Manual Therapy vs. Multicomponent Exercise in Cervicogenic Headache
2026年8月20日 更新者：Borna Farhoomand、Pamukkale University
Effects of Manual Therapy Versus Multicomponent Exercise on Sensorimotor Function, Suboccipital Muscle Thickness, and Central Sensitization in Cervicogenic Headache: A Double-Blind Randomized Controlled Trial
The purpose of this study is to compare the effects of manual therapy and a multicomponent exercise program on suboccipital muscle thickness, joint position sense, pain, central sensitization, balance, and kinesiophobia in patients diagnosed with cervicogenic headache.
Cervicogenic headache is a common secondary headache originating from dysfunction in the upper cervical spine. Dysfunction in the deep neck muscles, impaired neck joint awareness, and heightened pain sensitivity (central sensitization) are frequently observed in these patients. While both manual therapy and targeted exercise are used in physiotherapy practice, evidence regarding their direct comparative effects on suboccipital muscle morphology and somatosensory parameters remains limited.
Participants will be randomly assigned to one of two treatment groups for a duration of 4 weeks (12 sessions total):
- Manual Therapy Group: Receives joint mobilization, myofascial release, trigger point release, and suboccipital distraction targeting the cervical region.
- Multicomponent Exercise Group: Receives deep cervical flexor strengthening, cervical proprioception training, head-eye coordination training, and progressive balance exercises.
The main questions the study aims to answer are:
- Do manual therapy and multicomponent exercise improve suboccipital muscle thickness and cervical joint position sense in patients with cervicogenic headache?
- Is there a significant difference between manual therapy and multicomponent exercise in reducing pain intensity, central sensitization, disability, and fear of movement (kinesiophobia)? It is hypothesized that both intervention protocols will yield significant clinical improvements, with specific synergistic adaptations in muscle structure, somatosensory system processing, and pain-related fear.
調査の概要
状態
まだ募集していません
研究の種類
介入
入学 (推定)
32
段階
- 適用できない
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
- 大人
健康ボランティアの受け入れ
いいえ
説明
Inclusion Criteria:
- Diagnosis of cervicogenic headache by a specialist physician,
- Aged between 18 and 45 years,
- Ability to read and write (literate),
- Provision of signed informed consent to participate in the study.
Exclusion Criteria:
- History of head or neck surgery,
- History of spinal surgery,
- History of severe cardiac conditions or cardiac surgery that contraindicates exercise,
- History of ongoing or past malignancy,
- Diagnosis of psychiatric disorders,
- Diagnosis of migraine,
- Diagnosis of fibromyalgia,
- Having received medical (except analgesics), physical therapy, or other interventions (e.g., alternative medicine, massage therapy) for cervicogenic headache within the last 6 months,
- Engaging in regular exercise or attending an exercise facility within the last 6 months,
- Experiencing headaches strictly associated with the menstrual period,
- Investigator decision for exclusion based on ethical or clinical grounds,
- Communication problems interfering with evaluation and treatment.
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：ダブル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：Manual Therapy Group
Participants in this arm will receive 12 sessions of manual therapy (3 sessions per week for 4 weeks).
Interventions include upper cervical joint mobilization, myofascial release, suboccipital distraction, and trigger point therapy targeting the suboccipital and cervical region.
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Upper cervical joint mobilization, myofascial release, suboccipital distraction, and trigger point therapy targeting the cervical region.
|
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アクティブコンパレータ：Multicomponent Exercise Group
Participants in this arm will receive 12 sessions of a multicomponent exercise program (3 sessions per week for 4 weeks).
Interventions include deep cervical flexor strengthening, cervical proprioception training, gaze stability/head-eye coordination exercises, and progressive postural balance training.
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Deep cervical flexor strengthening, cervical proprioception exercises, gaze stability/head-eye coordination training, and progressive balance exercises.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change from Baseline Pain Intensity
時間枠：Baseline and Post-intervention (Week 4)
|
Evaluated using a 10-cm Visual Analog Scale (VAS) measured in centimeters to assess headache pain intensity.
