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.

Presentazione sul tema: "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."— Transcript della presentazione:

1 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

2 INTERVENTION PROGRAM Esercizio di rilassamento da ripetere 1-2 volte al giorno Mettersi su una comoda poltrona con il capo ben appoggiato e lievemente reclinato allindietro, 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 giorno Mettersi su una comoda poltrona con il capo ben appoggiato e lievemente reclinato allindietro, 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

3 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

4 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

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8 Intervention better better Control Headache Change from baseline baseline -2·72(-3·71 to -1·73) -3·21(-4·37 to -2·05) -1·26(-2·75 to 0·23) -1·76(-3·01 to -0·51) -3·72(-5·25 to -2·19) -6·46(-8·89 to -4·03) -1·50(-2·50 to -0·50) -2·99(-4·71 to -1·26) -2·56(-4·63 to -0·49) -3·67(-6·23 to -1·11) -0·55(-2·07 to 0·97) -1·21(-2·61 to 0·18) -1·93(-5·67 to 1·81) -3·76(-5·20 to -2·32) 0·11(-0·31 to 0·52) 0·11(-0·31 to 0·52) -8-6-4-20246 All subjects (n=344) Women (n=277) Men(n=67) Age <=45 years (n=170) Age >45 years (n=174) Depression or GAD (n=93) No Depression, No GAD (n=251) M only(n=105) TTH only (n=76) M and TTH (n=83) No M, no TTH (n=80) Headache, no MP (n=52) MP, no headache (n=31) Headache and MP (n=212) No Headache,no MP (n=49) SUBGROUPS ANALYSIS

9 Intervention better better Control Headache Change from baseline baseline -2·72(-3·71 to -1·73) -3·21(-4·37 to -2·05) -1·26(-2·75 to 0·23) -1·76(-3·01 to -0·51) -3·72(-5·25 to -2·19) -6·46(-8·89 to -4·03) -1·50(-2·50 to -0·50) -2·99(-4·71 to -1·26) -2·56(-4·63 to -0·49) -3·67(-6·23 to -1·11) -0·55(-2·07 to 0·97) -1·21(-2·61 to 0·18) -1·93(-5·67 to 1·81) -3·76(-5·20 to -2·32) 0·11(-0·31 to 0·52) 0·11(-0·31 to 0·52) -8-6-4-20246 All subjects (n=344) Women (n=277) Men(n=67) Age <=45 years (n=170) Age >45 years (n=174) Depression or GAD (n=93) No Depression, No GAD (n=251) M only(n=105) TTH only (n=76) M and TTH (n=83) No M, no TTH (n=80) Headache, no MP (n=52) MP, no headache (n=31) Headache and MP (n=212) No Headache,no MP (n=49) SUBGROUPS ANALYSIS

10 Effectiveness of an educational and physical programme in reducing headache, neck and shoulder pain: a workplace controlled trial. Mongini F, Ciccone G, Rota E, Ferrero L. Ugolini A, Evangelista A, Ceccarelli M, Galassi C Cephalalgia. 2008; 28:541–552

11 PRESS RELEASE Wednesday 14 May 2008 Office initiative reduces headaches and neck and shoulder pain 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

12 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

13 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

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]

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18 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

19 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

20 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.

21 Participants: 1913 Group 1: 917 111 Males, 796 females Group 2 : 996 152 Males, 824 females

22 Month 1 2 3 4 5 6 7 8 9 10 11 12 13 2 1 Group 2 Group 1 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

23 Month 1 2 3 4 5 6 7 8 9 10 11 12 13 2 1 Group 2 Group 1 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

24 HEADACHE 4.98 7.29 6.46 7.25 3 4 5 6 7 8 9 012 Time Frequency Group 1 Group 2 P =.91P <.000

25 NECK AND SHOULDERS 11.29 8.07 10.7 10.13 6 7 8 9 10 11 12 012 Time Frequency Group 1 Group 2 P =.27 P <.000

26 DRUGS 2.95 2.12 2.54 2.91 1 2 3 4 01 2 Time Mean Group 1 Group 2 P =.90 P <.05

27 HEADACHE

28 -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) -4-202

29 Month 1 2 3 4 5 6 7 8 9 10 11 12 13 2 1 Group 2 Group 1 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

30 HEADACHE 4.98 7.29 6.46 7.25 3 4 5 6 7 8 9 012 Time Frequency Group 1 Group 2 P =.91P <.000

31 HEADACHE 4.79 4.98 7.29 6.46 5.45 7.25 3 4 5 6 7 8 9 012 Time Frequency Group 1 Group 2 P =.91P <.000P =.06

32 NECK AND SHOULDERS 11.29 8.07 10.7 10.13 6 7 8 9 10 11 12 012 Time Frequency Group 1 Group 2 P =.27 P <.000

33 NECK AND SHOULDERS 11.29 7.47 8.07 10.7 10.13 8.13 6 7 8 9 10 11 12 012 Time Frequency Group 1 Group 2 P =.27 P <.000P =.20

34 DRUGS 2.95 2.12 2.54 2.91 1 2 3 4 01 2 Time Mean Group 1 Group 2 P =.90 P <.05

35 DRUGS 2.95 2.12 1.89 2.54 2.00 2.91 1 2 3 4 01 2 Time Mean Group 1 Group 2 P =.90 P <.05 P =.57

36 Biofeedback TENS TENS Exercises Exercises Physical activity Physical activity Trigger/tender points injection Trigger/tender points injection Cold spray Cold spray

37 BIOFEEDBACK

38 TENS

39 Trigger/tender points injection

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42 Ampliamento e rimodulazione del protocollo di raccolta dati, analisi clinica e terapia delle cefalalgie Applicazione del programma sul territorio a fini di prevenzione

43 Ampliamento e rimodulazione del protocollo di raccolta dati, analisi clinica e terapia delle cefalalgie Applicazione del programma sul territorio a fini di prevenzione

44 Torino

45 Grazie! Grazie!