K Luedtke1, W Boissonnault2, N Caspersen3, R Castien4, A Chaibi5, D Falla6, C Fernández-de-Las-Peñas7, T Hall8, J R Hirsvang3, T Horre9, D Hurley10, G Jull11, L S Krøll3, B K Madsen3, J Mallwitz12, C Miller13, B Schäfer14, T Schöttker-Königer15, W Starke15, H von Piekartz16, D Watson17, P Westerhuis18, A May19. 1. Department of Systems Neuroscience, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany. Electronic address: k.luedtke@uke.de. 2. University of Wisconsin-Madison, Department of Orthopedics and Rehabilitation, Wisconsin, USA. 3. Danish Headache Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, DK-2600 Glostrup, Denmark. 4. Department of General Practice and Elderly Care Medicine, EMGO+Institute for Health Care Research, VU University Medical Center, Amsterdam, The Netherlands. 5. Head and Neck Research Group, Research Centre, Akershus University Hospital, 1478, Oslo, Norway; Institute of Clinical Medicine, Akershus University Hospital and University of Oslo, 1474, Nordbyhagen, Norway. 6. School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK; Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany. 7. Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. 8. School of Physiotherapy and Exercise Science, Curtin University, P.O. Box U1987, Perth, WA 6845, Australia. 9. Physiotherapy Practice Jensen & Team, Nienstedtener Marktplatz 29, 22609 Hamburg, Germany. 10. Physiotherapy, Birmingham Community Healthcare NHS Trust, Birmingham, England, UK. 11. Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Australia. 12. Spine Center "Am Michel", Ludwig-Erhard-Str. 18, 20459 Hamburg, Germany. 13. Physiotherapy Department, University Hospital Birmingham Foundation Trust, Birmingham B15 2TH, UK. 14. Migraine and Headache Clinic Königstein im Taunus, Ölmühlweg 31, 61462 Königstein im Taunus, Germany. 15. Hochschule für Angewandte Wissenschaft und Kunst Hildesheim/Holzminden/Göttingen, Fakultät Soziale Arbeit und Gesundheit, Studiengang Ergotherapie, Logopädie und Physiotherapie, Goschentor 1, 31134 Hildesheim; Germany. 16. University of Applied Sciences Osnabrueck, Faculty of Business Managment and Social Science, Department Movement and Rehabilitation Science, Caprivistr. 30a, 49076 Osnabrück, Germany. 17. Watson Headache Institute, GPO Box 4714, Sydney, NSW 2001, Australia. 18. Heimlisbergstr. 47, 4513 Langendorf, Switzerland. 19. Department of Systems Neuroscience, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
Abstract
BACKGROUND: A wide range of physical tests have been published for use in the assessment of musculoskeletal dysfunction in patients with headache. Which tests are used depends on a physiotherapist's clinical and scientific background as there is little guidance on the most clinically useful tests. OBJECTIVES: To identify which physical examination tests international experts in physiotherapy consider the most clinically useful for the assessment of patients with headache. DESIGN/ METHODS: Delphi survey with pre-specified procedures based on a systematic search of the literature for physical examination tests proposed for the assessment of musculoskeletal dysfunction in patients with headache. RESULTS: Seventeen experts completed all three rounds of the survey. Fifteen tests were included in round one with eleven additional tests suggested by the experts. Finally eleven physical examination tests were considered clinically useful: manual joint palpation, the cranio-cervical flexion test, the cervical flexion-rotation test, active range of cervical movement, head forward position, trigger point palpation, muscle tests of the shoulder girdle, passive physiological intervertebral movements, reproduction and resolution of headache symptoms, screening of the thoracic spine, and combined movement tests. CONCLUSIONS: Eleven tests are suggested as a minimum standard for the physical examination of musculoskeletal dysfunctions in patients with headache.
BACKGROUND: A wide range of physical tests have been published for use in the assessment of musculoskeletal dysfunction in patients with headache. Which tests are used depends on a physiotherapist's clinical and scientific background as there is little guidance on the most clinically useful tests. OBJECTIVES: To identify which physical examination tests international experts in physiotherapy consider the most clinically useful for the assessment of patients with headache. DESIGN/ METHODS: Delphi survey with pre-specified procedures based on a systematic search of the literature for physical examination tests proposed for the assessment of musculoskeletal dysfunction in patients with headache. RESULTS: Seventeen experts completed all three rounds of the survey. Fifteen tests were included in round one with eleven additional tests suggested by the experts. Finally eleven physical examination tests were considered clinically useful: manual joint palpation, the cranio-cervical flexion test, the cervical flexion-rotation test, active range of cervical movement, head forward position, trigger point palpation, muscle tests of the shoulder girdle, passive physiological intervertebral movements, reproduction and resolution of headache symptoms, screening of the thoracic spine, and combined movement tests. CONCLUSIONS: Eleven tests are suggested as a minimum standard for the physical examination of musculoskeletal dysfunctions in patients with headache.
Authors: John J Leddy; Mohammad Nadir Haider; James M Noble; Brian Rieger; Steven Flanagan; Jacob I McPherson; Kenneth Shubin-Stein; Ghazala T Saleem; Louis Corsaro; Barry Willer Journal: Curr Neurol Neurosci Rep Date: 2021-11-24 Impact factor: 5.081
Authors: Andrea M Aegerter; Manja Deforth; Venerina Johnston; Markus J Ernst; Thomas Volken; Hannu Luomajoki; Beatrice Brunner; Julia Dratva; Gisela Sjøgaard; Achim Elfering; Markus Melloh Journal: BMC Musculoskelet Disord Date: 2020-06-19 Impact factor: 2.362
Authors: Kerstin Luedtke; Annika Basener; Stephanie Bedei; Rene Castien; Aleksander Chaibi; Deborah Falla; Cesar Fernández-de-Las-Peñas; Mirja Gustafsson; Toby Hall; Gwen Jull; Peter Kropp; Bjarne K Madsen; Benjamin Schaefer; Elizabeth Seng; Claudia Steen; Peter Tuchin; Harry von Piekartz; Bettina Wollesen Journal: BMJ Open Date: 2020-02-12 Impact factor: 2.692