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van der Meer H.1,2,3,4, Visscher C.4, Engelbert R.5,6, Mulleners W.7, Nijhuis-van der Sanden M.W.G.2, Speksnijder C.M.2,3
1University of Applied Sciences Amsterdam, Education of Physical Therapy, Amsterdam, Netherlands, 2Radboud UMC, IQ Healthcare, Nijmegen, Netherlands, 3University Medical Center Utrecht, Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, Utrecht, Netherlands, 4VU University Amsterdam, Academic Centre for Dentistry Amsterdam, Department of Oral Health Sciences, Amsterdam, Netherlands, 5Amsterdam University of Applied Sciences, Education of Physical Therapy, Amsterdam, Netherlands, 6University of Amsterdam, Academic Medical Center, Department of Rehabilitation, Amsterdam, Netherlands, 7Canisius Wilhelmina Ziekenhuis, Department of Neurology, Nijmegen, Netherlands
Background: Headache is a common disorder which may lead to substantial socio-economic loss. Treatment options include self-management strategies, medication and physical therapy. Physical therapists need to be able to screen for the presence of migraine and tension-type headache (TTH), so they can adjust their treatment strategies to the type of headache. A quick screening questionnaire to recognize migraine and TTH in the physical therapy practice is needed to enhance diagnostic process.
Purpose: The aim of this study is to create a headache screening questionnaire based on the ICHD-3 criteria for migraine and TTH, and to establish its content-, face- and criterion validity.
Methods: A screening questionnaire was developed for migraine and TTH based on the ICHD-3. The content- and face validity were checked by the research group and a headache research expert. A cross-sectional design was used during the validation phase of the study. For validation of this questionnaire, patients from the headache clinic from the Canisius Wilhelmina Hospital in Nijmegen, the Netherlands were recruited. The outcome of the questionnaire was compared to the ICHD-3 diagnosis of the headache specialist. For criterion validity we calculated sensitivity, specificity, likelihood ratios, and positive- and negative predictive values.
Results: A 10-item questionnaire has been developed: the Headache Screening Questionnaire. For validation of the Dutch version, a total of 105 patients were included in the study. The sensitivity and specificity were 89.1% and 54.0% respectively for probable migraine, and 91.7% and 47.8% respectively for probable TTH.
Conclusion(s): The HSQ-DV can be used as a screening tool for probable migraine and probable TTH due to a high sensitivity. For conformation of the diagnosis, collaboration with a headache specialist is preferred. Future research should establish the validity within the physical therapy practice.
Implications: With this screening questionnaire the physical therapists can use the HSQ-DV within their physical therapy practice to screen for migraine and TTH. When a primary headache is (probably) present, the PT can start treatment using treatable outcome measures for TTH and/or migraine. Also, advice can be given to the patient to contact a headache specialist for complementary diagnostics and treatment.
Funding acknowledgements: This study was funded by the Dutch Organisation for Scientific Research [grant number 023.006.004]. There is no conflict of interest.
Topic: Musculoskeletal
Ethics approval: A medical ethical waiver was obtained from the medical ethics committee at the Radboud university medical center (Radboudumc) of Nijmegen.
All authors, affiliations and abstracts have been published as submitted.
