• Journal of Oral Medicine and Pain
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• v.35 no.2
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• pp.123-133
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• 2010

The purpose of this study is to investigate Tension-type headache associated with pericranial tenderness and Headache attributed to temporomandibular joint disorder among Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score using RDC/TMD Axis II. Eighty five patients who visited the Kyung Hee University Dental Hospital were diagnosed as Tension-type headache associated with pericranial tenderness(n=48) and Headache attributed to temporomandibular joint disorder(n=37) by the International Classification of Headache Disorders, 2nd Edition, and were administered the Korean versions of the RDC/TMD Axis II- Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score. Then it was analyzed statistically by SPSS(ver. 10.0). T-test, The Wilcoxon-signed rank test and Mann-Whitney U test (p<0.05) were used. There were no significant differences in Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score between two groups. Tension type headache associated with pericranial tenderness and Headache attributed to temporomandibular joint disorder showed similar Axis II feature. Tension-type headache associated with pericranial tenderness may be related to Headache attributed to temporomandibular joint disorder.

• Journal of Acupuncture Research
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• v.25 no.2
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• pp.165-177
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• 2008

Objectives : Headache is one of the most common symptom in primary medical care. The purpose of this research is to examine persisting effects of acupuncture treatment for CTTH. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture method for the treatment of chronic tension-type headache. Volunteers who satisfied the requirements were enrolled in study. Evaluation of CTTH was measured by VAS, and Headache Disability Inventory(HDI), Six point Likert Scale, Algometer score(Rt, Lt) before and after treatments. Results : 32 subjects finished study. There were no difference between two group on age, sex, weight, height, blood pressure, pulse, respiratory rate, differentiation of symptoms, surmise of treatment. In change of VAS, after treatment decreased than before treatment in two group, but there were no statistical significance compared with two group and time. In change of HDI(Total score, Emotional score, Functional score) and Six point Likert scale, after treatment decreased than before treatment in two group, but there were no statistical significance compared with two group and time. In change of two sides Algometer score, after treatment increased than before treatment in two group, and Lt algometer score was statistical significance compared with two group(p<0.001). And both sides Algometer score, threr were statistical significance compared with time. Conclusions : Acupuncture treatment has persisting effects that improve the symptoms and decrease the temporal muscle tenderness in patient with chronic tension-type headache.

• The Journal of Korean Medicine
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• v.31 no.5
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• pp.41-59
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• 2010

Objective: Headache is one of the most common symptoms in primary medical care. The purpose of this study was to support medical treatment by consideration of a new CTTH (chronic tension-type headache) oriental medical diagnosis index. Methods: An Oriental medical diagnosis questionnaire was administered to a CTTH group, migraine group and normal group. The result was classified by using LDA, CART, factor diagnosis and tested in comparison with the original diagnosis. Also, weighting method based on expert opinions was done. Results: 1. The result analyzed by using LDA has an accuracy of 93.9% in comparison with the original diagnosis. 2. High accuracy showed when the test was performed with about 35 significant questions and four questions selected based on SPSS Wilks' lambda. 3. There was accuracy of 90.9% when differentiation was performed by using CART compared with original diagnosis. 4. 10 factors has a high initial value after factor analysis, consisting of questions to the similar differentiation. 5. Diagnosis formula of headache was made by using weighting method based on expert opinions. Conclusion: Oriental medical diagnosis questionnaires make it possible to classify headaches significantly. The study about weighting method of CTTH can make it possible to classify symptoms more accurately.

• Clinical and Experimental Pediatrics
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• v.58 no.2
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• pp.73-76
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• 2015

Isolated sphenoid sinusitis is a rare disease in children, and its symptoms are often nonspecific and confusing. Rarely, severe headache can be the first or only symptom of isolated sphenoid sinusitis. New daily persistent headache (NDPH) is a form of chronic daily headache that may have features of both migraines and tension-type headaches. NDPH is difficult to diagnose and requires a multifaceted approach. Here, we report on a 10-year-old boy and an 11-year-old girl who both presented with typical NDPH symptoms. These patients had no nasal symptoms or signs of infection. Neither nonsteroidal anti-inflammatory drugs nor topiramate had any effect on the headaches. Their neurological and ophthalmological examinations were normal. The results of routine blood work, including thyroid function tests, inflammatory markers, complete blood count, tests for viral infection, and a metabolic panel, were normal. A brain magnetic resonance imaging scan showed isolated sphenoid sinusitis. Both patients' symptoms resolved completely after approximately 1 month of oral antibiotics for sinusitis.

