Effects of Jones Technique and Cross Friction Massage on Cervicogenic Headache.

Comparative Effects of Jones Technique and Cross Friction Massage on Pain, Range of Motion and Functional Disability in Patients With Cervicogenic Headache.

Cervicogenic headache is a very incessant issue that is often faced by the general population. Cervicogenic headache is a significant issue in patients with upper cervical dysfunction. However, its physical therapy management is a subject of debate. As the Comparative effects of Jones technique and cross-friction massage have never been investigated in patients with cervicogenic headache and neck pain, this study aims to investigate the effects of these treatments on two study groups (Group A&B) respectively.

Study Overview

• Status: Not yet recruiting
• Conditions: Cervicogenic Headache
• Intervention / Treatment: Other: Jones technique; Other: Cross-friction massage

Detailed Description

This study will be a randomized clinical trial and will be conducted in Al-Khidmat Foundation Sahiwal. The study will be completed within the time duration of six months. A nonprobability convenience sampling technique will be used to collect the data. The sample size of 30 patients will be taken in this study, aged 20-to 50 years, will be allocated to two groups, Group A (Jones technique) and Group B (cross friction massage). Strain counter strain technique also known as the Jones technique will be performed with the patient laid supine on the treatment table, taking them to a position of comfort by extending, side-bending, and rotating the head away (ESARA) from the TP until the TP pain has reduced. Continues to monitor, maintaining the patient's position for 90 seconds. After 90 seconds have elapsed, the patient's head should be slowly and passively returned to a neutral position with 3 sessions/week for 6 weeks.

Group B will get cross friction massage for 15-20 minutes. Participants will be treated 3 times per week for 6 weeks. Pre and Post-treatment readings will be taken in 1st session and 6th week respectively. Assessment will be done via a 6-item Headache Impact scale and neck disability index. The Neck Disability Index will be used to examine neck pain intensity and cervicogenic headache symptoms. The 6-item Headache Impact Test scale will be used to examine headache severity and its adverse effects on social life and functions. A goniometer will be used to assess the rotation range of motion.

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Imran Amjad, Phd; Phone Number: 03324390125; Email: imran.amjad@riphah.edu.pk
• Study Contact Backup: Name: Imran Amjad, Phd; Phone Number: 051-5481826; Email: imran.amjad@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab
    • Sahiwal, Punjab, Pakistan, 57000
      • Al-Khidmat foundation Sahiwal.
      • Contact: Hajra Anwer; Phone Number: +92 334 7052438; Email: hajiraanwer@gmail.com
      • Principal Investigator: Hafiza Humna Ahmad, MS-OM

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Headache with neck stiffness and/or pain.
• Headache for the past 3 months at least once per week
• Aged 20-40 years
• Chronic neck pain for more than 3 months
• Baseline NDI score of at least 20% (10 points).
• Forward head posture

Exclusion Criteria

• Headache with neck stiffness and/or pain.
• Headache for the past 3 months at least once per week
• Aged 20-40 years
• Chronic neck pain for more than 3 months
• Baseline NDI score of at least 20% (10 points).
• Forward head posture

