month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 2 1 control group study group examination 2 both groups...
TRANSCRIPT
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
2
1
Control Group
Study Group
Examination 2 both groups
Examination 1 both groups
Examination 3 both groups
Intervention Study group
Intervention Control group
Both groups start diaries
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
INTERVENTION PROGRAM
Esercizio di rilassamento da ripetere 1-2 volte al giornoMettersi su una comoda poltrona con il capo ben appoggiato e lievemente reclinato all’indietro, o distesi a letto con 2 cuscini sotto il capo in un ambiente tranquillo. Lasciare cadere la mandibola fino a quando si raggiunge la posizione di massimo rilassamento (“fare la mandibola morta”). Rimanere in questa posizione per circa 15 minuti. E’ bene riscaldare i muscoli di spalle e collo con una sciarpa calda senza doverla tenere con le mani.
1) Mettersi contro una parete con piedi uniti. Talloni, spalle e capo devono essere ben aderenti al muro. Compiere movimenti ritmici rilasciando e riportando le spalle contro la parete.
3) Mettere le mani a coppa dietro al collo.. Il capo deve essere ben eretto. Sospingere il capo in alto e indietro facendo controresistenza con le mani. Rilasciare dopo 2-3 secondi.
2) Spalle ben aderenti alla parete. Con il capo compiere movimenti in avanti e indietro. (come nel film di Totò)
Esercizi di postura
Esercizio di rilassamento da ripetere 1-2 volte al giornoMettersi su una comoda poltrona con il capo ben appoggiato e lievemente reclinato all’indietro, o distesi a letto con 2 cuscini sotto il capo in un ambiente tranquillo. Lasciare cadere la mandibola fino a quando si raggiunge la posizione di massimo rilassamento (“fare la mandibola morta”). Rimanere in questa posizione per circa 15 minuti. E’ bene riscaldare i muscoli di spalle e collo con una sciarpa calda senza doverla tenere con le mani.
1) Mettersi contro una parete con piedi uniti. Talloni, spalle e capo devono essere ben aderenti al muro. Compiere movimenti ritmici rilasciando e riportando le spalle contro la parete.
3) Mettere le mani a coppa dietro al collo.. Il capo deve essere ben eretto. Sospingere il capo in alto e indietro facendo controresistenza con le mani. Rilasciare dopo 2-3 secondi.
2) Spalle ben aderenti alla parete. Con il capo compiere movimenti in avanti e indietro. (come nel film di Totò)
Esercizi di postura
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
2
1
Control Group
Study Group
Examination 2 both groups
Examination 1 both groups
Examination 3 both groups
Intervention Study group
Intervention Control group
Both groups start diaries
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
2
1
Control Group
Study Group
Examination 2 both groups
Examination 1 both groups
Examination 3 both groups
Intervention Study group
Intervention Control group
Both groups start diaries
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
InterventionIntervention betterbetter
ControlControl betterbetter
HeadacheHeadache
Change fromChange from baselinebaseline
-2·72(-3·71 to -1·73)-2·72(-3·71 to -1·73)
-3·21(-4·37 to -2·05)-3·21(-4·37 to -2·05)-1·26(-2·75 to 0·23)-1·26(-2·75 to 0·23)
-1·76(-3·01 to -0·51)-1·76(-3·01 to -0·51)-3·72(-5·25 to -2·19)-3·72(-5·25 to -2·19)
-6·46(-8·89 to -4·03)-6·46(-8·89 to -4·03)-1·50(-2·50 to -0·50)-1·50(-2·50 to -0·50)
-2·99(-4·71 to -1·26)-2·99(-4·71 to -1·26)-2·56(-4·63 to -0·49)-2·56(-4·63 to -0·49)-3·67(-6·23 to -1·11)-3·67(-6·23 to -1·11)-0·55(-2·07 to 0·97)-0·55(-2·07 to 0·97)
-1·21(-2·61 to 0·18)-1·21(-2·61 to 0·18)-1·93(-5·67 to 1·81)-1·93(-5·67 to 1·81)-3·76(-5·20 to -2·32)-3·76(-5·20 to -2·32) 0·11(-0·31 to 0·52)0·11(-0·31 to 0·52)
-8-8 -6-6 -4-4 -2-2 00 22 44 66
All subjects (n=344)All subjects (n=344)
Women (n=277)Women (n=277)
Men(n=67)Men(n=67)
Age <=45 years (n=170)Age <=45 years (n=170)Age >45 years (n=174)Age >45 years (n=174)
Depression or GAD (n=93)Depression or GAD (n=93)No Depression, No GAD (n=251)No Depression, No GAD (n=251)
M only(n=105)M only(n=105)TTH only (n=76)TTH only (n=76)
M and TTH (n=83)M and TTH (n=83)No M, no TTH (n=80)No M, no TTH (n=80)
Headache, no MP (n=52)Headache, no MP (n=52)MP, no headache (n=31)MP, no headache (n=31)
