Review article
Manual therapy in adults with tension-type headache: A systematic review
Terapia manual en adultos con cefalea tensional: revisión sistemática
C. Cumplido-Trasmontea, P. Fernández-Gonzálezb,c,
, I.M. Alguacil-Diegob,c, F. Molina-Ruedab,c
Corresponding author
a Centro Ecobody, Fuenlabrada, Madrid, Spain
b Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
c Laboratorio de Análisis del Movimiento, Biomecánica, Ergonomía y Control Motor (LAMBECOM), Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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TTH is the most prevalent primary headache.<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Episodic TTH (ETTH) may become chronic as a consequence of the central sensitisation caused by prolonged nociceptive stimulation in myofascial tissues.<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">2–5</span></a> Some authors believe that peripheral sensitisation is the main cause of ETTH, whereas chronic TTH (CTTH) may be caused by central sensitisation.<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">5,6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The efficacy of manual therapy (MT) in TTH seems evident. Numerous studies have found it to be effective in reducing headache frequency, intensity, and duration, with a positive influence on quality of life, disability, and cervical range of motion.<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">7–15</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">To date, several reviews have been conducted on the use of MT for TTH, the most recent dating from 2016<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">6</span></a>; however, the most recent study included in this review is from 2012. In another review from 2014, all trials included were published prior to 2011.<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">16</span></a> Some studies also include subjects with migraine and neck pain.<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">17</span></a> Another review published in 2015 only included studies comparing MT with pharmacological treatment; furthermore, it only considered pain intensity, frequency, and duration as outcome measures.<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">18</span></a> Another review, published in 2010, studied other pathological entities in addition to TTH, and therefore did not address in detail specific questions on this condition.<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">19</span></a> Finally, several reviews<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">20,21</span></a> have exclusively focused on MT with vertebral manipulation. Therefore, there is a need for an updated systematic review specifically addressing the effects of MT on TTH.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The aim of this systematic review is to assess the effectiveness of non-invasive MT in the treatment of patients with different types of TTH.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Development</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Inclusion and exclusion criteria</span><p id="par0030" class="elsevierStylePara elsevierViewall">We included studies meeting the following criteria: randomised clinical trials (RCT) including participants aged between 18 and 65 years and diagnosed with TTH according to the International Headache Society criteria.<a class="elsevierStyleCrossRefs" href="#bib0470"><span class="elsevierStyleSup">22,23</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">We searched for trials comparing interventions with joint mobilisations or physical therapy,<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,14,24</span></a> vertebral manipulation,<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">9,10,12,13,25</span></a> soft tissue techniques,<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8–10,12,13,15,24,25</span></a> cranial techniques,<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">26</span></a> or neurodynamic techniques<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">15</span></a> to a control group. Regarding outcome measures, we included studies assessing any of the following variables with their main assessment instruments: pain frequency with a headache diary<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,12–15</span></a>; pain intensity with the visual analogue scale,<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,12–15,26</span></a> pressure algometry,<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,15,24</span></a> the Headache Index,<a class="elsevierStyleCrossRefs" href="#bib0480"><span class="elsevierStyleSup">24,26</span></a> and the McGill Pain Questionnaire<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">12</span></a>; disability with the Headache Disability Index (HDI)<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,10,13</span></a>; quality of life with the Short Form-36 Health Survey<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">14</span></a> and the Short Form-12 Health Survey<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">9,25</span></a>; cervical range of motion with the Cervical Range of Motion Device<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,12,13</span></a> and goniometric measurements<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">24</span></a>; impact of headache on daily life with the Headache Impact Test (HIT-6)<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,13,15</span></a>; and such other outcome measures as presence of photophobia<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">10</span></a> or phonophobia,<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">10</span></a> self-perceived improvement,<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">8</span></a> and psychological aspects of pain (Multidimensional Headache Locus of Control).