• The Journal of Korean Physical Therapy
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• 제12권3호
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• pp.339-347
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• 2000

To elucidate pressure pain threshold of pericranial muscle due to involuntary. the effect of 30 min or forward head position(FHP) was studied in 20 patients with episodic tension-type headache and in 20 control without headache. Pressure pain thresholds were recorded before and after the FHP. and evaluated by pressure algometry. Thresholds increased in the patients and control after FHP. Relation between thresholds in patients anf control before FHP were not significant differences, but thresholds increased in patients after FHP. So, involutary muscle contraction due to FHP may be effect pressure pain threshold or pericranial muscle.

• Journal of Oral Medicine and Pain
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• 제34권3호
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• pp.325-331
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• 2009

본 연구는 측두하악장애와 연관된 두통의 유병율을 평가하고 측두하악장애와 연관된 두통의 양상을 평가함으로써 두통과 측두하악장애와의 관계를 평가하기 위하여 시행되었다. 2008년 1월부터 2008년 6월까지 측두하악장애 관련 증상을 주소로 조선대학교 치과병원 구강내과에 내원한 환자 중 일차성 두통을 가지고 있는 환자 66명을 대상으로 하여, 측두하악장애, 두통에 관한 평가를 시행하였다. 연구결과는 다음과 같다. 1. 측두하악장애을 기준으로 분류하였을 경우, 측두하악관절 및 저작근이 동시에 이환된 경우가 66명 중 36명(54.5%)로 가장 많았다. 2. 두통을 기준으로 분류하였을 경우, 긴장성 두통이 66명중 59명(89.39%)로 가장 많았다. 3. 66명 중 36명(54.5%)이 측두하악장애와 연관된 두통을 호소하였다. 4. 측두하악장애와 연관된 두통을 호소한 36명 중 19명(52.78%)이 본래 존재한 일차성 두통과는 다른 양상이 측두하악장애와 연관되어 나타난다고 하였다. 즉 측두하악장애와 일차성 두통을 동시에 가지고 있는 경우, 측두하악장애와 연관된 두통이 상대적으로 흔하게 발생된다고 볼 수 있을 것이다. 또한 그 중 과반수 이상이 기존 두통양상과는 다른 증상을 호소하는 것으로 보아, 측두하악장애와 두통의 연관성을 연구하는데 있어 새로운 두통양상에 대한 연구가 추가적으로 이루어져야 할 것이다. 또한 측두하악장애와 두통과의 연관성을 평가하기 위해서는 보다 많은 모집단을 대상으로, 보다 세분화된 기준을 가지고 대조군을 설정하여 평가하는 것이 추후에 필요할 것으로 사료된다.

• 대한정형도수물리치료학회지
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• 제8권2호
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• pp.5-17
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• 2002

The aim of study carried out to determine the effects of myofascial release on the cranial arteries velocity from November 11, 2001 to March 29, 2002 the objects were 10 patients who having the tension-type headache at H-hospital This research compared with measure the mean flow velocity middle cerebral artery, posterior cerebral artery, vertebral cerebral artery. Result obtain were as follows; 1. Middle cerebral artery blood velocity between pre treatment and after treatment for 10days experiment was significantly increased 9.76cm/s(p<0.05)in right, 4.88cm/s(p<0.05)in left. 2. Posterior cerebral artery blood velocity between pre treatment and after treatment experiment was difference 6.35cm/s(p<0.01)in right, 5.14cm/s(p<0.01)in left, between pre treatment and after treatment for 5days experiment was 11.48cm/s(p<0.01)in right, 10.74cm/s(p<0.01)in left, between pre treatment and treatment for 10days experiment was 12.92cm/s(p<0.001) in right, 12.68cm/s(p<0.001) in left. 3. Vertebral artery blood velocity between pre treatment and post treatment experiment was difference 4.48cm/s(p<0.05)in right, 6.10cm/s(p<0.05) in left, between pre treatment and after treatment for 5days experiment was 12.50cm/s(p<0.001)in right, 14.40cm/s(p<0.001)in left, between pre treatment and after treatment for 10days experiment was 14.70cm/s(p<0.001)in right, 13.90cm/s(p<0.001)in left.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권3호
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• pp.183-205
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• 2021

