Cervicogenic Headache
Conditions
Keywords
Instrument Assisted Soft Tissue Mobilization, mulligan therapy
Brief summary
this study will be conducted to investigate the impact of adding Instrument assisted soft tissue mobilization technique to mulligan therapy in patients with cervicogenic headache
Detailed description
Cervicogenic headache (CGH) has seen a notable rise in prevalence in recent years, substantially impairing patients' daily functioning and occupational productivity. Despite its considerable burden, CGH remains frequently underdiagnosed and inadequately managed, often progressing to a chronic state that heightens the risk of work absenteeism and long-term disability and as the most common type of pain disorders, affecting 66% of the global population, represent a major public health concern due to their detrimental impact on quality of life and economic productivity . Epidemiological data indicate that CGH affects 4.1% of the general population, with prevalence escalating to 17.5% among individuals with severe headaches.Instrument Assisted Soft Tissue Mobilization using Graston (GT®) tool is regarded as one the most advanced and promising methods ,utilizing a specially designed instrument to adress a variety of soft tissue pathologies such as myofascial adhesions , scar tissue restriction , tissue thickenings, ridges, fibrotic nodules, crystalline deposits . this technique works by generating a mobilizing effect ,which contributes to pain reduction ,enhanced range of motion and improved overall function.The Mulligan manual technique is considered one of the most effective forms of manipulations. In contrast to conventional mobilization, which depends entirely on the therapist, Mulligan proposed that applying pressure to the spinous processes while the patient is in a weight-bearing position would cause the facet joints to glide in a coordinated ,parallel direction . simultaneously ,this approach involve the patient's active participation during movemwnt in order to achieve the perfect therapeutic outcomes
Interventions
OTHERinstrumeted assissted soft tissue mobilization and mulligan therapy
the patients will receive IASTM tools over the length of targeted muscles (descending fiber of trapezius, suboccipitalis muscles ) for 5 minutes. also, SNAG technique; Each patient will be asked to sit comfortably, and the treating therapist will stand beside the patient. The patient's head will be free and cradled between the therapist's right forearm and body, and the therapist stand at the patient's right side. The therapist then will place his right index, middle, and ring fingers at the base of the occiput and kept his right little finger over the spinous process of C2. Next, with the lateral border of his left thenar eminence, gentle pressure will be applied in a ventral and upward direction(45 degrees) over the right little finger. finally postural correction execises
OTHERmulligan therapy
SNAG technique; Each patient will be asked to sit comfortably, and the treating therapist will stand beside the patient. The patient's head will be free and cradled between the therapist's right forearm and body, and the therapist stand at the patient's right side. The therapist then will place his right index, middle, and ring fingers at the base of the occiput and kept his right little finger over the spinous process of C2. Next, with the lateral border of his left thenar eminence, gentle pressure will be applied in a ventral and upward direction(45 degrees) over the right little finger. Finally, postural correction exercises will be addedd
the exercises will incluse, Stretching exercises for the sternocleidomastoids,the Scalenes,upper fibers of trapezius and strengthening exercises for cervical muscles
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
instrument-assisted soft tissue mobilization, Mulligan therapy, and postural correction exercises
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
-Unilateral CGH presentation * Age group above 18 years' old * History of chronic CGH (\>3 months) * CGH owing to cervical spine (neck) dysfunction * Reduced cervical motion * Neck stiffness and movement restriction
Exclusion criteria
* Participants with other types of headache (migraine headache) * Headache owing to other causes (sinus, tumor, neural, and tempero-mandibular joint issues) * Any contraindications to manual and manipulative therapy (fracture, instability, osteoporosis and neural symptoms) * Taking analgesics or corticosteroids and migraine-specific medications, such as triptans * Metastasis * Cardiac conditions (stroke and syncope) * Neurological conditions (radiculopathy, myelopathy)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| neck disability | up to 6 weeks | Assessment of neck function was performed by Arabic neck disability index. It is a valid and reliable tool in the assessment of neck function. It contains ten category/classes. Each category contains six choices (zero-five).Score from zero to four no disability, from five to 15 this is mild, From 15 to 24 this is moderate, from 25 to 34 this is severe, more than 34 this is a complete disability |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| pain intensity | up to 6 weeks | The scale will be used is the VAS, which consists of a line, usually 10 cm long, ranging from no pain or discomfort (zero) , to the worst pain that could possibly feel (10) |
| cervical range of motion | up to six weeks | The CROM device will be used to assess cervical range of motion. it is headmounted equipment consists of a plastic frame placed on the head over the nose and the ears, secured by a Velcro strap. Two independent inclinometers, 1 in the sagittal plane and 1 in the frontal plane, are attached to the frame and indicate the position of the head with respect to the line of gravity. A third inclinometer is positioned in the horizontal plane and indicates the position of the head in rotation, with respect to a reference position |
| muscle stiffness | up to six weeks | The MyotonPRO (Myoton AS, Tallinn, Estonia) is a recently introduced device that can objectively measure the mechanical properties of muscles including analyzing muccsle stiffness (N/m). The measurement procedure involved pressing the device against the skin, with a force of 0.18 N and instantly applying an impulse of 0.4 N for duration of 15 ms. The skin surface oscillation induced by the\\ MyotonPRO was measured |
| headache frequency | up to six weeks | the number of days the subjects experienced headaches (frequency) |
| headache duration | up to six weeks | the total number of hours they experienced headaches (duration) |
| medication intake | up to 6 weeks | The frequency with which they used painkillers (medication intake) for their headaches were also noted |
Contacts
CONTACTdoaa youssef, master
Outcome results
None listed