<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">14</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Exclusion criteria were as follows: (1) TTH was associated with some mechanical disorder, such as neck or shoulder pain; (2) patients with other types of headache (migraine, cervicogenic headache, etc.) were included; and (3) study assessed invasive physiotherapy and pharmacological treatment interventions.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Search strategy</span><p id="par0045" class="elsevierStylePara elsevierViewall">The search was conducted from September to November 2016. We selected studies published in English or Spanish between 2000 and 2016. We searched the Brain, PubMed, Web of Science, PEDro, Scopus, CINAHL, and ScienceDirect databases, using the following search strategy: (1) “tension-type headache”; (2) “manual therapy”; and (3) “tension-type headache” AND “manual therapy.”</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Review methodology</span><p id="par0050" class="elsevierStylePara elsevierViewall">Studies were selected on the basis of the title and abstracts obtained in the electronic searches; full texts of potentially relevant studies were reviewed by 2 reviewers. After identifying the articles meeting our inclusion criteria, we assessed their methodological quality with the CASP guidelines<a class="elsevierStyleCrossRefs" href="#bib0495"><span class="elsevierStyleSup">27,28</span></a> for clinical trials; the Oxford scale<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">29</span></a> was used to specify the level of evidence and degree of recommendation. We used the PRISMA guidelines<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">30</span></a> to assess the quality of reviews.</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Description of studies</span><p id="par0055" class="elsevierStylePara elsevierViewall">Of the 84 studies identified, we excluded 38 duplicate studies and 36 studies that did not meet the inclusion criteria (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">2,17,31–41,16,42–62</span></a> Data were extracted from 10 articles (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>):<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0060" class="elsevierStylePara elsevierViewall">Five studies (240 participants) compared suboccipital soft tissue inhibition with articulatory technique and occiput–atlas–axis global manipulation, the combination of both techniques, and a control group.<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">9,10,12,13,25</span></a></p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0065" class="elsevierStylePara elsevierViewall">One study (97 participants) compared soft tissue techniques with neuromobilisations, a combination of both, and placebo superficial massage.<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">15</span></a></p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0070" class="elsevierStylePara elsevierViewall">One study (35 participants) compared soft tissue techniques with Cyriax's vertebral mobilisation.<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">24</span></a></p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0075" class="elsevierStylePara elsevierViewall">One study (81 participants) compared craniocervical flexion exercises with a latex band combined with conventional physiotherapy techniques including massage techniques with frictions; mobilisations based on the Maitland® method and cervical, dorsal, and lumbar-pelvic posture retraining; and a control group undergoing conventional physiotherapy.<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">14</span></a></p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0080" class="elsevierStylePara elsevierViewall">One study (82 participants) compared MT techniques, exercises, and posture retraining to usual care by the general practitioner.<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">8</span></a></p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">-</span><p id="par0085" class="elsevierStylePara elsevierViewall">One study (60 participants) compared the resting supine position to the CV-4 technique and a control group.<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">26</span></a></p></li></ul></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">All studies included participants with TTH, 2 studies included adults with CTTH only,<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,24</span></a> and the remaining studies included both patients with CTTH and patients with ETTH.<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">9,10,12–15,25,26</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Intervention duration was 4 weeks in 7 studies,<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">9,10,12,13,15,24,25</span></a> more than 6 weeks in 2,<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,14</span></a> and only one session in one study.<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">26</span></a> Session duration ranged from 10 to 20<span class="elsevierStyleHsp" style=""></span>minutes in 8 studies,<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">9,10,12–15,25,26</span></a> and 30<span class="elsevierStyleHsp" style=""></span>minutes in 2 studies.<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,24</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">A third assessment to observe long-term effects was only conducted in 3 studies.<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,14,15</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Synthesis of results</span><p id="par0105" class="elsevierStylePara elsevierViewall">The most widely used outcome measures in the studies reviewed were intensity<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,12–15,26</span></a> and frequency<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,12–15</span></a> of TTH. All trials used a headache self-report or diary and the visual analogue scale to measure these variables. Furthermore, several studies also used pressure algometry,<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,15,24</span></a> the Headache Index,<a class="elsevierStyleCrossRefs" href="#bib0480"><span class="elsevierStyleSup">24,26</span></a> and the McGill Pain Questionnaire.