This systematic review and meta-analysis aimed to analyze the effectiveness of maxillary stabilization splint (SS) therapy to reduce headache (HA) intensity and HA frequency in patients with temporomandibular disorders (TMD)-HA comorbidity. Randomized controlled trials (RCTs) using full-arch coverage, hard resin, and maxillary SS therapy were included. Electronic databases, including Cochrane Library, MEDLINE through PubMed, Web of Science, and EMBASE, were searched. The risk of bias was analyzed based on Cochrane's handbook. The search yielded 247 references up to January 28, 2020. Nine RCTs were included at a high risk of bias. The comparison groups included other splints, counseling, jaw exercises, medications, neurologic treatment, and occlusal equilibration. Four studies reported a statistically significant reduction in HA intensity, and five studies reported significant improvement in HA frequency from baseline at 2-12 months in patients with TMD-HA comorbidity treated with a full-arch hard maxillary SS. HA frequency in tension-type HA (TTH) comorbid with TMD diagnoses of myofascial pain (MFP) or capsulitis/synovitis improved significantly with SS than that with full-arch maxillary non-occluding splint (NOS) in two studies. Comparison groups receiving hard partial-arch maxillary splint nociceptive trigeminal inhibition (NTI) showed statistically significant improvements in HA intensity in patients with mixed TMD phenotypes of MFP and disc displacement comorbid with "general HA." Comparison groups receiving partial-arch maxillary resilient/soft splint (Relax) showed significant improvements in both HA intensity and frequency in patients with HA concomitant with MFP. The meta-analysis showed no statistically significant difference in the improvement of pain intensity at 2-3 months with comparison of the splints (partial-arch soft [Relax], hard [NTI], and full-arch NOS) or splint use compliance at 6-12 months with comparison of the splints (partial-arch Relax and full-arch NOS) versus the SS groups in patients with various TMD-HA comorbidities. In conclusion, although SS therapy showed a statistically significant decrease in HA intensity and HA frequency when reported, the evidence quality was low due to the high bias risk and small sample size. Therefore, further studies are required.

• Journal of Acupuncture Research
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• 제26권2호
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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.

• Annals of Geriatric Medicine and Research
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• 제22권4호
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• pp.176-183
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• 2018

Background: Although the frequency and intensity of headaches decrease in older adults, headaches in this population are still an important neurological disorder. The purpose of this study was to investigate the associations of headache characteristics in older adults with the development of cardiovascular disease and cognitive dysfunction. Methods: We prospectively enrolled 125 older (${\geq}65$ years old) patients with headache who were making their first visit to outpatient clinics and who had no prior history of cognitive dysfunction from 11 hospitals in Korea between August 2014 and February 2015. We investigated the occurrence of newly developed/or recurrent headache, cardiovascular disease, cognitive dysfunction, and poor functional outcomes. Results: The mean age of all included patients was 72.6 years, 68.8% were women, and 43 (34.4%) had newly developed/or recurrent headache during follow-up. During a median follow-up of 31 months (interquartile range, 28-34 months), 21 participants (16.8%) experienced cardiovascular disease, and 26 (20.8%) developed cognitive dysfunction. Upon multivariate analysis and after adjusting for sex, age, and other factors, presence of newly developed/or recurrent headache was found to be associated with cardiovascular disease (hazard ratio [HR], 4.03; 95% confidence interval [CI], 1.28-12.61; p=0.017) and frequency of headache for the recent 3 months was related with cognitive dysfunction (HR, 1.05; 95% CI, 1.00-1.09; p=0.017) and poor functional outcomes (HR, 1.06; 95% CI, 1.01-1.11; p=0.011). Conclusion: Our study demonstrated that there is an increased risk of cardiovascular disease, cognitive dysfunction, and poor functional outcomes in older patients with frequent, newly developed, or recurrent headache.

• Journal of Acupuncture Research
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• 제26권1호
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• pp.99-109
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• 2009

목적 : 두통의 침술효과에 대한 연구가 꾸준히 이루어지고 있다. 하지만 많은 연구들에서 서로 상충되는 결과를 내놓고 있다. 이에 저자는 대조군 집단 시술의 역할과 시험의 특성에 대해 연구하는 데 있어 몇 가지 유형의 두통, 특히 긴장성 두통(Tension-type headache, TTH)과 편두통에 대한 침술의 대조군 시험에서 나타나는 일관성 없는 발견 사항들의 원인이 무엇인지에 대해 밝히려고 하였다. 방법 : 두통의 침술효과에 대해 보고하고 있는 11개의 임의대조군 시험(Randomized controlled trials, RCTs)을 대상으로 하여 위약 침술과 방법론적 특성 범주 III과 IV를 중심으로 위약 시술 분석, 비교를 실시하였다. 결과 : 임상적 유효성과의 상관관계에 있어 범주 III과 IV 사이에는 유의한 차이가 없었다. 표본 크기 계산, 표본 전체 크기, 진짜 집단과 위약 집단에 속한 피험자의 수에는 긍정적 결과와 중립적 결과 사이에 유의한 차이가 없었다. 결론 : 두통의 임의대조군 시험에 대한 다양한 유형의 위약 대조군과 침술의 방법론적 특성이 임상적 효과를 예측해 주는지의 여부에 대해 추가 연구가 이루어져야 하겠다.

