{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:57:38Z","timestamp":1791939458890,"version":"4.3.4"},"reference-count":78,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T00:00:00Z","timestamp":1609977600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Eval Health Prof"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>A number of hands-off therapies have been widely reported and are used in the management of headache. This systematic review and meta-analysis aimed to assess evidence supporting these therapies on selected headache outcomes. A systematic literature search for randomized clinical trials reporting on the effects of hands-off therapies for headache was performed in two electronic databases; PubMed and Web of Science (PROSPERO: CRD42018093559). Risk of bias was assessed using the Cochrane risk of bias tool. Meta-analysis was performed using Review Manager v5.4. Thirty-five studies, including 3,403 patients with migraine, tension-type or chronic headaches were included in the review. Methodological quality of the studies ranged from poor to good. Result-synthesis revealed weak to moderate evidence for aerobic exercises, relaxation training and pain education for reducing disability. Other hands-off interventions were either weak or limited in evidence. Meta-analysis of 22 studies indicated that the effect of hands-off therapies significantly differed from one another for pain intensity, disability and quality of life (p &lt; 0.05). Relaxation training, aerobic and active\/stretching exercises had significant effect on pain intensity and disability (p &lt; 0.05). To conclude, few hands-off therapies were effective on selected headache outcomes. Evidence to support other hands-off therapies is limited by paucity of studies.<\/jats:p>","DOI":"10.1177\/0163278720983408","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T18:55:01Z","timestamp":1610564101000},"page":"183-203","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Effectiveness of Hands-Off Therapy in the Management of Primary Headache: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3965-0759","authenticated-orcid":false,"given":"Naziru Bashir","family":"Mukhtar","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences, Ghent University, Belgium"},{"name":"Department of Physiotherapy, Bayero University Kano, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mira","family":"Meeus","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, Ghent University, Belgium"},{"name":"Pain in Motion International Research group, Belgium"},{"name":"Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ceren","family":"Gursen","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Hacettepe University, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jibril","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Bayero University Kano, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robby","family":"De Pauw","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, Ghent University, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Cagnie","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, Ghent University, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,1,7]]},"reference":[{"key":"bibr1-0163278720983408","doi-asserted-by":"publisher","DOI":"10.1093\/ecam\/nel050"},{"key":"bibr2-0163278720983408","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-6712.2011.00926.x"},{"issue":"5","key":"bibr3-0163278720983408","first-page":"18","volume":"9","author":"Aghaei Chadegani A.","year":"2013","journal-title":"Asian Social Science"},{"key":"bibr4-0163278720983408","doi-asserted-by":"publisher","DOI":"10.1017\/S1463423619000720"},{"key":"bibr5-0163278720983408","doi-asserted-by":"publisher","DOI":"10.1016\/j.nrleng.2016.06.007"},{"key":"bibr6-0163278720983408","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.2003.03070.x"},{"key":"bibr7-0163278720983408","doi-asserted-by":"publisher","DOI":"10.1111\/head.12204"},{"key":"bibr8-0163278720983408","doi-asserted-by":"publisher","DOI":"10.5539\/gjhs.v8n4p142"},{"key":"bibr9-0163278720983408","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318195b257"},{"key":"bibr10-0163278720983408","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001435"},{"issue":"8","key":"bibr11-0163278720983408","first-page":"900","volume":"64","author":"Bhombal S. 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