• Physical Therapy Korea
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• v.24 no.2
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• pp.37-47
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• 2017

Background: Active trigger points (TrPs) of the suboccipital muscles greatly contribute to the occurrence of chronic tension-type headache, with increased sensitivity of TrPs and facilitated referred pain. Objects: This study aimed to investigate whether the integration of high-frequency diathermy into suboccipital release is more beneficial than the use of suboccipital release alone. Methods: Thirty subjects were assigned to either experimental group-1 (EG-1) to undergo suboccipital release combined with high-frequency diathermy (frequency: 0.3 MHz, and electrode type: resistive electronic transfer), or EG-2 to undergo suboccipital release alone, or the control group (CG) with no intervention, with 10 subjects in each group. The assessment tools included the headache impact test 6 (HIT-6), perceived level of tenderness, neck disability index, and neck mobility. Intervention was performed for 10 minutes, twice per week, for 4 weeks, and measurements were performed before and after the interventions. Results: The between-group comparison of the post-test values and changes between pretest and post-test showed significant differences for all parameters at p<.05, except for the left-to-right lateral bending range. In the post hoc test, EG-1 showed significant differences for the parameters in comparison with the CG, while no significant differences in the perceived tenderness level, on both temporal regions, were found between EG-2 and CG. Furthermore, the HIT-6 score and perceived tenderness level, in the right temporal region, showed significant differences between EG-1 and EG-2. In the within-group comparison, EG-1 and EG-2 appeared to be significantly different between pretest and post-test (p<.05), except for the perceived tenderness level in the right temporal region, with significance for the EG-1 group only (p<.05). Conclusion: These findings suggest that the suboccipital release technique may be advantageous to improve headache, tenderness, and neck function and mobility, with more favorable effects with the incorporation of high-frequency diathermy.

• Journal of Korea Entertainment Industry Association
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• v.14 no.7
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• pp.539-548
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• 2020

TTH(tension-type headache) is the most common primary headache among adults. Long-term headaches cause chronic headaches and have a better impact on daily life. The purpose of this study is to compare the contributions to TTH through AVE(audio-visual entertainment) and STM(soft tissue mobilization) suitable for management of pathogenic and psychogenic factors of TTH. The participants of this study were from 30 people who complained of intermittent or persistent headaches for more than 6 months, and 10 participants each in the AVE group, STM group, and AVE plus STM group. In the assigned group, a total of 12 sessions were performed three times a week for 4 weeks after the baseline, followed by post-test. Outcome measures measured PPTs(pressure pain thresholds), psychophysiological parameters, and EEG(electroencephalogram). The measured results were analyzed for interaction between time and group through a two way rmANOVA(repeated measurement variance analysis). As a result of the PPTs, interaction was found in the results of the right trapezius (p<.05), and the more improvement was observed in the AVE group. Therefore, through AVE based on psychological factors rather than direct access to the muscles of pathogenic factors, a positive impact on the PPTs was shown, but the average value of the psychophysiological parameters and brain waves that were not statistically significant. The amount of change was observed. Through this, it is suggested that audio-visual stimulation could be considered in the management of TTH.

• Journal of Acupuncture Research
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• v.26 no.2
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• pp.59-70
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• 2009

Objectives : Although CTTH is one of the most common symptom in primary headache, the mechanism and treatment is not definite. The purpose of this study is to research about clinical characteristic and roentgenographic finding of the cervical spine in CTTH to determine relationship between the cervical spine and headache. Methods : This study was carried out on 93 patients with CTTH. By roentgenographic finding, they were classified into four groups - HNP, Spondylosis, Sprain, Normal. Then the HNP group was divided again into two groups - singer type and multiple type. Results: 1. Among 93 patients with CTTH, 69(74.19%) patients had abnormal cervical spine by roentgenographic finding. 2. There were HNP, spondylosis, sprain in abnormal roentgenographic finding. And a great majority of the patients were diagnosed as cervical sprain. 3. There were no significant difference between four groups on sex, weight, height, blood pressure, pulse, respiratory rate. But on ages, the HNP group showed the highest average while the sprain group showed the lowest. 4. The patients in HNP group had more frequent, severe pain, longer onset and higher onset-age than those of the other three group. 5. The patients in Multiple-type HNP group had severe pain, longer pain-duration, longer onset, more pre-symptoms and younger onset-age than those of the Single-type HNP group. Conclusions : A great majority of the patients with CTTH had abnormal cervical spines. Also, we found out that the worse the grade of HNP, heavier the level of headache.