<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">12</span></a> All the studies reported significant improvements after the intervention with regard to the control group. Combined therapy with different MT techniques had a larger effect.<a class="elsevierStyleCrossRefs" href="#bib0420"><span class="elsevierStyleSup">12,13,15</span></a> A study based on a craniocervical exercise programme showed a significant, long-lasting reduction in frequency and intensity.<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">14</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Four studies analysed changes in craniocervical range of motion,<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,12,13,24</span></a> with 3 using the CROM device<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,12,13</span></a>; results were better in the groups treated with manipulation techniques.<a class="elsevierStyleCrossRefs" href="#bib0420"><span class="elsevierStyleSup">12,13</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Three studies used the HDI. All treatment groups showed significant improvements in overall HDI scores. Total HDI score showed greater improvements with combined therapy of manipulation techniques plus suboccipital soft tissue inhibition in 2 studies.<a class="elsevierStyleCrossRefs" href="#bib0410"><span class="elsevierStyleSup">10,13</span></a> In one study, improvements only persisted at 8 weeks in the group that received cervical manipulation.<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">13</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Three studies assessed participants’ quality of life using the Short Form-36 Health Survey and its abbreviated version, the Short Form-12 Health Survey (Spanish-language version).<a class="elsevierStyleCrossRefs" href="#bib0675"><span class="elsevierStyleSup">63,64</span></a> One of these focused on quality of life with regard to professional life,<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">25</span></a> using only 4 items from the Short Form-12 Health Survey. The greatest improvement was observed in the group performing craniocervical exercises, posture retraining, and passive mobilisations based on the Maitland® method.<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">14</span></a> Quality of life in the professional domain improved especially in the group undergoing soft tissue techniques.</p><p id="par0125" class="elsevierStylePara elsevierViewall">The HIT-6 was used in 3 trials, obtaining statistically significant improvements over baseline values.<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,13,15</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">With regard to secondary outcome measures, one article analysed the presence of photophobia and phonophobia,<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">10</span></a> reporting improvements in the group receiving combined therapy of soft tissue inhibition plus cervical manipulation. Self-perceived improvement after treatment was assessed in one study; the MT group showed significant long- and short-term improvement.<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">8</span></a> One study<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">14</span></a> analysed the psychological aspects of pain using the Multidimensional Headache Locus of Control scale.<a class="elsevierStyleCrossRefs" href="#bib0685"><span class="elsevierStyleSup">65,66</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Methodological quality</span><p id="par0135" class="elsevierStylePara elsevierViewall">We contacted Espí-López<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">9,10,12,13,25</span></a> and Oliva-Pascual-Vaca<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">15</span></a> to clarify some issues related to the blinding of therapists<a class="elsevierStyleCrossRefs" href="#bib0420"><span class="elsevierStyleSup">12,13</span></a> and the participant selection process<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">9,10,12,13</span></a> in order to assess methodological quality. Only the first author provided the requested information.</p><p id="par0140" class="elsevierStylePara elsevierViewall">All studies scored between 8 and 10 in the CASP guidelines (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). The Oxford scale was used to assess both the level of evidence and the degree of recommendation. All studies were classified with a level of evidence 2B, with the exception of one, which was classified 1B.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">Regarding drop-outs, 2 studies reported no drop-outs<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">9,10</span></a> and there were explained drop-outs in 3<a class="elsevierStyleCrossRefs" href="#bib0420"><span class="elsevierStyleSup">12,13,24</span></a> and unexplained drop-outs in another 3 studies.<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,14,15</span></a> Finally, no mention was made of drop-outs in 2 studies.<a class="elsevierStyleCrossRefs" href="#bib0485"><span class="elsevierStyleSup">25,26</span></a></p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0150" class="elsevierStylePara elsevierViewall">The aim of this systematic review was to assess the effectiveness of MT in patients with TTH by gathering and critically analysing RCTs.</p><p id="par0155" class="elsevierStylePara elsevierViewall">All the studies analysed show positive results in patients receiving physiotherapy with MT. This review only includes patients diagnosed with TTH according to the International Headache Society criteria.