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Jones technique; Strain counter strain (Jones technique) will be applied to this group	Other: Jones technique; Strain counter strain technique also known as Jones technique will be performed with the patient lay supine on the treatment table, taking them to a position-of-comfort by extending, side-bending, and rotating the head away (ESARA) from the TP until the TP pain has reduced. Continues to monitor, maintaining the patient's position for 90 seconds. After 90 seconds has elapsed, the patient's head should be slowly and passively returned to a neutral position with 3 sessions/week for 6 weeks. In essence, the TP should be relieved by placing the patient in a position of comfort, holding this position for 90 seconds, and slowly returning the patient to a neutral position.
Active Comparator: Cross-friction massage; Cross-friction massage will be applied to this group.	Other: Cross-friction massage; Group B will get cross friction massage for 15-20 mins. Participants will be treated 3 times per week for 6 weeks. Pre and Post-treatment readings will be taken in 1st session and 6th week respectively.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain: Visual Analogue Scale(VAS)	A Visual Analogue Scale (VAS) is one of the pain rating scales used for the first time in 1921 by Hayes and Patterson. It is often used in epidemiologic and clinical research to measure the intensity or frequency of various symptoms. From the patient's perspective, this spectrum appears continuous; their pain does not take discrete jumps, as a categorization of none, mild, moderate and severe would suggest. It was to capture this idea of an underlying continuum that the VAS was devised.	4th week
Function: Headache Impact Test - HIT-6	The HIT-6 consists of six items: pain, social functioning, role functioning, vitality, cognitive functioning, and psychological distress. The patient answers each of the six related questions using one of the following five responses: "never", "rarely", "sometimes", "very often", or "always".	4th week
Active cervical range of motion	To measure the cervical range of motion, the universal goniometer will use	4th week
Disability: Neck Disability Index NDI	The Neck Disability Index (NDI) is a 10-item questionnaire that measures a patient's self-reported neck pain related disability. A higher NDI score means the greater a patient's perceived disability due to neck pain. The minimally clinically important change by patients has been found to be 5 or 10%.	4th week

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Dr Hajra, Riphah International University

Publications and helpful links

General Publications

• Ylinen J, Nikander R, Nykanen M, Kautiainen H, Hakkinen A. Effect of neck exercises on cervicogenic headache: a randomized controlled trial. J Rehabil Med. 2010 Apr;42(4):344-9. doi: 10.2340/16501977-0527.
• Mohamed AA, Shendy WS, Semary M, Mourad HS, Battecha KH, Soliman ES, Sayed SHE, Mohamed GI. Combined use of cervical headache snag and cervical snag half rotation techniques in the treatment of cervicogenic headache. J Phys Ther Sci. 2019 Apr;31(4):376-381. doi: 10.1589/jpts.31.376. Epub 2019 Apr 1.
• Khan ZK, Ahmed SI, Baig AAM, Farooqui WA. Effect of post-isometric relaxation versus myofascial release therapy on pain, functional disability, rom and qol in the management of non-specific neck pain: a randomized controlled trial. BMC Musculoskelet Disord. 2022 Jun 13;23(1):567. doi: 10.1186/s12891-022-05516-1.
• Kong YS, Kim YM, Shim JM. The effect of modified cervical exercise on smartphone users with forward head posture. J Phys Ther Sci. 2017 Feb;29(2):328-331. doi: 10.1589/jpts.29.328. Epub 2017 Feb 24.
• Yang DJ, Kang DH. Comparison of muscular fatigue and tone of neck according to craniocervical flexion exercise and suboccipital relaxation in cervicogenic headache patients. J Phys Ther Sci. 2017 May;29(5):869-873. doi: 10.1589/jpts.29.869. Epub 2017 May 16.
• Watson DH, Trott PH. Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia. 1993 Aug;13(4):272-84; discussion 232. doi: 10.1046/j.1468-2982.1993.1304272.x.
• Putra IPM, Nugraha MHS, Tianing NWJPTJoI. Combined Deep Transverse Friction and Muscle Energy Technique on Mechanical Neck Pain: Article Review. 2020;1(1):17-22.
• Yasin M, Gondal MJI, Qamar MM, Basharat A, Rasul A, Ahmed WJMJoDDPU. Effects of deep friction massage and static stretching in non-specific neck pain. 2019;12(4):331-4.

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2024
• Primary Completion (Estimated): August 1, 2024
• Study Completion (Estimated): September 1, 2024

Study Registration Dates

• First Submitted: June 6, 2024
• First Submitted That Met QC Criteria: June 6, 2024
• First Posted (Actual): June 11, 2024

Study Record Updates

• Last Update Posted (Actual): June 11, 2024
• Last Update Submitted That Met QC Criteria: June 6, 2024
• Last Verified: June 1, 2024

More Information

Terms related to this study

• Keywords: neck pain; Cervicogenic Headache; Strain counter strain,; cross friction massage,
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Pain; Neurologic Manifestations; Headache Disorders; Headache Disorders, Secondary; Headache; Post-Traumatic Headache
• Other Study ID Numbers: REC/ RCR & AHS/23/01108

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