Clinical features of manual therapy interventions in people with tension-type headache: A scoping review

Background: Tension-type headache is the most prevalent primary headache, often managed with manual ther apy. However, intervention protocols vary widely, and the clinical rationale is often unclear. Objective: This scoping review aimed to map the characteristics of manual therapy interventions appl...

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Autores: Bravo Vázquez, Ana, Anarte Lazo, Ernesto, Gonzalez Álvarez, M. Elena, Rodríguez Blanco, Cleofás, Bernal Utrera, Carlos
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:dnet:idus________::c4c7853afe823e368f3cb06c52bfeb0e
Acceso en línea:https://hdl.handle.net/11441/186042
https://doi.org/10.1016/j.msksp.2026.103526
Access Level:acceso abierto
Palabra clave:Tension-type headache
Manual therapy
Rehabilitation
Scoping review
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spelling Clinical features of manual therapy interventions in people with tension-type headache: A scoping reviewBravo Vázquez, AnaAnarte Lazo, ErnestoGonzalez Álvarez, M. ElenaRodríguez Blanco, CleofásBernal Utrera, CarlosTension-type headacheManual therapyRehabilitationScoping reviewBackground: Tension-type headache is the most prevalent primary headache, often managed with manual ther apy. However, intervention protocols vary widely, and the clinical rationale is often unclear. Objective: This scoping review aimed to map the characteristics of manual therapy interventions applied in randomized controlled trials for tension-type headache. Methods: A comprehensive search was conducted across PubMed, Embase, Scopus, and Web of Science. The last search was performed on September 14, 2025. The protocol was prospectively registered in the Open Science Framework (OSF registration: https://osf.io/w7xs5). Trials involving manual therapy for adults with tension- type headache were included. Data were extracted on intervention type, dosage, target structures, therapist background, and outcomes. Results: Thirty-three trials involving 1852 participants were included. Manual therapy techniques ranged from spinal manipulation and myofascial release to suboccipital inhibition and friction massage. Treatment dosage varied considerably in frequency and duration. Most studies targeted cervical or suboccipital structures, with few addressing temporomandibular or postural components. Considerable variability was also observed in outcome measures. Conclusion: The review highlights the diversity of manual therapy techniques, targeted structures, treatment dosages, and therapist backgrounds in the management of tension-type headache. The heterogeneity and limited mechanistic rationale in the included studies restrict interpretability. Future research should focus on mechanism-informed, individualized interventions with standardized reporting.ElsevierFisioterapiaCTS954: Innovaciones en Salud y Calidad de Vida2026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/186042https://doi.org/10.1016/j.msksp.2026.103526reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésMusculoskeletal Science and Practice, 82, 103526. https://www.sciencedirect.com/science/article/pii/S246878122600041X?via%3Dihubinfo:eu-repo/semantics/openAccessoai:dnet:idus________::c4c7853afe823e368f3cb06c52bfeb0e2026-06-17T12:51:07Z
dc.title.none.fl_str_mv Clinical features of manual therapy interventions in people with tension-type headache: A scoping review
title Clinical features of manual therapy interventions in people with tension-type headache: A scoping review
spellingShingle Clinical features of manual therapy interventions in people with tension-type headache: A scoping review
Bravo Vázquez, Ana
Tension-type headache
Manual therapy
Rehabilitation
Scoping review
title_short Clinical features of manual therapy interventions in people with tension-type headache: A scoping review
title_full Clinical features of manual therapy interventions in people with tension-type headache: A scoping review
title_fullStr Clinical features of manual therapy interventions in people with tension-type headache: A scoping review
title_full_unstemmed Clinical features of manual therapy interventions in people with tension-type headache: A scoping review
title_sort Clinical features of manual therapy interventions in people with tension-type headache: A scoping review
dc.creator.none.fl_str_mv Bravo Vázquez, Ana
Anarte Lazo, Ernesto
Gonzalez Álvarez, M. Elena
Rodríguez Blanco, Cleofás
Bernal Utrera, Carlos
author Bravo Vázquez, Ana
author_facet Bravo Vázquez, Ana
Anarte Lazo, Ernesto
Gonzalez Álvarez, M. Elena
Rodríguez Blanco, Cleofás
Bernal Utrera, Carlos
author_role author
author2 Anarte Lazo, Ernesto
Gonzalez Álvarez, M. Elena
Rodríguez Blanco, Cleofás
Bernal Utrera, Carlos
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Fisioterapia
CTS954: Innovaciones en Salud y Calidad de Vida
dc.subject.none.fl_str_mv Tension-type headache
Manual therapy
Rehabilitation
Scoping review
topic Tension-type headache
Manual therapy
Rehabilitation
Scoping review
description Background: Tension-type headache is the most prevalent primary headache, often managed with manual ther apy. However, intervention protocols vary widely, and the clinical rationale is often unclear. Objective: This scoping review aimed to map the characteristics of manual therapy interventions applied in randomized controlled trials for tension-type headache. Methods: A comprehensive search was conducted across PubMed, Embase, Scopus, and Web of Science. The last search was performed on September 14, 2025. The protocol was prospectively registered in the Open Science Framework (OSF registration: https://osf.io/w7xs5). Trials involving manual therapy for adults with tension- type headache were included. Data were extracted on intervention type, dosage, target structures, therapist background, and outcomes. Results: Thirty-three trials involving 1852 participants were included. Manual therapy techniques ranged from spinal manipulation and myofascial release to suboccipital inhibition and friction massage. Treatment dosage varied considerably in frequency and duration. Most studies targeted cervical or suboccipital structures, with few addressing temporomandibular or postural components. Considerable variability was also observed in outcome measures. Conclusion: The review highlights the diversity of manual therapy techniques, targeted structures, treatment dosages, and therapist backgrounds in the management of tension-type headache. The heterogeneity and limited mechanistic rationale in the included studies restrict interpretability. Future research should focus on mechanism-informed, individualized interventions with standardized reporting.
publishDate 2026
dc.date.none.fl_str_mv 2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/186042
https://doi.org/10.1016/j.msksp.2026.103526
url https://hdl.handle.net/11441/186042
https://doi.org/10.1016/j.msksp.2026.103526
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Musculoskeletal Science and Practice, 82, 103526.
https://www.sciencedirect.com/science/article/pii/S246878122600041X?via%3Dihub
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
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