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Baseline and Post-intervention (Week 4)
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Change from Baseline Central Sensitization Inventory Score
時間枠：Baseline and Post-intervention at 4 Weeks
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Assessed using the 25-item Central Sensitization Inventory (CSI) with a total score ranging from 0 to 100 to evaluate the severity of central sensitization.
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Baseline and Post-intervention at 4 Weeks
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Change from Baseline Tampa Scale for Kinesiophobia Score
時間枠：Baseline and Post-intervention at Week 4
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Evaluated using the Tampa Scale for Kinesiophobia (TSK) 4-point Likert scale (17-68 score range) to measure fear of movement and re-injury.
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Baseline and Post-intervention at Week 4
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Change from Baseline Migraine Disability Assessment Score
時間枠：Baseline and Post-intervention at 4 Weeks.
|
Assessed using the 5-item Migraine Disability Assessment (MIDAS) questionnaire to evaluate the total number of days with headache-related disability (score range 0 to 21+ for disability severity grades I to IV)
|
Baseline and Post-intervention at 4 Weeks.
|
|
Change from Baseline Neck Disability Index Score
時間枠：Baseline and Post-intervention at 4 Weeks
|
Evaluated using the 10-item Neck Disability Index (NDI) questionnaire to measure neck pain-related functional disability (score range 0 to 50, higher scores indicating higher disability).
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Baseline and Post-intervention at 4 Weeks
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change from Baseline Suboccipital Muscle Thickness
時間枠：Baseline and Post-intervention at 4 Weeks
|
Evaluated using B-mode ultrasonography (9-12 MHz linear probe) to measure the thickness (in millimeters) of the rectus capitis posterior major (RCPM) and obliquus capitis superior (OCS) muscles bilaterally at the C1-C2 level.
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Baseline and Post-intervention at 4 Weeks
|
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Change from Baseline Cervical Joint Position Sense Error
時間枠：Baseline and Post-intervention at 4 Weeks
|
Evaluated using the Cervical Range of Motion (CROM) device to measure cervical joint position error (in degrees) at target angles set at 65% of the participant's active range of motion.
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Baseline and Post-intervention at 4 Weeks
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Change from Baseline Head-Eye Movement Control Test Score
時間枠：Baseline and Post-intervention at Week 4
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Evaluated using the Head-Eye Movements Control Test, scored as 0 (negative/stable), 1 (moderately positive), or 2 (strongly positive/unstable).
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Baseline and Post-intervention at Week 4
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Change from Baseline Deep Cervical Flexor Muscle Endurance
時間枠：Baseline and Post-intervention (Week 4).
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Assessed in seconds using the Cervical Deep Neck Flexor Muscle Endurance Test in a hook-lying chin tuck position.
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Baseline and Post-intervention (Week 4).
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Change from Baseline Postural Balance Score
時間枠：Baseline and Post-intervention at Week 4
|
Measured using the Sway mobile application across five stance positions (feet together, left/right tandem, left/right single-leg) under blindfolded conditions, producing a total balance score from 0 to 100.
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Baseline and Post-intervention at Week 4
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Change from Baseline Cervical Range of Motion
時間枠：Baseline and Post-intervention at 4 Weeks
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Evaluated using the Baseline CROM Deluxe device to measure active cervical flexion, extension, right/left lateral flexion, and right/left rotation in degrees.
Two trials will be performed for each movement and the arithmetic mean will be analyzed.
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Baseline and Post-intervention at 4 Weeks
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研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (推定)
2026年9月1日
一次修了 (推定)
2027年2月28日
研究の完了 (推定)
2027年3月31日
試験登録日
最初に提出
2026年8月17日
QC基準を満たした最初の提出物
2026年8月17日
最初の投稿 (実際)
2026年8月20日
学習記録の更新
投稿された最後の更新 (実際)
2026年8月24日
QC基準を満たした最後の更新が送信されました
2026年8月20日
最終確認日
2026年8月1日
詳しくは
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