The Effect of Specific Strength-Training on Tension-Type Headache in Children 9-17 Years

• Headache [ Time Frame: At baseline ] [ Designated as safety issue: No ]
  Number of headache days/ 4 weeks. Mean VAS Score (pain)/4 weeks.
• Muscle Capacity [ Time Frame: At baseline ] [ Designated as safety issue: No ]

  Neck and shoulder muscle function variables:

  MVC(maximal voluntary static capacity). RFD(rate of force development). FS (Force-steadiness).

• Headache [ Time Frame: After the 10 weeks intervention programme ] [ Designated as safety issue: No ]
  Number of headache days/ 4 weeks. Mean VAS Score (pain)/4 weeks.
• Headache [ Time Frame: At 3 months follow up. ] [ Designated as safety issue: No ]
  Number of headache days/ 4 weeks. Mean VAS Score (pain)/4 weeks.
• Muscle Capacity [ Time Frame: After the 10 weeks intervention programme ] [ Designated as safety issue: No ]

  Neck and shoulder muscle function variables:

  MVC(maximal voluntary static capacity). RFD(rate of force development). FS(Force-steadiness).

• Muscle Capacity [ Time Frame: At 3 months follow up. ] [ Designated as safety issue: No ]

  Neck and shoulder muscle function variables:

  MVC(maximal voluntary static capacity). RFD(rate of force development). FS(Force-steadiness).

• TTS [ Time Frame: At baseline ] [ Designated as safety issue: No ]
  Total Tenderness Score ( palpation of percranial tenderness).
• Physical fitness [ Time Frame: At baseline ] [ Designated as safety issue: No ]
  Submaximal ergometer bicycle test
• TTS [ Time Frame: After the 10 weeks intervention programme ] [ Designated as safety issue: No ]
  Total Tenderness Score ( palpation of pericranial tenderness).
• TTS [ Time Frame: At 3 months follow up. ] [ Designated as safety issue: No ]
  Total Tenderness Score ( palpation of pericranial tenderness).
• Physical fitness [ Time Frame: After the 10 weeks intervention programme ] [ Designated as safety issue: No ]
  Submaximal ergometer bicycle test
• Physical fitness [ Time Frame: At 3 months follow up. ] [ Designated as safety issue: No ]
  Submaximal ergometer bicycle test

• TTS [ Time Frame: At baseline ] [ Designated as safety issue: No ]
  Total Tenderness Score ( palpation of percranial tenderness).
• Physical fitness [ Time Frame: At baseline ] [ Designated as safety issue: No ]
  Submaximal ergometer bicycle test
• TTS [ Time Frame: After the 10 week intervention programme ] [ Designated as safety issue: No ]
  Total Tenderness Score ( palpation of percranial tenderness).
• TTS [ Time Frame: At 3 month follow up. ] [ Designated as safety issue: No ]
  Total Tenderness Score ( palpation of percranial tenderness).
• Physical fitness [ Time Frame: After the 10 week intervention programme ] [ Designated as safety issue: No ]
  Submaximal ergometer bicycle test
• Physical fitness [ Time Frame: At 3 month follow up. ] [ Designated as safety issue: No ]
  Submaximal ergometer bicycle test

This study aims at examining muscle strength capacity in neck and shoulder muscles in children and adolescents with and without tension-type headache, and furthermore examining the effect of a 10 week specific strength training programme for neck and shoulder muscles compared to a multi-disciplinary approach in 10 weeks.

Frequent and chronic tension type headache are the most frequent pain illnesses in children with a prevalence of 0.5-7,6%. Frequent or daily headache leads to constraints in the child's life in relation to school and social activities.

The underlying pathophysiological mechanisms are not yet fully examined. In several studies in adults and in children it is found that the shoulder muscles are tense and tender, but it is not known whether this phenomenon is primary or secondary to tension-type headache. A decrease in muscle capacity is furthermore found in studies. We therefore aim at examining parameters for muscle function in order to compare the differences between children with and without headache, and at examining the effect of a 10 week progressive specific strength training programme on headache compared to an in time comparable multidisciplinary intervention based on lifestyle counseling.

• Device: Specific Strength Training
  10 weeks of progressive specific strength training for neck and shoulder muscles.
  Other Name: A
• Behavioral: Lifestyle Counseling
  10 weeks of counseling by nurse and physiotherapist in lifestyle changes.
  Other Name: B

• Active Comparator: Specific Strength Training
  10 weeks of specific strength training of neck and shoulder muscles using elastic resistance.
  Intervention: Device: Specific Strength Training
• Active Comparator: Lifestyle Counseling
  10 weeks of counseling by nurse and physiotherapist in lifestyle changes.
  Intervention: Behavioral: Lifestyle Counseling

Inclusion Criteria:

• primary tension-type headache with no more than one episode of migraine pr. month

Exclusion Criteria:

• post-trauma headache
• co-morbidity

• The University Hospitals Centre for Nursing and Care Research, Copenhagen
• The Beckett-Fond
• The Fond of Jørgen Holm and Elisa F. Hansen