Tension-Type Headache
Conditions
Keywords
Tension-Type Headache, Mulligan Mobilizations, Active release technique, cervical spine, manual therapy
Brief summary
Tension-type headaches, characterized by a dull, aching head pain, are one of the most prevalent forms of headache disorders worldwide. Although they are typically not associated with severe disability or neurological symptoms, they can significantly impact an individual's quality of life due to chronic pain and discomfort. Non-pharmacological interventions, such as manual therapy techniques, have gained prominence in headache management, offering potential relief and functional improvements for patients. This study aims to investigate the comparative effectiveness of two widely used manual therapy approaches, Mulligan mobilization and Active Release Technique (ART), in alleviating pain, reducing disability, and enhancing range of motion (ROM) in patients suffering from tension-type headaches. Understanding which technique offers superior outcomes is vital for optimizing headache management strategies.
Detailed description
This randomized controlled trial (RCT) will recruit adult participants diagnosed with tension-type headaches according to standardized criteria. Eligible individuals will be randomly assigned to one of three groups: The Mulligan mobilization group, the ART group, and the control group. Each group will undergo a specific manual therapy intervention protocol administered by trained therapists. The primary outcome measures will include assessments of pain intensity via VAS, disability levels via Headache disability index (HDI), Stress levels will be assessed by PSS (Perceived Stress Scale), and ROM of the cervical spine by using the Flexion rotation test. Secondary outcomes will encompass patient-reported measures of headache frequency, medication usage, and overall quality of life. Data will be collected at baseline, immediately post-intervention, and at follow-up intervals. Statistical analyses will be conducted to assess and compare the effects of the two interventions on the primary and secondary outcomes using ANOVA from SPSS software, thereby addressing the research question regarding their relative efficacy. This study holds the potential to enhance the evidence base for non-pharmacological headache management and guide clinicians and patients toward more effective treatment choices.
Interventions
OTHERMulligan mobilizations
The duration of the intervention will be 4 weeks, 3 sessions a week, a total of 12 sessions will be given to the study participants. Each session will last for 30 minutes. Conventional physical therapy will be given to participants along with Mulligan mobilizations.
OTHERActive Release Technique
The duration of the intervention will be 4 weeks, 3 sessions a week, a total of 12 sessions will be given to the study participants. Each session will last for 30 minutes. Conventional physical therapy will be given to participants along with the Active release technique.
OTHERMulligan mobilizations with active release technique
The duration of intervention will be 4 weeks, 3 sessions a week, a total of 12 sessions will be given to the study participants. Each session will last for 30 minutes. Conventional physical therapy will be given to participants along with mulligan mobilizations with active release technique.
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Blinding refers to a practice where study participants are prevented from knowing certain information that may somehow influence them-thereby tainting the results.
Intervention model description
Participants are assigned to one of the treatment arms at the beginning of the trial and continue in that arm throughout the length of the trial.
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Individuals aged 18-35 years. * Diagnosis of chronic tension-type headache according to the International Classification of --Headache Disorders (ICHD-3) criteria. * Baseline HDI from 10 and above, and NPRS score 3 and above. * No prior exposure to any of the two interventions (ART and Mulligan Mobilization).
Exclusion criteria
* All other types of headaches. * Individuals taking medications for headaches. * Serious neurological or medical conditions that could affect the study outcomes. * History of psychiatric disorders. * Recent head or neck trauma or surgery. * Contraindications for any of the two interventions. * Participation in other headache management studies during the study period.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain: Numeric Pain Rating Scale(NPRS) | 4th week | Changes from baseline Numeric pain rating scale is The 11-point scale used to capture the patient's level of pain. The scale is anchored on the left with the phrase ''no pain'' and on the right with the phrase ''worst imaginable pain.'' Patients rate their current level of pain and their worst and least amount of pain in the last 24 hours. Numeric pain scales have been shown to be reliable and valid with validity range from 0.86 to 0.95 and high test-retest reliability r=0.96. |
| Range of motion Cervical(Rotation) | 4th week | Changes from the baseline ROM range of motion of cervical rotation will be taken with the help of a universal goniometer. |
| Range of motion Cervical(Side bending) | 4th week | Changes from the baseline ROM range of motion of cervical side bending will be taken with the help of a universal goniometer. |
| Range of motion Cervical(Extension) | 4th week | Changes from the baseline ROM range of motion of cervical extension will be taken with the help of universal goniometer. |
| Disability: Headache Disability Index(HDI) | 4th week | Changes from baseline the Headache Disability Index (HDI) is a valid and reliable questionnaire designed to assess the impact of headaches on daily functioning and activities. It is often used to quantify the level of disability associated with headaches. The HDI consists of 25 items, and each item is scored on a scale from 0 to 6. |
| Range of motion Cervical(Flexion) | 4th week | Changes from the baseline ROM range of motion of cervical flexion will be taken with the help of a universal goniometer. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Stress: Perceived Stress Scale(PSS) | 1st week | Changes from the baseline the Perceived Stress Scale (PSS) is a classic stress assessment instrument. The questions in this scale ask about your feelings and thoughts during the last month. In each case, you will be asked to indicate how often you felt or thought a certain way For each question choose from the following alternatives: 0 - never, 1 - almost never, 2 - sometimes, 3 - fairly often, 4 - very often |
Countries
Pakistan
Contacts
Primary ContactImran Amjad, PhD
Backup ContactImran Amjad, PhD
Outcome results
None listed