Cervicogenic Headache
Conditions
Keywords
integrated neuromuscular inhibition technique, postural correction exercises, cervicogenic headache
Brief summary
this study will be conducted to investigate the impact of adding integrated neuromuscular inhibition technique to postural correction exercises in patients with cervicogenic headache
Detailed description
Cervicogenic headache (CeH) is a secondary headache attributed to dysfunctions of the cervical spine. CGH is a non-throbbing, unilateral, side locked headache that originates in the cervical spine and gradually spreads to the occipital, temporal and orbital areas. It is associated with neck pain or stiffness and is often aggravated by sustained neck postures, repeated neck movements or physical activity. INIT is effective as it causes sustained or intermittent compression which causes ischemia reduces local circulation until pressure is released, after which a flushing of fresh oxygenated blood occurs. Mechanoreceptors impulses interface with slower pain messages reducing amount of pain messges reaching the brain, releasing pain relieving hormones, decreasing myofascial pain. Stretches the taut bands of muscles fibers. INIT along with strengthening excercises proved to be beneficial in decreasing disability improving Range of motion.
Interventions
OTHERIntegrated Neuromuscular Inhibition Technique
Patients will receive integrated neuromuscular inhibition technique in the form of intermittent ischemic compression, strain counterstrain, and muscle energy technique plus postural correction exercises
The exercise program will be in the form of stretching exercises for the sternocleidomastoids (SCM), the scalenes, and upper fibers of trapezius; strengthening isometric exercises for the neck flexors, extensors, lateral flexors, and neck rotators; and postural correction exercises.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
opaque sealed envelope
Intervention model description
integrated neuromuscular inhibition technique and postural correction exercises
Eligibility
Sex/Gender
ALL
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* 20 to 60 years old patient with unilaterally of the head pain * pain triggered by external pressure over the upper cervical joints (c1-c3) * pain elicited by the neck movements, and/or sustained awkward positions with reduced neck ROM * headache intensity pain score of at least 20mm on the Visual analogue scale (VAS) * headache frequency of at least once a week for at least 3 months * minimum neck disability index score of 10 points or greater
Exclusion criteria
* Migraine, tension- type headache, tumor, osteoporosis, fracture, rheumatoid arthritis and metabolic diseases. * Prolonged history of steroid use. * Resting blood pressure greater than 140/90 mmhg. * cervical spinal stenosis, diminished sensation and central nervous system involvement, * previous
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pain intensity | up to six weeks | visual analogue scale will be used to asses pain intensity which patient will be instructed to put point on line from no pain to tolerable pain. The scale consists of a line, usually 100 mm long, ranging from no pain or discomfort (zero) , to the worst pain that could possibly feel . |
| headache disability | up to 6 weeks | The Headache spesific Disability Questionnaire was used to assess headcahe disability. it is a self-administered scale with 9 items that assesses pain intensity, work or school disruptions, and the effect on recreational activities in individuals with headache complaints. Higher scores reflect greater impairment. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| headache frequency | up to six weeks | the number of days the subjects feel headache (headache frequency). |
| pressure pain threshold | up to 6 weeks | pressure pain threshold pressure pain threshold will be assessed by commander algometer |
| headache duration | up to six weeks | the total hours of headache (headache duration). |
| medication intake | up to six weeks | from the patients' diary in the last week , medications intake will be recorded as follow: 1) not at all; 2) once a week; 3) once every couple of days; 4) once or twice a day; or 5) three or more times a day |
| cervical range of motion | up to 6 weeks | range of motion will be measured by inclinometer CROM. The CROM (deluxe version - Performance Attainment Associates, Roseville, MN, USA) measures the cervical range of motion5- for fexion, extension, lateral fexion, and rotation using separate inclinometers. These inclinometers are attached to a frame similar to that for eyeglasses one in the sagittal plane for fexion - extension, second in the frontal plane for lateral fexion and a third in the horizontal plane for rotation. |
Contacts
Primary Contactalshaymaa abd elazeim, phd
Outcome results
None listed