</p><p id="par0160" class="elsevierStylePara elsevierViewall">All but one<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">24</span></a> of the studies used an adequate sample size (≥60 participants). However, methodological flaws were present in several studies, justifying cautious interpretation of the results. Firstly, only 3 trials were considered double-blind<a class="elsevierStyleCrossRefs" href="#bib0420"><span class="elsevierStyleSup">12,13,15</span></a>; no blinding is mentioned or only participants were blinded in the remaining studies. Secondly, only one study<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">8</span></a> calculated confidence intervals to determine the precision of the effect on the clinical findings. Another important consideration was the similarity of the groups at the beginning of the study: 2 trials did not describe the groups,<a class="elsevierStyleCrossRefs" href="#bib0485"><span class="elsevierStyleSup">25,26</span></a> which may have led to a confounding effect, for instance sex differences: some authors have found that women present a better response to physiotherapy than do men, and that patients with CTTH respond better than those with ETTH.<a class="elsevierStyleCrossRef" href="#bib0695"><span class="elsevierStyleSup">67</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">In terms of outcome measures, most studies reported improved scores on the visual analogue scale.<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,12–15,26</span></a> All studies assessing headache frequency reported significant improvements. It should be noted that 3 studies analysing the disability caused by TTH showed significant improvements in the HDI, which has good psychometric properties in the study of headache.<a class="elsevierStyleCrossRefs" href="#bib0700"><span class="elsevierStyleSup">68,69</span></a> The Spanish version of the tool<a class="elsevierStyleCrossRef" href="#bib0710"><span class="elsevierStyleSup">70</span></a> was used in one study.<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">13</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall">Quality of life improved significantly with treatments including a craniocervical exercise programme,<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">14</span></a> as reflected in changes in the Short Form-36 Health Survey score.<a class="elsevierStyleCrossRef" href="#bib0715"><span class="elsevierStyleSup">71</span></a> Significant improvements were also observed in the HIT-6 (which assesses the impact of headache on the patient's work or daily activities)<a class="elsevierStyleCrossRef" href="#bib0720"><span class="elsevierStyleSup">72</span></a> in the 3 studies that used it.<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,13,15</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">We established the presence of photophobia and phonophobia as secondary outcome measures, given the importance of assessing these symptoms; however, only one study included them.<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">12</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">After analysing the experimental protocols used in the studies, we can conclude that the dose of MT was very heterogeneous. Treatment duration in all studies ranged from 10 to 30<span class="elsevierStyleHsp" style=""></span>minutes for 4–6 weeks. Other systematic reviews recommend sessions of 30–45<span class="elsevierStyleHsp" style=""></span>minutes every 7–10 days.<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">6</span></a> In most of the studies, follow-up and assessment only consisted of a pre- and post-treatment examination; few studies included a third analysis.<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">8,14,15</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">According to the findings of the studies reviewed, manipulation therapy might be more useful for gaining mobility in the neck, and improving disability indices and pain frequency. Soft tissue treatment achieved a greater improvement in the impact and intensity of pain. Most studies agreed that groups undergoing any combined therapy based on MT showed greater improvements than those receiving the different techniques separately.<a class="elsevierStyleCrossRefs" href="#bib0410"><span class="elsevierStyleSup">10,12,13,15</span></a> Considering the information from the studies analysed, we believe that one effective treatment would consist of the combination of soft tissue techniques and structural techniques, in addition to craniocervical flexion exercises.</p><p id="par0190" class="elsevierStylePara elsevierViewall">In line with previous reviews,<a class="elsevierStyleCrossRefs" href="#bib0390"><span class="elsevierStyleSup">6,16,18–21,48</span></a> the studies analysed report that changes after MT are clinically significant. However, further studies of high methodological quality are needed to demonstrate the effectiveness of MT in improving quality of life and decreasing the disability caused by TTH.</p><p id="par0195" class="elsevierStylePara elsevierViewall">This review presents several limitations. Some can be attributed to the samples used in some studies, since after contacting the lead author, we discovered that 2 studies included the same participants<a class="elsevierStyleCrossRefs" href="#bib0420"><span class="elsevierStyleSup">12,13</span></a>; another 2 studies also used a single sample.<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">9,10</span></a> Furthermore, there may be studies published in other languages, which we have not included.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclusions</span><p id="par0200" class="elsevierStylePara elsevierViewall">Physiotherapy treatment based on MT achieves positive outcomes in pain intensity and frequency, disability, impact of headache, quality of life, and craniocervical range of motion in adults with TTH. Although the results show a clinical improvement, there is no clear evidence that any one technique is superior to another; the combination of both techniques is the most effective treatment.