Deep Neck Flexors Training Versus Muscle Energy Technique on Cervicogenic Headache

Cervicogenic Headache Clinical Trial

Official title:

Effects of Deep Neck Flexors Training Versus Muscle Energy Technique on Cervicogenic Headache

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05754931
• Other study ID #: Hirah Naseem
• Status: Completed
• Phase: N/A
• Start date: March 15, 2023
• Est. completion date: September 15, 2023

Study information

• Verified date: March 2024
• Source: Riphah International University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Aim of this study is to compare the effects of deep neck flexors stretching versus muscles energy technique on pain, cervical range of motion, sleep disturbance and cervical spine posture in patients with Cervicogenic headache and interpret which technique is better among both.A randomized control trial that will include total 28 participants.The first group will receive deep neck flexors stretching along with conventional therapy and 2nd group will receive muscles energy technique along with conventional therapy.Data collected will be analyzed through SPSS 25.

Description:

Cervicogenic headache is a disabling condition associated with musculoskeletal impairment of the cervical region.Cervicogenic headache is a clinical syndrome characterized by primarily unilateral pain that originates in the neck, typically provoked by neck movement or pressure over tender points in the neck, with reduced range of movement of the cervical spine.Cervicogenic Headache is pain referred to the head from a source in the cervical spine. It can influence the patient's quality of life in addition to a loss of functions when compared with the groups with other headache disorders.

A variety of invasive and noninvasive therapeutic modalities are used in the treatment of cervicogenic headache.Physical therapy is considered as most effective treatment of cervicogenic headache including modalities, manual therapy, muscle stretching, Muscle Energy Techniques, deep neck flexors training, Instrument-Assisted Soft Tissue Mobilization , therapeutic exercises and kinesiology tapping.Deep cervical flexor exercise is a low-load exercise focused on deep cervical flexor muscles, as described by Jull et al. This exercise targets the deep flexor muscles of the cervical region, rather than the superficial flexor muscles. Deep neck flexor training is said to improve the Cervicogenic headache according to the literature review.

According to the Literature review, in cervicogenic headache 2 group of muscles are involved i.e. deep cervical flexors (longus colli, longus capitis, Rectus capitis and Longus capitus) gets weakened and cervical extensors (suboccipital and upper trapezius) gets tightened. It is evident that deep neck flexor training is effective in improving pain, cervical range of motion and posture in Cervicogenic headache. Muscle Energy techniques are also proven to reduce pain and improve range of motion so post isometric relaxation will use in this study. Limited literature is available which compares the effects of post isometric relaxation deep neck flexors and specifically on Cervicogenic headaches. Aim of this study is to compare the effects of these techniques on pain, cervical range of motion, sleep disturbance and cervical spine posture in patients with Cervicogenic headache and interpret which technique is better among both. I hope that this study will add valuable literature and scope for future researchers to work on this topic.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 28
• Est. completion date: September 15, 2023
• Est. primary completion date: August 15, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 55 Years

Eligibility

Inclusion Criteria:

• Subjects aged 18 - 55 years.

• Both male and female subjects will be recruited in the study.

• Unilateral headache (without side shift) related by pain, movement and sustaining

• position of neck started from the occiput spread to the tempro-frontal region for more than 3 months

• >20 degree movement restriction in cervical ROM, especially in the upper cervical rotation.

• Positive flexion rotation test to confirm Cervicogenic headache.

• Subjects with rounded shoulders having distance between on the table and the acromion>2.5 cm

Exclusion Criteria:

• Fracture or previous surgery on vertebral column

• History of spinal stenosis or disc prolapse

• dysfunction or headache with autonomic involvement

• Other types of headache including migraine, tension type etc.

• laxity of alar ligaments

• vertebra basilar artery insufficiency

• Patients with a history of physiotherapy at least 3 months prior to the study.

Related Conditions & MeSH terms

• Cervicogenic Headache
• Headache
• Post-Traumatic Headache

Intervention

Other:
• Deep neck flexors training + Conventional therapy
Hold for 10 sec and repeated 10 times.Patients will be treated 3 times a week for 4 consecutive weeks
• Muscles energy techniques + conventional therapy
position of patient is in maximal comfort and lengthening After engaging the barrier use of an isometric contraction Feel the release and lengthen the muscle repeated for 4 time per session Patients will be treated 3 times a week for 4 consecutive weeks

Locations

Country	Name	City	State
Pakistan	Railway General Hospital	Rawalpindi	Punjab

Sponsors (1)

Lead Sponsor	Collaborator
Riphah International University

Country where clinical trial is conducted

Pakistan, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Numeric Pain rating scale	The Numeric Pain Rating Scale (NPRS) measures the subjective intensity of pain.	4 weeks
Secondary	Inclinometer	Measurements of cervical flexion, extension, lateral flexion, and rotation will be measured using inclinometer	4 weeks
Secondary	Cervical posture	For measurement of cervical posture, photographs taken from the side were used for objective measurement of forward head posture	4 weeks
Secondary	Insomnia Severity Index (ISI)	It is a brief self-report questionnaire that measures the patient's perception of insomnia severity	4 weeks