Assessment, Triage and Physiotherapy Management for Patients with HeadacheS
Headache is a clinical symptom and is one of the most common neurological disorders of the nervous system in the population. It is a painful and disabling manifestation that can be triggered by a primary cause (migraine, tension-type headache, facial vascular pain...) or secondary (vascular, infectious, traumatic, drug...). This symptom is a frequent reason for consultation in general practice or emergency care. Worldwide, the estimated prevalence of headache in adults is about 70% (painful episode felt at least once a year). Although headache varies considerably from one region of the world to another, it is considered a public health issue in terms of disability and financial cost to society. The Global Burden of Disease Study, in 2016 ranks headache as a whole as the 2nd leading cause of years living with the symptom. Headaches impact all dimensions of the patients life (personal and professional) and contribute to strongly modify behaviors such as the constant apprehension of the next painful episode.
Tutor
Dr Anthony Demont is a lecturer at the University Paris Cité, and works as a part-time specialized physiotherapist in the management of patients with chronic pain and headache disorders. He is attached to the Centre of Research in Epidemiology and Statistics (ECAMO team) on various research topics including models of care involving PTs with extended scope of practice, and specifically for patients with chronic disorders such as headache. Anthony has written a number of papers, teaches at a postgraduate level, and made many national and international presentations on these topics. He is a member of the French Society for the Study of Migraine and Headaches Disorders. Anthony is a project manager for the development of clinical guidelines for French National Authority for Health.
ABSTRACT:
Primary headaches (migraine and tension-type headache, among others) are the most prevalent in the population and their diagnosis is based on the subjective criteria from the International Classification of Headache with a normal clinical examination that does not justify additional investigations. Secondary headaches are of multiple etiologies and require diagnostic confirmation based on a clinical examination and, depending on the case, additional explorations (such as brain and cervical CT scans, cerebral magnetic resonance imaging, etc.). Cervicogenic headache, according to international criteria, are to be related to a cervical musculoskeletal disorder with hemicrania +/- associated with neck pain and sometimes dizziness.
The understanding of headache and the pathophysiology of its chronication has evolved in the literature and therefore conditions the use of valid and reliable evaluation to triage the patient towards the most appropriate physiotherapy treatment. Knowledge of pain modulation, evaluation of the factors of headache chronicity and triage of patients based on a multidisciplinary approach (physiotherapy and medication) must be mastered to allow
patients with headache to receive the most appropriate treatment to improve their symptoms, function and health-related quality of life.
Course Outline
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Be able to perform a thorough subjective examination of the patient presenting with a headache and/or facial pain with regard to the criteria of the International Classification of Headache and the international clinical guidelines.
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Be able to triage patients following the initial assessment, and recognize situations where medical advice is required.
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Define the mechanisms of action and the interest of pharmacological treatment interacting with physiotherapy care with regard to the patient.
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Know how to explore the psychosocial factors and carry out an adapted objective examination of the patient in order to formulate clinical hypotheses for treatment planning.
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Apply the most appropriate therapeutic strategies for the patient according to the form of headache that the patient presents.
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Be able to allow the acquisition of self-care skills to patients in order to aim at the empowerment of their management.
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Be able to reassess the characteristics of the patients to define the relevance of the proposed treatment.
Who can attend:
Physiotherapists
Occupational Therapists
Chiropractors
Osteopaths
Medical Doctors