</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflicts of interest</span><p id="par0205" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1572295" "titulo" => "Abstract" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Development" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1416493" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1572294" "titulo" => "Resumen" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Desarrollo" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1416492" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Development" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Inclusion and exclusion criteria" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Search strategy" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Review methodology" ] ] ] 6 => array:3 [ "identificador" => "sec0030" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Description of studies" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Synthesis of results" ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Methodological quality" ] ] ] 7 => array:2 [ "identificador" => "sec0050" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0055" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0060" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-09-26" "fechaAceptado" => "2017-12-01" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1416493" "palabras" => array:5 [ 0 => "Tension-type headache" 1 => "Physiotherapy" 2 => "Rehabilitation" 3 => "Manual therapy" 4 => "Treatment" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1416492" "palabras" => array:5 [ 0 => "Cefalea tensional" 1 => "Fisioterapia" 2 => "Rehabilitación" 3 => "Terapia manual" 4 => "Tratamiento" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tension-type headache is the most common primary headache, with a high prevalence and a considerable socioeconomic impact. Manual physical therapy techniques are widely used in the clinical field to treat the symptoms associated with tension-type headache. This systematic review aims to determine the effectiveness of manual and non-invasive therapies in the treatment of patients with tension-type headache.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Development</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We conducted a systematic review of randomised controlled trials in the following databases: Brain, PubMed, Web of Science, PEDro, Scopus, CINAHL, and Science Direct. Ten randomised controlled trials were included for analysis. According to these studies, manual therapy improves symptoms, increasing patients’ well-being and improving the outcome measures analysed.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusions</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Manual therapy has positive effects on pain intensity, pain frequency, disability, overall impact, quality of life, and craniocervical range of motion in adults with tension-type headache. None of the techniques was found to be superior to the others; combining different techniques seems to be the most effective approach.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Development" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Introducción</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La cefalea tensional es la cefalea primaria más usual, con una prevalencia elevada y unas consecuencias socioeconómicas de gran impacto. Las técnicas de terapia manual, desde la fisioterapia, son muy utilizadas en el abordaje del conjunto de síntomas que puede provocar. El propósito fue realizar una revisión sistemática sobre la efectividad de las terapias manuales y no invasivas en el tratamiento de pacientes que presentan cefalea tensional en sus actuales formas.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Desarrollo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se llevó a cabo una revisión sistemática de la literatura en busca de ensayos controlados y aleatorizados. Se emplearon las siguientes bases de datos: Brain, PubMed, Web of Science, PEDro, Scopus, CINHAL y Science Direct. Se analizaron 10 estudios, todos ellos ensayos controlados y aleatorizados. Según los estudios individuales, la intervención logra mejorar la clínica, aportando bienestar al paciente y mejorando las distintas medidas de resultado analizadas.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusiones</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La terapia manual logra efectos positivos sobre la intensidad y la frecuencia del dolor, la discapacidad, el impacto, la calidad de vida y el rango de movimiento craneocervical en adultos con cefalea tensional. No se encuentra superioridad entre una técnica con respecto a otra, siendo más efectivo el tratamiento combinado de estas.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Desarrollo" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Cumplido-Trasmonte C, Fernández-González P, Alguacil-Diego IM, Molina-Rueda F. Terapia manual en adultos con cefalea tensional: revisión sistemática. Neurología. 2019. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.nrl.2017.12.004">https://doi.org/10.1016/j.nrl.2017.12.004</span></p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2917 "Ancho" => 3034 "Tamanyo" => 420550 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Flow chart showing the article selection process.</p> <p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">MT: manual therapy; RCT: randomised clinical trial; TTH: tension-type headache; WoS: Web of Science.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">CG: control group; CROM: cervical range of movement; CV-4: compression of the fourth ventricle; G1: group 1; G2: group 2; G3: group 3; G4: group 4; HDI: Headache Disability Index; HI: Headache Index; HIT-6: Headache Impact Test; MHLC: Multidimensional Headache Locus of Control; MT: manual therapy; PPT: pressure pain threshold; SF-12: Short Form-12 Health Survey; SF-36: Short Form-36 Health Survey; VAS: visual analogue scale.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Article \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Type of intervention \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Treatment duration \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Outcome measures \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Experimental protocol \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Main results \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hanten et al.