Manual Techniques in Cervicogenic Headache

August 23, 2021 updated by: Riphah International University

Comparison of Deep Friction Massage and Post Isometric Relaxation Technique in Cervicogenic Headache

This project will explore the effect of deep friction massage and post isometric relaxation techniques in Cervicogenic headache. The population sample will be 20 divided randomly into two groups by Lottery method. Then i will collect data from central hospital, Gujranwala. One group will be treated with a deep friction massage technique thrice a week for 3 weeks. Another group will be treated with a post isometric relaxation technique thrice a week for 3 weeks. Both groups will receive a heating pad and neck isometric as baseline treatment. Baseline measurements are taken by an inclinometer. After a treatment plan, the group will be assessed again and post-treatment measured values will be compared with the pretest values. Subjects will be asked to come for follow-up after 4 weeks. The follow-up will show which technique is more effective in subjects having Cervicogenic headaches. Both the techniques used are non-invasive and having minimum side effects. This project will help Physical Therapy Practitioner to explore which technique is more useful to treat Cervicogenic headaches.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Cervicogenic headache is a relatively common and still controversial form of headache arising from structures in the neck. In patients with this disorder, attacks or chronic fluctuating periods of neck/head pain may be provoked by the sustained neck. The International Headache Society (IHS), 2013 defined Cervicogenic Headache (CGH) as a secondary headache, which implies that headache is caused by a disorder of the cervical spine and its components bony, disc, and soft tissue elements. CGH can be a perplexing pain disorder that is refractory to treatment if it is perceived. Patients with CGH exhibited decreases in the quality of life comparable to migraine patients and patients with tension-type headaches, with even lower scores for physical functioning.

.Headache is a common disorder affecting up to 66% of the general population. headache negatively influences both quality of life and labor productivity.Cervicogenic headache is one of the common types of headache accounting for 0.4-15% of the headache population.

we distinguished it from other types of headaches, such as a migraine, that may present with some common symptoms. The International Headache Society (IHS) classified CGH as a secondary headache arising from musculoskeletal disorders in the cervical spine. The complicated convergence of cervical afferents with trigeminal afferents in the trigemino-cervical complex is intended as the physiologic basis of a headache arising from cervical structures.

The aim of friction massage is to take care of the quality at intervals the soft tissue structures of ligament, tendon, and muscle and stop adherent scars from forming. The massage is deep and should be applied transversally to the precise tissue concerned in contrast to the superficial massage given within the longitudinal direction parallel to the vessels which boosts circulation and come of fluid. Profound cervical flexor (DCF) has a noteworthy postural capacity in supporting and rectifying the cervical lordosis. It has been discovered that specific muscles in the cervical spine have a tendency to debilitate , the most widely recognized of these being the DCF.

MET is a treatment technique that includes a willful constriction of a subject's muscle in a correctly controlled bearing, against a counterforce that is given by the specialist. MET is utilized to diminish the pain, extend the tight muscles and belts, decrease muscle tone, enhances nearby flow, strengthen the feeble musculature, and mobilizes the joint restrictions. MET increases the extensibility of muscles and spinal range of motion, treating patients with reduced mobility. Extending includes the use of manual or mechanical power to prolong/protract the structures that are adaptively been abbreviated and are hypomobile.

Post-isometric relaxation (PIR) may be a technique typically employed by manual therapists for treating muscle tension and joint pathology in myofascial pain syndromes There is a lack of evidence demonstrating the efficacy of deep friction massage therapy in the management of cervicogenic headache, particularly targeting cervical muscle tightness related to Cervicogenic headache. The purpose of this study is to compare the effect of soft tissue massage with MET to access which technique has a greater clinical impact than others in improving cervicogenic headache.

Study Type

Interventional

Enrollment (Actual)

20

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab
      • Gujrānwāla, Punjab, Pakistan, 54560
        • Central Hospital Gujranwala

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

14 years to 56 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Both genders.
  • Symptoms duration more than 6 months.
  • Age 18 -60
  • Patient has confirmed the diagnosis of cervicogenic headache

Exclusion Criteria:

  • Rule out cervical malignancy
  • infection (such as osteomyelitis or diskitis)
  • osteoporosis, inflammatory arthritis.
  • fracture, pregnancy
  • cord compression, uncontrolled hypertension
  • cardiovascular disease
  • in the setting of carotid or vertebral artery disease.
  • Trauma cases

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Deep Neck Flexor Massage
INTERVENTIONAL GROUP(DEEP Neck FLEXOR MASSAGE)
Other: Deep Neck Flexor Massage
Deep friction massage is a specific connective tissue massage that was given across the affected fibers.The therapist's fingers and patient's skin must move as one, otherwise moving subcutaneous fascia against muscle or ligament could lead to blister formation or subcutaneous bruising.The friction massage must have sufficient sweep and be deep enough.
Active Comparator: Post-Isometric Relaxation Technique
CONTROL GROUP (POST-ISOMETRIC RELAXATION TECHNIQUE)
Other: Post-Isometric Relaxation Technique
The PIR technique is performed as follows.The hypertonic muscle is taken to a length just short of pain, or to the point where resistance to movement is first noted.A submaximal (10-20%) contraction of the hypertonic muscle is performed away from the barrier for between 5 and 10 seconds and the therapist applies resistance in the opposite direction . The patient should inhale during this effort.After the isometric contraction the patient is asked to relax and exhale while doing so.Following this a gentle stretch is applied to take up the slack till the new barrier.Starting from this new barrier, the procedure is repeated two or three times.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Headache disability index
Time Frame: 3 week

This scale is used to identify difficulties that you may be experiencing because of your headache. Please check off "YES", "SOMETIMES", or "NO" to each item. Proforma consist of 25 question

Scoring The following responses are given the following values:

Response Points Yes 4 Sometimes 2 No 0 Interpretation A 29 point change (95% confidence interval) or greater in the total score from test to retest must occur before the change can be attributed to treatment effects.
3 week

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Upper cervical spine(ROM)
Time Frame: 3 weeks
standard technique for measuring cervical spine motions in different rotations, including sagittal, frontal, transversal, and rotational
3 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Muhammad Sana ullah, MS, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 10, 2021

Primary Completion (Actual)

August 10, 2021

Study Completion (Actual)

August 10, 2021

Study Registration Dates

First Submitted

July 6, 2021

First Submitted That Met QC Criteria

July 6, 2021

First Posted (Actual)

July 8, 2021

Study Record Updates

Last Update Posted (Actual)

August 24, 2021

Last Update Submitted That Met QC Criteria

August 23, 2021

Last Verified

August 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/Lhr/20/0111/Bushra

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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