• Korean Journal of Acupuncture
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• v.23 no.1
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• pp.95-109
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• 2006

Objectives : There has been a considerable debate about how to best control for placebo effects in clinical trials of acupuncture. Recently several sham needles were developed and validated. This study aimed at summarising the validation studies of these needles and evaluating the outcomes of the randomised controlled trials (RCTs) using them. Methods : Computerised literature searches were performed using 'acupuncture' AND 'placebo OR sham' with a limitation of the results to RCTs in Medline via PubMed and the Cochrane Library. Only formally validated sham needle controlled studies were included. Data were extracted regarding study design, condition, sample size, credibility testing, intervention and outcomes. Methodological quality was assessed using a modified Jadad scale. Results : Three validated sham needles by Streitberger, Park, and Fink, were identified. Acupuncture's effectiveness for various conditions was tested using these needles in 12 RCTs. Real acupuncture was superior to sham acupuncture for rotator cuff tendonitis and hypertension. No significant differences between real acupuncture and sham acupuncture emerged for chemotherapy-related nausea and vomiting, postoperative nausea and vomiting, menstrually related migraine, acute stroke rehabilitation, chronic/episodic tension-type headache, neutrophil respiratory burst in healthy volunteers, alcohol withdrawal symptoms and chronic poststroke leg spasticity. Conclusions : The new sham devices have been adequately validated and may be useful tools for investigating specific research question. In spite of the sham needle's limits, the results of RCTs using such devices tend to suggest that the clinical effects of acupuncture are largely due to a placebo response.

• Korean Journal of Acupuncture
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• v.30 no.1
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• pp.21-26
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• 2013

Objectives : The purpose is to introduce the recent large-scale clinical researches for safety, efficacy and effectiveness of acupuncture in Germany. Results : In 2000, the German Federal Committee of Physicians and Health insurer proposed that large research initiatives on acupuncture, Acupuncture Model Projects(Modellvorhaben Akupunktur), could be conducted by health insurance companies for several pain that acupuncture is syndromes to justify the insurance-based reimbursement. Accordingly, 4 clinical researches were carried out; the Acupuncture Safety and Health economics studies(ASH), the Acupuncture Randomised Trial(ART), the Acupuncture in Routine Care studies(ARC), and the German Acupuncture trial(GERAC). Meanwhile, ASH is a prospective observational study for safety and costs. ART and GERAC are composed of RCTs for efficacy. ARC includes 6 pragmatic RCTs with additional non-randomized cohort study for effectiveness. We investigated the papers related to them and discussed about the outcomes. The researches showed that acupuncture is effective in practice for several chronic conditions such as migraine, tension-type headache, chronic low back pain, osteoarthritis of knee, dysmenorrhea, and allergic rhinitis. Based in part on them, the German health authorities decided that acupuncture would be included into routine reimbursement by social health insurance funds for chronic low back pain and chronic osteoarthritis of the knee in 2006. Conclusions : The German clinical researches may suggest the clues for establishing the evidence of acupuncture treatment.

• Journal of Acupuncture Research
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• v.28 no.6
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• pp.1-17
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• 2011

Objectives : This study aimed to review randomized controlled trials of acupuncture performed in South Korea that used sham acupuncture as a control group. Methods : The following databases were searched through the end of September 2011: Koreanstudies information service system (KISS), Korean medical database (KMbase), national discovery OR science leaders (NDSL), oriental medicine advance searching integrated system (OASIS), and research information service system (RISS). The following search terms were used: acupuncture AND (sham or placebo). The reference lists of searched articles and Korea institute of oriental medicine (KIOM) reports(2005~2009) were identified. The following data were extracted: year/first author, disease, number of participants, blinding, intervention, outcome, and result. Where appropriate, we performed meta-analysis. The methodological quality was assessed according to the Jadad scale and 'risk of bias' by Cochrane Handbook procedure. Results : Twenty-nine studies were included in this review. In eighteen studies, penetrating sham controls were used as the control intervention, whereas the remaining eleven studies adopted non-penetrating sham controls such as the Park Sham Device or blunt auricular acupuncture. Nine studies showed statistically significant difference in outcomes. Twelve studies concerning insomnia after stroke, chronic tension-type headache, idiopathic Parkinson's disease, Hwa-Byung, and smoking cessation were included in meta-analysis. A meta-analysis of insomnia after stroke only found significant difference(MD -4.31, 95% Cl -6.19 to -2.42, $p$<0.00001). In general, all of the studies showed low methodological quality(Jadad score: mean 2.1). Risk of bias by Cochrane Handbook procedure varied. Conclusions : The results of this study could not suggest conclusive evidence that acupuncture is more effective than sham acupuncture in several diseases. In the future, more studies with rigorous acupuncture trials using sham controls should be conducted.