<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">26</span></a> (2000) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 groups:G1: CV-4G2: resting supine positionG3: no treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">One session for each group10<span class="elsevierStyleHsp" style=""></span>min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Headache IndexVAS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">G1: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20; G2: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20; G3: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20 (no characteristic differences between groups)Assessment after treatment (immediate effects)No drop-outs reported \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No significant differences between groups at the end of treatment. G1 presented a greater improvement than G2 and G3 (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.05). \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Demirturk et al.<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">24</span></a> (2002) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 groups:G1: superficial heat, connective tissue manipulationG2: superficial heat, massage, and Cyriax's vertebral mobilisation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 sessions, 4 weeks, 30<span class="elsevierStyleHsp" style=""></span>min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Headache diary including frequency, intensity, and HIActive CROMPPT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">G1: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>18; G2: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>17100% womenAssessment after treatment and at one month5 explained drop-outs (both groups with <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Significant improvement in both groups (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.01) and in HI, CROM, and intensity (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>.05). No significant differences between groups. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Van Ettekoven and Lucas<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">14</span></a> (2006) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 groups:CG: conventional physiotherapyCTP: conventional physiotherapy with craniocervical training \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sessions: 20<span class="elsevierStyleHsp" style=""></span>min, 6 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Headache diaryVASSF-36MHLC Scale \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CG: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>42; CT: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>38Drop-out rate of 3.7%Assessment after treatment and at 6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At 6 weeks of follow-up, the CTP group showed a significant improvement in pain frequency (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.0001), intensity (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.001), and duration (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.01); and quality of life (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001). \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Castien et al.<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">8</span></a> (2011) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 groups:MT: combination of mobilisations, exercises, and posture correctionUC: usual care by general practitioner \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 sessions, 30<span class="elsevierStyleHsp" style=""></span>min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Headache diaryVASHDIHIT-6CROM deviceAlgometryNeck flexor muscle enduranceSelf-perceived improvement \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MT: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>41UC: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>41No significant differences between groupsAssessment at 8 and 26 weeks7 participants were lost to follow-up (3 in the MT group and 4 in the UC group) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At 8 weeks:A 50% reduction in headache frequency was observed in 87.5% of patients in the MT group and 27.5% in the UC group. Favourable changes in the remaining variables in the MT group.At 26 weeks:A 50% reduction in headache was observed in 81.6% of the patients in the MT group and 40.5% in the UC group. Smaller but still positive effects in the MT group. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Espí-López and Gómez-Conesa<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">12</span></a> (2014) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 groups:G1: manual therapy: suboccipital soft tissue inhibitionG2: occiput–atlas–axis global manipulationG3: combination of 1 and 2CG: no treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 sessions, 20<span class="elsevierStyleHsp" style=""></span>min, 4 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CROM deviceMcGill Pain QuestionnaireVASHeadache diary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">G1: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20; G2: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>22; G3: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20; CG: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>22Assessment after treatment and at one month. 4 drop-outs (2 in G2 and 2 in CG) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">In the weekly record, G3 showed a significant improvement in frequency until the end of the study. Intensity was reduced in G2 and G3. Neck extension improved in G1 and G2, but improvements did not persist at one month of follow-up. Left lateral neck flexion notably improved in G2; the improvement persisted at one month of follow-up. All treatments improved left and right rotation; these improvements persisted at one month of follow-up in G1 and G2. