Jaw Muscle Function in Patients With Tension-type Headache

NCT ID: NCT04196127

Last Updated: 2019-12-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-12-06

Study Completion Date

2021-06-30

Brief Summary

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Patients with tension-type headache (TTH) and migraine often experience musculoskeletal complaints, like neck pain and/or jaw pain. Earlier studies have revealed an association between different headache types and neck pain and discussed the possible role of the cervical muscles. Furthermore, patients with neck pain show a decrease in motor control of the jaw, without having any other signs of TMD. Similarly, studies in patients with TMD have only found an indication for poorer neck muscle function. Patients with TMD also show a decrease in bite force and force steadiness compared to healthy controls. It is however, unknown if bite force and force steadiness are similarly impaired in patients with headache and/or neck pain.

The current study will take a closer look at the jaw muscle function of in patients with TTH, with and without neck pain.

Detailed Description

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Tension-type headache (TTH) and migraine has been found to coincide with cervical pain, musculoskeletal dysfunction and/or temporomandibular disorders (TMD). The possible interplay between these three symptoms/disorders, headache, neck pain and TMD, have not been studied completely, only in sections. Earlier studies have revealed an association between different headache types and neck pain and discussed the possible role of the cervical muscles. Patients with TTH and (chronic) migraine exhibit lower muscle strength in the neck extensor muscles compared to healthy controls. Patients with neck pain show a decrease in motor control of the jaw, without having any other signs of TMD. Similarly, studies in patients with TMD have only found an indication for poorer neck muscle function while patients with TMD also show a decrease in bite force and force steadiness compared to healthy controls. It is however, unknown if bite force and force steadiness are similarly impaired in patients with headache and/or neck pain.

Muscle tenderness increases with increasing headache frequency and intensity in TTH while this association is not present in migraine patients. Tenderness has a significant influence on the neck muscle function in TTH patients and there is a negative correlation between Total Tenderness (TTS) and muscle force. There is currently, however, no clear understanding of the influence of tenderness on the function of jaw muscles in TTH patients.

The current project will increase the investigator's understanding of the interplay or dependency between the function of the jaw and neck muscles in TTH patients. If a comorbidity of TMD or neck pain make TTH patients more prone to dysfunction of jaw and neck muscles, this may lead to a subgrouping of these TTH patients. Together with the muscle function deficits discovered in the current case control study, this may suggest a targeted treatment for TTH to be tested in a follow up randomized control study.

Conditions

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Headache Disorders Tension-Type Headache

Keywords

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Bite force Temporomandibular disorder Neck pain

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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TTH

Patients with tension-type headache. They may not experience migraine, but can experience neck pain and/or temporomandibular dysfunction.

Bite force testing

Intervention Type OTHER

Maximum bite force examination with a force intra-oral measuring device

Healthy controls

Participants without frequent headaches. They may experience neck pain and/or temporomandibular dysfunction.

Bite force testing

Intervention Type OTHER

Maximum bite force examination with a force intra-oral measuring device

Interventions

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Bite force testing

Maximum bite force examination with a force intra-oral measuring device

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age between 18 and 55 years old.
* Diagnosed Frequent episodic TTH (1-14 headache days / month) or chronic TTH (≥15 headache days/ month) based on the ICHD-3.
* Maximum 3 days of migraine per month.
* Signed informed acceptance of participation.

Exclusion Criteria

* medication overuse headache (ICHD-3)
* missing more than 1 molar,
* previous whiplash or head trauma,
* other major physical or neurological diseases,
* diagnosed depression, other mental illness
* unable to understand and speak Danish.
* Pregnant or lactating women.
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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UMC Utrecht

OTHER

Sponsor Role collaborator

Academic Centre for Dentistry in Amsterdam

OTHER

Sponsor Role collaborator

Danish Headache Center

OTHER

Sponsor Role lead

Responsible Party

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Bjarne Kjeldgaard Madsen

Physiotherapist, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bjarne Kjeldgaard Madsen, PT, PhD

Role: PRINCIPAL_INVESTIGATOR

Danish Headache Center

Locations

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Danish Headache Center Rigshospitalet - Glostrup

Glostrup Municipality, , Denmark

Site Status RECRUITING

Countries

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Denmark

Central Contacts

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Bjarne Kjeldgaard Madsen, PT, PhD

Role: CONTACT

Phone: +45 38 63 22 24

Email: [email protected]

Dianna Bartolin Christiansen

Role: CONTACT

Phone: +45 38 63 22 24

Email: [email protected]

Facility Contacts

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Bjarne K Madsen, phd stud.

Role: primary

References

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Armijo-Olivo S, Warren S, Fuentes J, Magee DJ. Clinical relevance vs. statistical significance: Using neck outcomes in patients with temporomandibular disorders as an example. Man Ther. 2011 Dec;16(6):563-72. doi: 10.1016/j.math.2011.05.006. Epub 2011 Jun 12.

