The effectiveness of Sustained Natural Apophyseal Glide on Flexion Rotation Test, pain intensity, and functionality in subjects with Cervicogenic Headache: A Systematic Review of Randomized Trials

Ricardo Cardoso, Adérito Seixas, Sandra Rodrigues, Isabel Moreira-Silva, Nuno Ventura, Joana Azevedo, Filippo Monsignori, Ricardo Cardoso, Adérito Seixas, Sandra Rodrigues, Isabel Moreira-Silva, Nuno Ventura, Joana Azevedo, Filippo Monsignori

Abstract

Objective: To determine the effect of sustained natural apophyseal glide (SNAG) on Flexion Rotation Test, pain intensity, and functionality in subjects with Cervicogenic Headache (CH).

Methods: The research was conducted on five computerized databases PubMed/Medline, Web of Science, PEDro, Lilacs, and Cochrane Library (CENTRAL), using the keywords combination: (sustained natural apophyseal glide OR SNAG OR joint mobilization OR Mulligan) AND (cervicogenic headache) according to PRISMA guidelines. The methodological quality of the included studies was analyzed using the Physiotherapy Evidence Database (PEDro) scale.

Results: Eight articles fulfilled the eligibility criteria and were included in the review. The selected studies had a methodological quality of 6.6/10 on the PEDro scale and included a total of 357 participants. The SNAG significantly improved pain, Flexion Rotation Test and reduced functional symptoms.

Conclusion: The available evidence suggests that SNAG may be a relevant intervention for CH.

Keywords: Cervicogenic headache; Physiotherapy; Randomized controlled trials; SNAG; Sustained natural apophyseal glide.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the literature selection process
Fig. 2
Fig. 2
Methodological quality assessment of the included studies with PEDro scale. (2) Subjects were randomly allocated to groups (in a crossover study, subjects were randomly allocated an order in which treatments were received); (3) allocation was concealed; (4) the groups were similar at baseline regarding the most important prognostic indicators; (5) there was blinding of all subjects; (6) there was blinding of all therapists who administered the therapy; (7) there was blinding of all assessors who measured at least one key outcome; (8) measures of at least one key outcome were obtained from more than 85%; of the subjects initially allocated to groups; (9) all subjects for whom outcome measures were available received the treatment or control condition as allocated or, where this was not the case, data for at least one key outcome was analysed by “intention to treat”; (10) the results of between-group statistical comparisons are reported for at least one key outcome; (11) the study provides both point measures and measures of variability for at least one key outcome

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Source: PubMed

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