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Espí-López et al.<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">13</span></a> (2014) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 groups:G1: manual therapy: suboccipital soft tissue inhibitionG2: occiput–atlas–axis global manipulationG3: combination of 1 and 2CG: no treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 sessions, 20<span class="elsevierStyleHsp" style=""></span>min, 4 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HIT-6HDIVASCROM-deviceHeadache diary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">G1: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20; G2: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>22; G3: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20; CG: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>22Assessment after treatment and at one month4 drop-outs (2 in G2 and 2 in CG) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Short-term effects on HIT-6 scores in G2, and in all treatment groups at one month.G2 and G3 showed the greatest improvements in HDI score; all groups, including the CG, showed improvements during follow-up.ROM improved in all 4 groups, but improvements only persisted in the treatment groups.Frequency and intensity showed greater improvements in G2 and G3. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Espí-López et al.<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">10</span></a> (2014) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 groups:G1: manual therapy: suboccipital soft tissue inhibitionG2: occiput–atlas–axis global manipulationG3: combination of 1 and 2CG: no treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 sessions, 20<span class="elsevierStyleHsp" style=""></span>min, 4 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HDIPhotophobiaPhonophobiaPericranial tension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">G1: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19; G2: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19; G3: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19; CG: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19Assessment after treatment and at one monthNo drop-outs reported \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">All 3 treatment groups showed significant differences on the emotional subscale; the greatest effect was observed in G3.G3 showed significant reductions in frequency of pericranial tension, photophobia, and phonophobia; the remaining groups did not show any of these improvements.In all items of the HDI, G3 showed greater improvements than G1 and CG. The best results on the functional scale were observed in G2.In terms of severity, G2 showed greater improvements than G1 and CG. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Monzani et al.<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">25</span></a> (2016) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 groups:G1: manual therapy: suboccipital soft tissue inhibitionG2: occiput–atlas–axis global manipulationG3: combination of 1 and 2CG: no treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 sessions, 20<span class="elsevierStyleHsp" style=""></span>min, 4 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 items of the SF-12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">G1: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20; G2: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20; G3: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20; CG: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20Assessment after treatment and at one monthNo drop-outs reported \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">All treatments showed a great positive impact on the participants’ quality of work life.Treatment with an inhibitory technique lead to higher reported quality of work life in participants with low frequency of work presenteeism; in contrast, manipulative treatment was more effective in improving the quality of work life when the frequency of work presenteeism was high or very high. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Espí-López et al.<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">9</span></a> (2016) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 groups:G1: manual therapy: suboccipital soft tissue inhibitionG2: occiput–atlas–axis global manipulationG3: combination of 1 and 2CG: no treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 sessions, 20<span class="elsevierStyleHsp" style=""></span>min, 4 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SF-12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">G1: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19; G2: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19; G3: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19; CG: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19Assessment after treatment and at one monthNo drop-outs reported \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No changes to quality of life were observed in any group but in G1, which showed a medium-sized effect during follow-up (0.51).All groups but CG showed improvements in bodily pain and social functioning.Vitality showed greater improvement in G3, with an effect size of 0.79.All treatment groups showed improvements in their emotional role.Mental health was significantly improved in G2 after treatment and in G2 and G3 at one month of follow-up. The frequency of feelings of discouragement and depression only improved in G3, in both assessments. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ferragut-Garcías et al.