to Stuidy the Effect of Cognitive Behavior Threapy CBT on Smartphone Addiction Patients With Tension Type Headache

Hatem Mostafa

Status: Enrolling

Conditions: Smartphone Addiction; Tension Type Headache

Treatments: Other: deep friction massage; Other: sub-occipital inhibitory pressure; Behavioral: cognitive behavioral therapy; Other: Exercises for forward head posture; Other: Spinal manipulation

Study type: Interventional

Funder types: Other

Identifiers

NCT06631222

P.T.REC/120/005099

Details and patient eligibility

About

The goal of this clinical trial is to learn if cognitive behavioral approach works to treat tension type headache in smartphone addiction in adults. The main questions it aims to answer are:

Is there an effect of adding cognitive behavior approach to physical therapy (manual therapy, corrective exercise therapy) on pain pressure threshold, forward head posture and headache intensity in smartphone addiction patients with tension-type headache? Researchers will compare adding cognitive behavior approach to physical therapy (manual therapy, corrective exercise therapy) to see if cognitive behavior approach works to treat tension type headache in smartphone addiction than physical therapy alone.

Participants will:

All participants will receive twelve treatment sessions (twice per week) in a 6 weeks period with a rest period of 48 to 72 hour between them.

Enrollment: 40 estimated patients

Sex: All

Ages: 19 to 34 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Subjects were those diagnosed with tension type headache by neurologists based on the criteria of the International Headache Society.
• age between 19-34.
• International Headache Society diagnostic criteria of tension type headaches:
• Frequent ETTH or CTTH diagnosed, in both cases more than three months.
• Episodes of pain from 30 minutes to 7 days Fulfil 2 or more of the following characteristics:
• Bilateral location of pain.
• Non-pulsatile pain pressure.
• Pain mild to moderate.
• The headache does not increase with physical activity.
• The headache may be associated with pericranial tenderness.
• Controlled pharmacologically.
• Myofascial TrPs were bilaterally explored in upper trapezius, splenius capitis, sternocleidomastoid, masseter, superior oblique, levator scapulae and suboccipital muscles, TrP diagnosis was conducted following the diagnostic criteria:
• presence of a palpable taut band within a skeletal muscle.
• presence of a hypersensitive tender spot in the taut band.
• local twitch response elicited by snapping palpation of the taut band reproduction of the typical referred pain pattern of the TrP in response to compression.
• TrPs were considered active if both the local and the referred pain evoked by manual palpation reproduced total or partial pattern of the headache.
• Patients with FHP who have craniovertebral angle less than 49 degrees were included. Forward head posture is measured by calculating the angle between the horizontal line passing through C7 and a line extending from the tragus of the ear to C7.
• patients with smartphone addiction who will score 31 for males and 33 for females on smartphone addiction scale - short version.

Exclusion criteria

• rheumatoid arthritis.
• suspected malignancy.
• pregnancy.
• if they had received manual therapy treatment in the 2 months before enrolment into the study.
• Patients with infrequent episodic tension type headache, or with probable frequent and infrequent forms of tension type headache or other concomitant headache.
• They can never have vomiting or headache episodes during the treatment.
• Episodic tension type headache patients may experience very occasionally photophobia or phonophobia during their episodes of headache.
• Chronic tension type headache patients may experience very occasionally photophobia, phonophobia or mild nausea during headache episodes.
• Pain aggravated by movement of the head.
• Metabolic or musculoskeletal problems with similar headache symptoms.
• Previous trauma to the cervical spine.
• Active vertigo history.
• Poorly controlled hypertension.
• Atherosclerosis.
• Advanced osteoarthritis.
• Patients undergoing pharmacological adaptation or changes in the prophylactic medication.
• Excessive emotional stress.
• Patients with heart devices.
• Joint instability.
• Neurological disorders.
• Laxity of cervical soft tissues.
• Radiographic abnormalities.
• Generalized hyperlaxity or hypermobility.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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40 participants in 2 patient groups

control group

Active Comparator group

Description:

the participants will receive a conventional standard physical therapy program (sub-occipital inhibitory pressure, Spinal manipulation, deep friction massage and corrective exercises)

Treatment:

Other: Spinal manipulation

Other: Exercises for forward head posture

Other: sub-occipital inhibitory pressure

Other: deep friction massage

experimental group

Experimental group

Description:

the participants will be treated with behavior change model in addition to a conventional standard physical therapy program for tension-type headache.

Treatment:

Other: Spinal manipulation

Other: Exercises for forward head posture

Behavioral: cognitive behavioral therapy

Other: sub-occipital inhibitory pressure

Other: deep friction massage