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Table 2 - Summary table of levels of evidence [181] and grades of recommendations of manual therapies for primary headaches

From: Assessing and treating primary headaches and cranio-facial pain in patients undergoing rehabilitation for neurological diseases

Type of manual therapies

Levels of evidence

Grades of recommendations

Chiropractic therapy

1-

C

Osteopathic Manipulative Treatment

1+

B

Myofascial technique

2-

D

Multimodal Approach

2-

D

  1. Legend for Levels of evidence
  2. 1++ High quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias
  3. 1+ Well-conducted meta-analyses, systematic reviews, or RCTs with a low risk of bias
  4. 1- Meta-analyses, systematic reviews, or RCTs with a high risk of bias
  5. 2++ High quality systematic reviews of case control or cohort or studies; high quality case control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is causal
  6. 2+ Well-conducted case control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is causal
  7. 2- Case control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not causal
  8. 3 Non-analytic studies, e.g., case reports, case series
  9. 4 Expert opinion
  10. Legend for Grades of recommendations
  11. A: At least one meta-analysis, systematic review, or RCT rated as 1++, and directly applicable to the target population; or a body of evidence consisting principally of studies rated as 1+, directly applicable to the target population, and demonstrating overall consistency of results
  12. B: A body of evidence including studies rated as 2++, directly applicable to the target population, and demonstrating overall consistency of results; or extrapolated evidence from studies rated as1++ or 1 +
  13. C: A body of evidence including studies rated as 2+, directly applicable to the target population and demonstrating overall consistency of results; or extrapolated evidence from studies rated as 2++
  14. D: evidence level 3or4; or extrapolated evidence from studies rated as 2 +
  15. GPP: recommended best practice based on the clinical experience of the guideline development group
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The Journal of Headache and Pain

ISSN: 1129-2377

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