurements only before and after intervention. Results: There was a significant improvement in the ATrP, Neck ROM, NDI and PSQI in the group of patients to whom the MFR technique and MFREx were applied. MFREx was more effective in increasing neck mobility. Conclusions: According to this study, the application of MFR is effective in improving neck movement and sleep quality in chronic tension headache patients.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.1
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• pp.21-29
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• 2019

Objectives This study is designed to verify the effectiveness of electroacupuncture (EA) on both side acupuncture point GB12, GB20 for chronic tension type headache (CTTH). Methods Subjects aged 18-65 years who had suffered from CTTH for more than 3months were recruited from September 2016 to May 2017. Thirty subjects were voluntarily recruited and they were randomly divided into 2 groups; 15 to EA group, another 15 to sham-EA group. The treatment sessions were performed every 2-4 days for a total of three sessions over 1 week. The symptoms of headache were assessed before the treatment and after a week from the last treatment by visual analogue scale (VAS), headache frequency (HF), Korean Headache Impact Test-6 (KHIT-6). Demographic characteristics of all participants were compared between the groups upon using chi-square test. Wilcoxon signed rank test was used to evaluate the values between baseline and follow-up. Wilcoxon rank sum test was performed to evaluate the differences between groups. p-values less than 0.05 were considered as significant. Results Before and after the intervention, no difference in VAS and KHIT-6 was observed between groups. HF of EA group decreased significantly compared with that of sham-EA group. Within the EA group VAS, HF and KHIT-6 decreased significantly after the treatment. Meanwhile, only KHIT-6 decreased significantly after the treatment in sham-EA group. Conclusions This study suggests that EA on both side acupuncture point GB12 and GB20 is applicable to improve symptoms in patients with CTTH.

• The Journal of Korean Physical Therapy
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• v.21 no.4
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• pp.9-16
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• 2009

Purpose: This study was done to assess the effect of changes in forward head posture (FHP), neck mobility and headache clinical parameters on episodic tension-type headache (ETTH) and chronic tension-type headache (CTTH) who did craniocervial exercises. Methods: Twelve CTTH subjects and twelve ETTH subjects were studied. Side-view pictures of subjects were taken in both sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. Cervical range of motion (CROM) was employed to measure cervical mobility. A headache diary was kept to assess headache intensity, frequency, and duration. All subjects did three types of craniocervical exercise over 8 weeks. Measurements were done at pre-treatment, and at 4 and 8 weeks post-treatment. Results: Forward head posture and headache-related clinical parameters showed a significant improvement after craniocervical exercise (p<0.05). Flexion/extension and left/right rotation of CROM was significantly increased after the intervention (p<0.05), whereas changes in left/right bending did not reach statistical significance. Conclusion: This study indicates that craniocervical exercise may be effective in the management of tension-type headache.

• Journal of Acupuncture Research
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• v.25 no.2
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• pp.165-177
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• 2008

Objectives : Headache is one of the most common symptom in primary medical care. The purpose of this research is to examine persisting effects of acupuncture treatment for CTTH. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture method for the treatment of chronic tension-type headache. Volunteers who satisfied the requirements were enrolled in study. Evaluation of CTTH was measured by VAS, and Headache Disability Inventory(HDI), Six point Likert Scale, Algometer score(Rt, Lt) before and after treatments. Results : 32 subjects finished study. There were no difference between two group on age, sex, weight, height, blood pressure, pulse, respiratory rate, differentiation of symptoms, surmise of treatment. In change of VAS, after treatment decreased than before treatment in two group, but there were no statistical significance compared with two group and time. In change of HDI(Total score, Emotional score, Functional score) and Six point Likert scale, after treatment decreased than before treatment in two group, but there were no statistical significance compared with two group and time. In change of two sides Algometer score, after treatment increased than before treatment in two group, and Lt algometer score was statistical significance compared with two group(p<0.001). And both sides Algometer score, threr were statistical significance compared with time. Conclusions : Acupuncture treatment has persisting effects that improve the symptoms and decrease the temporal muscle tenderness in patient with chronic tension-type headache.

• Journal of Oriental Neuropsychiatry
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• v.24 no.1
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• pp.45-62
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• 2013

Objectives : The purpose of this study was to compare the efficacy of Needle-Embedding Therapy with Acupuncture for Chronic Tension-type Headache (CTTH) patients. Methods : The study recruited Chronic Tension-type Headache patients. A total of twenty-six patients were divided into 2 groups. 13 subjects were placed into a needle-embedding therapy group and 13 subjects into an acupuncture therapy group by a randomization table. The needle-embedding therapy group was treated with needle-embedding at Fengchi (GB20), while the acupuncture therapy was acupunctured at Fengchi (GB20). Then, a comparative analysis was conducted by comparing the results with those measured by a Blood pressor, Heart rate variability (HRV), Henry Ford Headache Disablity Inventory (HDI) Internet Headache Impact Test (HIT), and Visual Analogue Scale (VAS). Results & Conclusions : As a result of evaluation by using the self-rating headache index (VAS, HDI, HIT), pain score declined in both groups. But they were not difference between the two groups.