• Journal of Oral Medicine and Pain
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• 제31권4호
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• pp.327-335
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• 2006

긴장성두통은 일반적으로 근육성 두통이 많지만 측두하악관절장애 등과 같은 관절통이 주소인 경우도 있는데 본 연구의 목적은 근육통을 호소하는 긴장성 두통환자와 측두하악관절의 통증을 호소하는 긴장성 두통환자의 임상적 통증양상을 비교 연구하는데 있다. 일정기간 긴장성두통을 주소로 내원한 환자 167명을 관절통군 18명, 근육통군 50명, 그리고 관절통과 근육통이 함께 있는 관절근육통군 99명을 대상으로, 국제두통학회에서 제시한 두통의 진단기준인 통증의 질, 통증의 강도, 통증의 양측성 유무 그리고 일상생활시 통증의 증가유무, 악습관의 유무 등을 설문조사한 후 통계처리 하여 결과를 얻었다. 1. 통증의 질은 세 군 모두 둔통이 많았다. 관절통군이 94%, 근육통군이 94%, 그리고 관절근육통군이 85%로 둔통이 많았다. 그러나, 세 군간의 통계적으로 유의한 차이는 없었다. 2. 통증의 강도는 세 군 모두 심하지 않은 정도의 통증이 많았다. 관절통군이 89%, 근육통군이 88%. 그리고 관절근육통이 94%로 비심도의 비율이 높았다. 하지만, 세 군간의 통계적으로 유의한 차이는 없었다 3. 통증의 양측성 유무는 세 군 모두 편측성이 많았으나, 관절통군이 83%, 근육통군이 82%, 그리고 관절근육통군이 63%로 편측성이 많았다. 세 군간의 통계적으로 유의한 차이는 없었다. 4. 일상생활시 통증의 증가유무는 세 군 모두 악화되는 경우가 많았으며, 관절근육통에서 75%로 관절통의 61%, 근육통의 54%보다 악화되는 비율이 통계적으로 유의성있게 더 높았다(p=0.03). 이상의 연구로 관절통 혹은 근육통 하나 만이 있는 긴장성 두통 환자보다, 관절통과 근육통을 모두 가지고 있는 긴장성 두통환자는 더욱 쉽게 악화됨이 관찰되었다.

• 대한임상독성학회지
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• 제4권2호
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• pp.155-157
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• 2006

Myoclonus is manifested in a variety of situations including metabolic derangements, brain lesions, epilepsy, and drugs toxicity. We reported a rare case of amitriptyline-induced myoclonus. A 64-year-old man with a tension-type headache was administered amitriptyline at 15 mg/day. Eight days after initiation of amitriptyline, multifocal myoclonus developed, involving the face and upper extremities. Two hours after the administration of clonazepam at 1 mg, myoclonus resolved completely.

• Korean Journal of Acupuncture
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• 제23권1호
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• pp.95-109
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• 2006

Objectives : There has been a considerable debate about how to best control for placebo effects in clinical trials of acupuncture. Recently several sham needles were developed and validated. This study aimed at summarising the validation studies of these needles and evaluating the outcomes of the randomised controlled trials (RCTs) using them. Methods : Computerised literature searches were performed using 'acupuncture' AND 'placebo OR sham' with a limitation of the results to RCTs in Medline via PubMed and the Cochrane Library. Only formally validated sham needle controlled studies were included. Data were extracted regarding study design, condition, sample size, credibility testing, intervention and outcomes. Methodological quality was assessed using a modified Jadad scale. Results : Three validated sham needles by Streitberger, Park, and Fink, were identified. Acupuncture's effectiveness for various conditions was tested using these needles in 12 RCTs. Real acupuncture was superior to sham acupuncture for rotator cuff tendonitis and hypertension. No significant differences between real acupuncture and sham acupuncture emerged for chemotherapy-related nausea and vomiting, postoperative nausea and vomiting, menstrually related migraine, acute stroke rehabilitation, chronic/episodic tension-type headache, neutrophil respiratory burst in healthy volunteers, alcohol withdrawal symptoms and chronic poststroke leg spasticity. Conclusions : The new sham devices have been adequately validated and may be useful tools for investigating specific research question. In spite of the sham needle's limits, the results of RCTs using such devices tend to suggest that the clinical effects of acupuncture are largely due to a placebo response.