<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">15</span></a> (2017) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 groups:A: placebo superficial massageB: soft tissue techniquesC: neurodynamicsD: combination of B and C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 sessions, 15<span class="elsevierStyleHsp" style=""></span>min, 4 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PPTHeadache diaryVASHIT-6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">A: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>25; B: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>25; C: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>25; <span class="elsevierStyleItalic">D</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>25Assessment after treatment and at one month3 unexplained drop-outs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Intensity and frequency notably improved in all groups but group A (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001). Combined treatment (group D) showed the greatest effect. Group A showed lower values in all outcome measures (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001).HIT-6: decrease of 13.1%, 13.5%, and 16.3% vs baseline in groups B, C, and D, respectively. \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2693806.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Summary of the study results.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">0<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>no; 1<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>yes.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Study \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="6" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">(A) Are the results of the study valid?</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">(B) What were the results?</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">(C) Will the results help me in caring for my patients?</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Total \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clearly defined question \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Random allocation \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All patients considered \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Blinding of patients, assessors, and clinicians \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Similar groups at start of trial \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Groups treated equally \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Effect size \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Precision of estimated effect \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Applicability to the local population \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clinically relevant results \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Justified risks/costs and benefit \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hanten et al.<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">26</span></a> (2000) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9/11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Demirturk et al.<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">24</span></a> (2002) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8/11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Van Ettekoven and Lucas<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">14</span></a> (2006) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8/11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Castien et al.<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">8</span></a> (2011) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10/11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Espí-López and Gómez-Conesa<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">12</span></a> (2014) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10/11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Espí-López et al.<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">13</span></a> (2014) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9/11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Espí-López et al.<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">10</span></a> (2014) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10/11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Monzani et al.<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">25</span></a> (2016) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8/11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 20 | 23 | 43 |
| 2024 October | 208 | 179 | 387 |
| 2024 September | 141 | 183 | 324 |
| 2024 August | 106 | 202 | 308 |
| 2024 July | 121 | 107 | 228 |
| 2024 June | 165 | 128 | 293 |
| 2024 May | 162 | 201 | 363 |
| 2024 April | 119 | 138 | 257 |
| 2024 March | 200 | 155 | 355 |
| 2024 February | 156 | 122 | 278 |
| 2024 January | 216 | 125 | 341 |
| 2023 December | 239 | 167 | 406 |
| 2023 November | 289 | 338 | 627 |
| 2023 October | 310 | 254 | 564 |
| 2023 September | 212 | 163 | 375 |
| 2023 August | 228 | 152 | 380 |
| 2023 July | 202 | 138 | 340 |
| 2023 June | 178 | 140 | 318 |
| 2023 May | 312 | 226 | 538 |
| 2023 April | 266 | 174 | 440 |
| 2023 March | 258 | 244 | 502 |
| 2023 February | 135 | 173 | 308 |
| 2023 January | 107 | 145 | 252 |
| 2022 December | 79 | 37 | 116 |
| 2022 November | 100 | 19 | 119 |
| 2022 October | 97 | 27 | 124 |
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| 2022 June | 92 | 50 | 142 |
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| 2022 February | 110 | 19 | 129 |
| 2022 January | 150 | 31 | 181 |
| 2021 December | 66 | 21 | 87 |
| 2021 November | 56 | 22 | 78 |
| 2021 October | 176 | 64 | 240 |
| 2021 September | 209 | 145 | 354 |
| 2021 August | 78 | 16 | 94 |
| 2021 July | 36 | 33 | 69 |
| 2021 June | 28 | 11 | 39 |
| 2021 May | 28 | 48 | 76 |
| 2021 April | 40 | 94 | 134 |
| 2021 March | 45 | 69 | 114 |
| 2021 February | 21 | 38 | 59 |
| 2021 January | 28 | 55 | 83 |
| 2020 December | 32 | 37 | 69 |
| 2020 November | 30 | 48 | 78 |
| 2020 October | 22 | 17 | 39 |
| 2020 September | 40 | 42 | 82 |
| 2020 August | 28 | 50 | 78 |
| 2020 July | 24 | 25 | 49 |
| 2020 June | 21 | 50 | 71 |
| 2020 May | 17 | 48 | 65 |
| 2020 April | 14 | 36 | 50 |
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