Headache and MP (n=212)Headache and MP (n=212)No Headache,no MP (n=49)No Headache,no MP (n=49)
SUBGROUPSANALYSIS
InterventionIntervention betterbetter
ControlControl betterbetter
HeadacheHeadache
Change fromChange from baselinebaseline
-2·72(-3·71 to -1·73)-2·72(-3·71 to -1·73)
-3·21(-4·37 to -2·05)-3·21(-4·37 to -2·05)-1·26(-2·75 to 0·23)-1·26(-2·75 to 0·23)
-1·76(-3·01 to -0·51)-1·76(-3·01 to -0·51)-3·72(-5·25 to -2·19)-3·72(-5·25 to -2·19)
-6·46(-8·89 to -4·03)-6·46(-8·89 to -4·03)-1·50(-2·50 to -0·50)-1·50(-2·50 to -0·50)
-2·99(-4·71 to -1·26)-2·99(-4·71 to -1·26)-2·56(-4·63 to -0·49)-2·56(-4·63 to -0·49)-3·67(-6·23 to -1·11)-3·67(-6·23 to -1·11)-0·55(-2·07 to 0·97)-0·55(-2·07 to 0·97)
-1·21(-2·61 to 0·18)-1·21(-2·61 to 0·18)-1·93(-5·67 to 1·81)-1·93(-5·67 to 1·81)-3·76(-5·20 to -2·32)-3·76(-5·20 to -2·32) 0·11(-0·31 to 0·52)0·11(-0·31 to 0·52)
-8-8 -6-6 -4-4 -2-2 00 22 44 66
All subjects (n=344)All subjects (n=344)
Women (n=277)Women (n=277)
Men(n=67)Men(n=67)
Age <=45 years (n=170)Age <=45 years (n=170)Age >45 years (n=174)Age >45 years (n=174)
Depression or GAD (n=93)Depression or GAD (n=93)No Depression, No GAD (n=251)No Depression, No GAD (n=251)
M only(n=105)M only(n=105)TTH only (n=76)TTH only (n=76)
M and TTH (n=83)M and TTH (n=83)No M, no TTH (n=80)No M, no TTH (n=80)
Headache, no MP (n=52)Headache, no MP (n=52)MP, no headache (n=31)MP, no headache (n=31)
Headache and MP (n=212)Headache and MP (n=212)No Headache,no MP (n=49)No Headache,no MP (n=49)
SUBGROUPSANALYSIS
Effectiveness of an educational and physical Effectiveness of an educational and physical programme in reducing headache, neck and programme in reducing headache, neck and shoulder pain: a workplace controlled trial. shoulder pain: a workplace controlled trial.
Mongini F, Ciccone G, Rota E, Ferrero L. Ugolini A, Evangelista A, Ceccarelli M, Galassi C
Cephalalgia. 2008; 28:541–552Cephalalgia. 2008; 28:541–552
PRESS RELEASE
Wednesday 14 May 2008Office initiative reduces headaches and neck and shoulderpain by more than 40 per cent
Office staff who took part in an eight-month workplace initiative reported that headaches and neck and shoulder pain fell by more than 40 per cent and their use of painkillers halved, according to research published in the May issue of Cephalalgia
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
2
1
Control Group
Study Group
Examination 2 both groups
Examination 1 both groups
Examination 3 both groups
Intervention Study group
Intervention Control group
Both groups start diaries
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
2
1
Control Group
Study Group
Examination 2 both groups
Examination 1 both groups
Examination 3 both groups
Intervention Study group
Intervention Control group
Both groups start diaries
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
.Long term benefits of an educational and physical program on headache, and neck and shoulder pain in a working community
Mongini F, Ciccone G, Rota E, Ferrero L. Ugolini A, Evangelista A, Ceccarelli M, Galassi C
J. of Pain 2009 Apr 22. [Epub ahead of print]
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
2
1
Control Group
Study Group
Examination 2 both groups
Examination 1 both groups
Examination 3 both groups
Intervention Study group
Intervention Control group
Both groups start diaries
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
2
1
Control Group
Study Group
Examination 2 both groups
Examination 1 both groups
Examination 3 both groups
Intervention Study group
Intervention Control group
Both groups start diaries
Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14
Headache
1st Group
2nd Group
Intervention1st Reiteration
2nd Reiteration
Intervention1st Reiteration
2nd Reiteration
0
.2
.4
.6
.8
1
1.2
1.4
1.6
1.8
1st Group
2nd Group
Neck and Shoulder Pain
0
.2
.4
.6
.8
1
1.2
1.4
1.6
1.8
Drugs Consumption
1th Group 192 192 192 192 183 180 178 177 169 166 163 163 161 159 157
2th Group 192 192 192 192 186 180 182 181 178 174 170 170 167 168 165
Days
0
.2
.4
.6
.8
1
1.2
1.4
1.6
1.8
0 30 60 90 120 150 180 210 240 270 300 330 360 390 420
Od
ds
Ra
tio
Confirmation of the positive effects of an an educational and physical program on headache, and neck and shoulder pain in a working community.
Mongini et al. Submitted.