Reference Type BACKGROUND
PMID: 21658987 (View on PubMed)

Ashina S, Bendtsen L, Lyngberg AC, Lipton RB, Hajiyeva N, Jensen R. Prevalence of neck pain in migraine and tension-type headache: a population study. Cephalalgia. 2015 Mar;35(3):211-9. doi: 10.1177/0333102414535110. Epub 2014 May 22.

Reference Type BACKGROUND
PMID: 24853166 (View on PubMed)

Ballenberger N, von Piekartz H, Danzeisen M, Hall T. Patterns of cervical and masticatory impairment in subgroups of people with temporomandibular disorders-an explorative approach based on factor analysis. Cranio. 2018 Mar;36(2):74-84. doi: 10.1080/08869634.2017.1297904. Epub 2017 Mar 20.

Reference Type BACKGROUND
PMID: 28317439 (View on PubMed)

Bendtsen L, Fernandez-de-la-Penas C. The role of muscles in tension-type headache. Curr Pain Headache Rep. 2011 Dec;15(6):451-8. doi: 10.1007/s11916-011-0216-0.

Reference Type BACKGROUND
PMID: 21735049 (View on PubMed)

Fernandez-de-las-Penas C, Perez-de-Heredia M, Molero-Sanchez A, Miangolarra-Page JC. Performance of the craniocervical flexion test, forward head posture, and headache clinical parameters in patients with chronic tension-type headache: a pilot study. J Orthop Sports Phys Ther. 2007 Feb;37(2):33-9. doi: 10.2519/jospt.2007.2401.

Reference Type BACKGROUND
PMID: 17366957 (View on PubMed)

Florencio LL, de Oliveira AS, Carvalho GF, Tolentino Gde A, Dach F, Bigal ME, Fernandez-de-las-Penas C, Bevilaqua Grossi D. Cervical Muscle Strength and Muscle Coactivation During Isometric Contractions in Patients With Migraine: A Cross-Sectional Study. Headache. 2015 Nov-Dec;55(10):1312-22. doi: 10.1111/head.12644. Epub 2015 Sep 21.

Reference Type BACKGROUND
PMID: 26388193 (View on PubMed)

de Groot RJ, Wetzels JW, Merkx MAW, Rosenberg AJWP, de Haan AFJ, van der Bilt A, Abbink JH, Speksnijder CM. Masticatory function and related factors after oral oncological treatment: A 5-year prospective study. Head Neck. 2019 Jan;41(1):216-224. doi: 10.1002/hed.25445. Epub 2018 Dec 15.

Reference Type BACKGROUND
PMID: 30552819 (View on PubMed)

Madsen BK, Sogaard K, Andersen LL, Skotte JH, Jensen RH. Neck and shoulder muscle strength in patients with tension-type headache: A case-control study. Cephalalgia. 2016 Jan;36(1):29-36. doi: 10.1177/0333102415576726. Epub 2015 Apr 1.

Reference Type BACKGROUND
PMID: 25834271 (View on PubMed)

Madsen BK, Sogaard K, Andersen LL, Skotte J, Tornoe B, Jensen RH. Neck/shoulder function in tension-type headache patients and the effect of strength training. J Pain Res. 2018 Feb 23;11:445-454. doi: 10.2147/JPR.S146050. eCollection 2018.

Reference Type BACKGROUND
PMID: 29503581 (View on PubMed)

Testa M, Geri T, Gizzi L, Petzke F, Falla D. Alterations in Masticatory Muscle Activation in People with Persistent Neck Pain Despite the Absence of Orofacial Pain or Temporomandibular Disorders. J Oral Facial Pain Headache. 2015 Fall;29(4):340-8. doi: 10.11607/ofph.1432.

Reference Type BACKGROUND
PMID: 26485381 (View on PubMed)

Testa M, Geri T, Pitance L, Lentz P, Gizzi L, Erlenwein J, Petkze F, Falla D. Alterations in jaw clenching force control in people with myogenic temporomandibular disorders. J Electromyogr Kinesiol. 2018 Dec;43:111-117. doi: 10.1016/j.jelekin.2018.07.007. Epub 2018 Jul 26.

Reference Type BACKGROUND
PMID: 30269020 (View on PubMed)

van der Meer HA, Speksnijder CM, Engelbert RHH, Lobbezoo F, Nijhuis-van der Sanden MWG, Visscher CM. The Association Between Headaches and Temporomandibular Disorders is Confounded by Bruxism and Somatic Symptoms. Clin J Pain. 2017 Sep;33(9):835-843. doi: 10.1097/AJP.0000000000000470.

Reference Type BACKGROUND
PMID: 28002094 (View on PubMed)

von Piekartz H, Pudelko A, Danzeisen M, Hall T, Ballenberger N. Do subjects with acute/subacute temporomandibular disorder have associated cervical impairments: A cross-sectional study. Man Ther. 2016 Dec;26:208-215. doi: 10.1016/j.math.2016.09.001. Epub 2016 Sep 23.

Reference Type BACKGROUND
PMID: 27744136 (View on PubMed)

Other Identifiers

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091219

Identifier Type: -

Identifier Source: org_study_id