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Table 1 Identified randomised controlled trials (RCTs) for non-pharmacological treatments for tension-type headache. Studies were found in existing guidelines and systematic reviews, or via a search for individual RCTs

From: Manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture and patient education for patients with tension-type headache. A systematic review and meta-analysis

Non-pharmacological treatment

Number of RCTs identified

Intervention

Comparison

Outcomes assessed in the studies

Manual joint mobilisation techniques

6 (Ajimsha et al. [31]); Castien et al. [32]; Espi-Lopez et al. 2014a [33]; Espi-Lopez et al. 2014b [34]; Espi-Lopez et al. 2016 [35]; Rolle et al. [36])

Direct myofascial release technique (Ajimsha et al.), manual therapy (Castien et al.), osteopathic manual therapy (Rolle et al.), suboccipital muscle manipulation (Espi-Lopez 2014a, 2014b, 2016).

Sham intervention (Ajimsha et al.; Rolle et al.), treatment as usual (Castien et al.), no treatment (Espi-Lopez 2014a, 2014b, 2016).

• Headache frequency (at the end of treatment and at follow-up)

• Quality of life (at the end of treatment and at follow-up)

• Headache intensity

• Serious adverse events

Supervised physical activity

2 (Alvarez-Melcon et al .[37]; Andersen et al. [38])

Training program for the neck and relaxation (Alvarez-Melcon et al.) and training of neck and shoulder using an elastic band (Andersen et al.).

Relaxation (Alvarez-Melcon et al.) and weekly information on health (Andersen et al).

• Headache frequency (at the end of treatment and at follow-up)

• Headache intensity

• The use of attack-medicine/analgesics

Psychological treatment

3 (Cathcart et al. [39]; Holroyd et al. [40]; Omidi et al. [41])

Mindfulness-based therapy (Cathcart et al.), cognitive behavioural stress management (Holroyd et al.) and mindfulness-based stress reduction (Omidi et al.).

Waiting list (Cathcart et al.), placebo (Holroyd et al.) and medical treatment as usual (Omidi et al.).

• Headache frequency

• Stress symptoms

Acupuncture

1 (Jena et al. [42])

Acupuncture

No treatment

• Quality of life

• Number of days with migraine

• Serious adverse events

Patient education

None identified