Headache diagnosis and treatment: A pilot knowledge and needs assessment among physical therapists

Author:

Minen Mia T.1,Whetten Christopher1,Messier Danielle2,Mehta Sheena2,Williamson Anne2,Verhaak Allison23ORCID,Grosberg Brian23

Affiliation:

1. Department of Neurology NYU Grossman School of Medicine New York New York USA

2. Hartford HealthCare Headache Center West Hartford Connecticut USA

3. Department of Neurology University of Connecticut School of Medicine Farmington Connecticut USA

Abstract

AbstractObjectiveThe objective of this pilot study was to assess physical therapists’ (PTs) knowledge and needs regarding headache diagnosis and management.BackgroundWhile there is significant research on physical therapy and cervicogenic headache, studies suggest that migraine is often under‐recognized, misdiagnosed, and inadequately treated across society despite its high prevalence and burden. Because migraine commonly includes concurrent neck pain and/or vestibular symptoms, patients with migraine may present to PTs for treatment. Very little is known about PTs' headache and migraine education, knowledge, and clinical practices.MethodsA team of headache specialists and PTs adapted a previously used headache knowledge and needs assessment survey to help ascertain PTs' knowledge and needs regarding headache treatment. The cross‐sectional survey was distributed online via Research Electronic Data Capture (REDCap) to PTs within a large healthcare system in Connecticut.ResultsAn estimated 50.5% (101/200) of PTs invited to complete the survey did so. Only 37.6% (38/101) of respondents reported receiving any formal headache or migraine education in their professional training, leading to knowledge gaps in differentiating and responding to headache subtypes. Only 45.5% (46/101) were able to identify that migraine is characterized by greater pain intensity than tension‐type headache, and 22.8% (23/101) reported not knowing the duration of untreated migraine. When asked about the aspects of care they believe their patients with headache would like to see improved, PTs reported education around prevention and appropriate medication use (61/100 [61.0%]), provider awareness of the degree of disability associated with migraine (51/100 [51.0%]), and diagnostics (47/100 [47.0%]).ConclusionThis sample of PTs from one healthcare system demonstrates knowledge gaps and variations in clinical practice for managing their patients with headache. Future research on integrating additional opportunities for headache education for physical therapists, including evidence‐based behavioral therapies, is needed to ascertain whether it is likely to improve patient care.

Publisher

Wiley

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