Participants: 1913Participants: 1913
Group 1: 917 Group 1: 917
111 Males, 796 females111 Males, 796 females
Group 2 : 996 Group 2 : 996
152 Males, 824 females152 Males, 824 females
Month 1 2 3 4 5 6 7 8 9 10 11 12 13
2
1
Group2
Group1
Diaries
Diaries
Intervention Study group
Intervention Control group
Diaries and data collection
Month 1 2 3 4 5 6 7 8 9 10 11 12 13
Month 1 2 3 4 5 6 7 8 9 10 11 12 13
2
1
Group2
Group1
Diaries
Diaries
Intervention Study group
Intervention Control group
Diaries and data collection
Month 1 2 3 4 5 6 7 8 9 10 11 12 13
HEADACHE
4.98
7.29
6.467.25
3
4
5
6
7
8
9
0 1 2
Time
Fre
qu
enc
y
Group 1
Group 2
P = .91 P < .000
NECK AND SHOULDERS
11.29
8.07
10.7
10.13
6
7
8
9
10
11
12
0 1 2
Time
Fre
qu
enc
y
Group 1
Group 2
P = .27 P < .000
DRUGS
2.95
2.12
2.54
2.91
1
2
3
4
0 1 2
Time
Mea
n
Group 1
Group 2
P = .90 P < .05
-1.60(-2.17, -1.03)
-2.03(-2.95, -1.12)
-1.61(-2.26, -0.95)
-1.75(-2.42, -1.08)
-1.99(-2.79, -1.19)
-1.37(-2.20, -0.53)
-1.73(-2.93, -0.52)
-0.53(-2.21, 1.16)
-1.80(-2.80, -0.80)
-1.80(-2.40, -1.20)
-1.04(-2.59, 0.51)
Group 1better
Group 2better
Between Groupsdifferences
Females (N=1618)
Males (N=263)
Age<=45 (N=717)
Age>45 (N=1164)
Office Workers (N=780)
Educative/Social employees (N=797)
Traffic Polices (N=153)
Other workers (N=151)
High Level Educ. (N=288)
Intermediate Level Educ. (N=1317)
Low Level Educ. (N=276)
-4 -2 0 2
HEADACHE
HEADACHE
-1.94(-3.06, -0.81)
-2.66(-3.47, -1.85)
-1.39(-2.46, -0.33)
-0.13(-0.90, 0.65)
-1.00(-1.94, -0.06)
-0.15(-1.36, 1.07)
-2.17(-2.88, -1.45)
-0.23(-0.44, -0.03)
Group 1
better
Group 2
better
Between Groups
differences
M only (N=541)
TTH only (N=430)
M and TTH (N=669)
No M, No TTH (N=241)
Headache, no MP (N=313)
MP, no headache (N=144)
Headache and MP (N=1327)
No Headache,no MP (N=97)
-4 -2 0 2
Month 1 2 3 4 5 6 7 8 9 10 11 12 13
2
1
Group2
Group1
Diaries
Diaries
Intervention Study group
Intervention Control group
Diaries and data collection
Month 1 2 3 4 5 6 7 8 9 10 11 12 13
HEADACHE
4.98
7.29
6.467.25
3
4
5
6
7
8
9
0 1 2
Time
Fre
qu
enc
y
Group 1
Group 2
P = .91 P < .000
HEADACHE
4.794.98
7.29
6.46
5.45
7.25
3
4
5
6
7
8
9
0 1 2
Time
Fre
qu
enc
y
Group 1
Group 2
P = .91 P < .000 P = .06
NECK AND SHOULDERS
11.29
8.07
10.7
10.13
6
7
8
9
10
11
12
0 1 2
Time
Fre
qu
enc
y
Group 1
Group 2
P = .27 P < .000
NECK AND SHOULDERS
11.29
7.47
8.07
10.7
10.13
8.13
6
7
8
9
10
11
12
0 1 2
Time
Fre
qu
enc
y
Group 1
Group 2
P = .27 P < .000 P = .20
DRUGS
2.95
2.12
2.54
2.91
1
2
3
4
0 1 2
Time
Mea
n
Group 1
Group 2
P = .90 P < .05
DRUGS
2.95
2.12
1.89
2.54
2.002.91
1
2
3
4
0 1 2
Time
Mea
n
Group 1
Group 2
P = .90 P < .05 P = .57
BiofeedbackBiofeedback
TENSTENS
ExercisesExercises
Physical activityPhysical activity
Trigger/tender points injectionTrigger/tender points injection
Cold sprayCold spray
BIOFEEDBACK
TENS
Trigger/tender points injectionTrigger/tender points injection
• Ampliamento e rimodulazione del protocollo di raccolta dati, analisi clinica e terapia delle cefalalgie
• Applicazione del programma sul territorio a fini di prevenzione
• Ampliamento e rimodulazione del protocollo di raccolta dati, analisi clinica e terapia delle cefalalgie
• Applicazione del programma sul territorio a fini di prevenzione
Torino
Grazie!Grazie!