Effects of Cervical Manual Therapy on Cervicogenic Headache

NCT03385889 | Completed

• 1 other identifier: ShenandoahU(2017-2018)
• Study Type: interventional
• Target: 35
• Locations: 1 country
• Sites: 1

Brief Summary

The effects of cervical spine manual therapy, including mobilization and manipulation, on cervical spine range of motion, joint position sense, and balance is unknown among individuals with cervicogenic headache. Previous studies have indicated improved frequency of headache, decreased perceived disability, and demonstrated improved neuromuscular function following upper cervical manipulation. Other authors report improved cervical spine range of motion, joint position sense, and balance following cervical spine manual therapy for individuals with cervicogenic dizziness. Through an experimental design, this study aims to determine the effects of cervical spine manual therapy on variables such as cervical spine range motion, joint position sense, and balance among individuals with headache of a cervical spine origin.

Conditions

Unilateral Headache; Musculoskeletal Neck Pain

Keywords

Cervicogenic Headache; Manual Therapy; Joint Position Sense; Balance

Outcome Measures

Primary Outcomes (1)

• Change in Cervical Flexion Rotation Test (CFRT)

  The Cervical Range of Motion (CROM) instrument will be placed on the subject. The subject will lie supine on the treatment table. The investigator will then passively flex the entire cervical spine and then rotate the head to both the left and right. The range of motion available in each direction, as measured by the CROM, will be recorded.

  Post-Intervention, 4-weeks

Secondary Outcomes (2)

• Change in Joint Position Error

  Post-Intervention, 4-weeks

• Change in Balance as measured by NeuroCom Balance Master

  Post-Intervention, 4-weeks

Study Arms (3)

Cervical Spine Mobilization Group

EXPERIMENTAL

Subjects with cervicogenic headache who will be assigned to cervical spine mobilization group and receive intervention directed to C1/2 of ipsilateral side of unilateral dominant headache.

Procedure: Cervical Spine Mobilization

Cervical Spine Manipulation Group

EXPERIMENTAL

Subjects with cervicogenic headache who will be assigned to cervical spine manipulation group and receive intervention directed to C1/2 of ipsilateral side of unilateral dominant headache.

Procedure: Cervical Spine Manipulation

Control Group

NO INTERVENTION

No intervention. Subjects in this groups will wait for 5 minutes between pre- and post-testing of dependent variables.

Interventions

Cervical Spine Mobilization PROCEDURE

C1/2 graded mobilizations (Grade III/IV) provided to C1/2 segment on ipsilateral side of unilateral headache. Mobilizations will be completed for 3 sets of 30 seconds.

Cervical Spine Mobilization Group

Cervical Spine Manipulation PROCEDURE

C1/2 manipulation (Grade V) provided to C1/2 segment on ipsilateral side of unilateral headache. The goal of the manipulation technique is to elicit an audible cavitation. If no cavitation is achieved upon the first attempt, a second and final attempt will be completed. No more than two attempts will be utilized per each subject in this allocated group.

Cervical Spine Manipulation Group

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Over the age of 18
• Signs and symptoms consistent with cervicogenic headache (including unilateral headache, headache that improves or resolves as cervical disorder or lesion improves or resolves, headache that is made worse with cervical movement or sustained painful neck positions, reduced cervical range of motion
• Headache frequency of at least once a week for 3 months

You may not qualify if:

• Bilateral headaches
• Non-musculoskeletal red flags
• Two or more positive neurologic signs indicative of nerve root compression
• Diagnosed with cervical spinal stenosis
• Bilateral upper extremity symptoms
• Symptoms indicative of central nervous system lesion
• History of whiplash injury within the previous 6 weeks
• Prior head or neck surgery
• Has received treatment for head or neck pain from any practitioner within the previous month
• Has received physical therapy or chiropractic treatment for head or neck pain within the previous 3 months
• Having a known vestibular or balance dysfunction (BPPV, unilateral vestibular loss, etc.)
• Other headaches that do not originate from the cervical spine, primarily migraine, vascular (cervical artery dysfunction), and tension-type headache.

Sponsors & Collaborators

• Shenandoah University: lead

Study Sites (1)

Shenandoah University

Winchester, Virginia, 22601, United States

Location

Related Publications (5)

• Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013 Jul;33(9):629-808. doi: 10.1177/0333102413485658. No abstract available.

  PMID: 23771276 BACKGROUND

• Dunning JR, Butts R, Mourad F, Young I, Fernandez-de-Las Penas C, Hagins M, Stanislawski T, Donley J, Buck D, Hooks TR, Cleland JA. Upper cervical and upper thoracic manipulation versus mobilization and exercise in patients with cervicogenic headache: a multi-center randomized clinical trial. BMC Musculoskelet Disord. 2016 Feb 6;17:64. doi: 10.1186/s12891-016-0912-3.

  PMID: 26852024 RESULT

• Reid SA, Callister R, Katekar MG, Rivett DA. Effects of cervical spine manual therapy on range of motion, head repositioning, and balance in participants with cervicogenic dizziness: a randomized controlled trial. Arch Phys Med Rehabil. 2014 Sep;95(9):1603-12. doi: 10.1016/j.apmr.2014.04.009. Epub 2014 May 2.

  PMID: 24792139 RESULT

• Kristjansson E, Treleaven J. Sensorimotor function and dizziness in neck pain: implications for assessment and management. J Orthop Sports Phys Ther. 2009 May;39(5):364-77. doi: 10.2519/jospt.2009.2834.

  PMID: 19411769 RESULT

• de Vries J, Ischebeck BK, Voogt LP, van der Geest JN, Janssen M, Frens MA, Kleinrensink GJ. Joint position sense error in people with neck pain: A systematic review. Man Ther. 2015 Dec;20(6):736-44. doi: 10.1016/j.math.2015.04.015. Epub 2015 May 2.

  PMID: 25983238 RESULT

MeSH Terms

Conditions

Headache; Post-Traumatic Headache

Condition Hierarchy (Ancestors)

Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Headache Disorders, Secondary; Headache Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Study Officials

• Karen Abraham, PhD, PT

  Shenandoah University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Assessors of joint position sense, balance, and cervical spine range of motion via the Cervical Flexion Rotation Test will be blinded to group allocation
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Physical Therapy

Model Details: Pre-test, Post-test, control group design 3 groups - mobilization, manipulation, control

Study Record Dates

• First Submitted: December 20, 2017
• First Posted: December 29, 2017
• Study Start: February 15, 2018
• Primary Completion: May 15, 2018
• Study Completion: January 1, 2019
• Last Updated: April 4, 2019

Record last verified: 2019-04

Locations

US (1)