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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Effects of Strength Training on Neck Muscle Function and Tenderness in Patients with Chronic Headache: A Secondary Analysis of a Clinical Trial

by
Jordi Padrós-Augé
1,2,*,
Gemma Victoria Espí-López
3,4,*,
Henrik Winther Schytz
5,
Karen Søgaard
6,7,
Rafel Donat-Roca
1,2,
Henrik Baare Olsen
7 and
Bjarne Kjeldgaard Madsen
5
1
Department of Physiotherapy, University of Vic—Central University of Catalonia, Campus UManresa, 08242 Manresa, Spain
2
Sport, Exercise and Human Movement, University of Vic—Central University of Catalonia, 08500 Vic, Spain
3
Exercise Intervention for Health Research Group (EXINH-RG), Faculty of Physiotherapy, University of Valencia, Gasco Oliag St., 5, 46010 Valencia, Spain
4
Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gasco Oliag St., 5, 46010 Valencia, Spain
5
Danish Headache Centre, Department of Neurology, Faculty of Health Sciences, Glostrup Hospital, 2600 Copenhagen, Denmark
6
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark
7
Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(20), 7364; https://doi.org/10.3390/jcm14207364
Submission received: 16 September 2025 / Revised: 9 October 2025 / Accepted: 16 October 2025 / Published: 17 October 2025
(This article belongs to the Special Issue Headache: Updates on the Assessment, Diagnosis and Treatment)
Versions Notes

Abstract

Background/Objectives: This study presents a secondary analysis from a previously published trial on strength training and postural correction in chronic headache patients. Here, we investigate changes in neck muscle function and tenderness, and their relationship with headache symptoms. Methods: A total of 22 headache patients from a single-arm open-label trial were included in this study to assess muscle function and tenderness. The maximum voluntary contraction of neck flexion and extension, shoulder elevation, and craniocervical flexion test were performed at baseline, week eight, and week 14. The extension/flexion ratio of the neck, the rate of force development, and the early rate of force development for shoulder elevation were calculated. Muscle tenderness was analyzed using the total tenderness score (TTS) and correlations between these outcomes and headache changes were explored. Results: After the intervention muscle tenderness significantly decreased (−5.6 ± 6.4; p < 0.001) and significant improvements in muscle function were observed. Correlations of muscle function showed a significant and moderate correlation between TTS and extension/flexion ratio (Spearman rho: 0.567, p = 0.014). Conclusions: The results indicate that strength training and postural correction improve muscle function and reduce pericranial tenderness in patients with chronic headaches. These findings suggest that muscle tenderness and extension/flexion ratio may be useful for monitoring exercise interventions focused on improving the strength and balance of the neck in patients with chronic headaches.
Keywords: chronic headache; migraine; tension-type headache; exercise therapy; strength training; muscle function chronic headache; migraine; tension-type headache; exercise therapy; strength training; muscle function

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MDPI and ACS Style

Padrós-Augé, J.; Espí-López, G.V.; Schytz, H.W.; Søgaard, K.; Donat-Roca, R.; Olsen, H.B.; Madsen, B.K. Effects of Strength Training on Neck Muscle Function and Tenderness in Patients with Chronic Headache: A Secondary Analysis of a Clinical Trial. J. Clin. Med. 2025, 14, 7364. https://doi.org/10.3390/jcm14207364

AMA Style

Padrós-Augé J, Espí-López GV, Schytz HW, Søgaard K, Donat-Roca R, Olsen HB, Madsen BK. Effects of Strength Training on Neck Muscle Function and Tenderness in Patients with Chronic Headache: A Secondary Analysis of a Clinical Trial. Journal of Clinical Medicine. 2025; 14(20):7364. https://doi.org/10.3390/jcm14207364

Chicago/Turabian Style

Padrós-Augé, Jordi, Gemma Victoria Espí-López, Henrik Winther Schytz, Karen Søgaard, Rafel Donat-Roca, Henrik Baare Olsen, and Bjarne Kjeldgaard Madsen. 2025. "Effects of Strength Training on Neck Muscle Function and Tenderness in Patients with Chronic Headache: A Secondary Analysis of a Clinical Trial" Journal of Clinical Medicine 14, no. 20: 7364. https://doi.org/10.3390/jcm14207364

APA Style

Padrós-Augé, J., Espí-López, G. V., Schytz, H. W., Søgaard, K., Donat-Roca, R., Olsen, H. B., & Madsen, B. K. (2025). Effects of Strength Training on Neck Muscle Function and Tenderness in Patients with Chronic Headache: A Secondary Analysis of a Clinical Trial. Journal of Clinical Medicine, 14(20), 7364. https://doi.org/10.3390/jcm14207364

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