Thrust Joint Manipulation and Reverse SNAGS (Sustained Natural Apophyseal Glides) in Cervicogenic Headache

NCT04521218 | Completed

• 1 other identifier: REC/00694 Amna Arshad
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of the study was to compare the effect of upper cervical thrust joint manipulation and reverse Sustained Natural apophyseal Glide on intensity of pain, pain pressure threshold, range of motion and headache disability in patients with cervicogenic headache. A randomized control trial was conducted at Max Rehab and Physical therapy center, Islamabad. The sample size was calculated through open epi tool is 16. The participants were divided in two groups, 8 participants in experimental group and 8 participants in control group. The study duration was six months. Sampling technique applied was Purposive sampling for recruitment and group randomization using sealed envelope method. Only 20 to 40 years participants with cervicogenic headache and associated symptoms were included in the study. Tools used in this study are Numeric pain rating Scale (NPRS), Algometer, Inclinometer and headache disability index (HDI). Data analyzed through Statistical Package for the Social Sciences (SPSS) version 23.

Conditions

Cervicogenic Headache

Keywords

Thrust joint manipulation; Reverse sustained natural apophyseal glides; Cervicogenic headache; Mobilization and Manipulation

Outcome Measures

Primary Outcomes (1)

• Numeric Pain Rating Scale

  Changes from base Line Numeric Pain rating scale is a scale for pain starting from 0-10. where 0 indicate no pain and 10 indicate severe pain.

  12th Day

Secondary Outcomes (6)

• Pressure Pain Threshold (PPT)

  12th Day

• Headache Disability Index

  12th Day

• Range of Motion(ROM) Cervical (Flexion)

  12th Day

• ROM Cervical (Extension)

  12th Day

• ROM Cervical (Side Bend)

  12th Day

Study Arms (2)

Thrust joint Manipulation

EXPERIMENTAL

Thrust joint Manipulation, heat application, Strengthening exercise and home plan

Other: Thrust Joint Manipulation

Reverse Sustained Natural apophyseal glides

ACTIVE COMPARATOR

Reverse Sustained Natural apophyseal glides (SNAG), heat application, Strengthening exercise and home plan.

Other: Reverse Sustained Natural apophyseal glides

Interventions

Thrust Joint Manipulation OTHER

Experimental group included TJM, Cervical hot pack, strengthening exercises and home plan; 3 sessions of manipulation per week and total of 4 weeks. Measurement will be taken at base level and after the last session, i.e. Pain intensity, pain pressure threshold, ROM, and disability. These exercises included. Cervical Flexion, Extension Rotation, lateral flexion and back strengthening exercises. These all exercises were performed 3 x 15 Repetitions with 10 sec hold. This protocol was for 4 weeks and 3 sessions per week. Home plan exercises includes Craniocervical Flexion, Craniocervical Extension, Rotation Exercise, Lateral Flexion Exercise, Chin Tuck in and Shoulder blade exercise were advised to perform 3 x 10 Repetition with 10 - 30 sec hold.

Thrust joint Manipulation

Reverse Sustained Natural apophyseal glides OTHER

Control group included Moist Hot Pack (Cervical contour- 8.25 x 10 x 2) for 10 Mins, Reverse SNAGS (10 Repetitions holding for 10 sec in each glide with a rest time of 30 seconds in between), Strengthening exercise and home plan. 3 sessions of mobilization per week and total of 4 weeks. Measurement will be taken at base level and after the last session, i.e. Pain intensity, pain pressure threshold, ROM, and disability. These exercises included. Cervical Flexion, Extension Rotation, lateral flexion and back strengthening exercises. These all exercises were performed 3 x 15 Repetitions with 10 sec hold. This protocol was for 4 weeks and 3 sessions per week. Home plan exercises includes Craniocervical Flexion, Craniocervical Extension, Rotation Exercise, Lateral Flexion Exercise, Chin Tuck in and Shoulder blade exercise were advised to perform 3 x 10 Repetition with 10 - 30 sec hold

Reverse Sustained Natural apophyseal glides

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Headache frequency of at least 1 per week for a minimum of 3 months
• Secondary Headache (cervical spine dysfunction)
• International Classification of headache Disorder:
• Pain localized in the neck and occiput, which can spread to other areas in the head, such as forehead, orbital region, temples, vertex, or ears, usually unilateral.
• Pain is precipitated or aggravated by specific neck movements or sustained postures.
• At least one of the following:
• Resistance to or limitation of passive neck movements
• Changes in neck muscle contour, texture, tone, or response to active and passive stretching and contraction
• Abnormal tenderness of neck musculature

You may not qualify if:

• Other types of headache
• Trigger points of upper cervical muscles
• Congenital conditions of cervical spine
• Cervical Disc herniation
• Fracture
• Cervical Artery disease
• Red flags of Thrust Joint Manipulation

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Max health Rehabilitation Centre

Islamabad, Fedral, 44000, Pakistan

Location

Related Publications (18)

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  PMID: 6640659 BACKGROUND

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  PMID: 9664748 BACKGROUND

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  PMID: 14588366 BACKGROUND

• Lord SM, Barnsley L, Wallis BJ, Bogduk N. Third occipital nerve headache: a prevalence study. J Neurol Neurosurg Psychiatry. 1994 Oct;57(10):1187-90. doi: 10.1136/jnnp.57.10.1187.

  PMID: 7931379 BACKGROUND

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  PMID: 19066663 BACKGROUND

• Evers S. Comparison of cervicogenic headache with migraine. Cephalalgia. 2008 Jul;28 Suppl 1:16-7. doi: 10.1111/j.1468-2982.2008.01609.x. No abstract available.

  PMID: 18494987 BACKGROUND

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  PMID: 19747657 BACKGROUND

• van Suijlekom JA, Weber WE, van Kleef M. Cervicogenic headache: techniques of diagnostic nerve blocks. Clin Exp Rheumatol. 2000 Mar-Apr;18(2 Suppl 19):S39-44.

  PMID: 10824286 BACKGROUND

• Biondi DM. Cervicogenic headache: diagnostic evaluation and treatment strategies. Curr Pain Headache Rep. 2001 Aug;5(4):361-8. doi: 10.1007/s11916-001-0026-x.

  PMID: 11403740 BACKGROUND

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  PMID: 15062532 BACKGROUND

• Jull G, Barrett C, Magee R, Ho P. Further clinical clarification of the muscle dysfunction in cervical headache. Cephalalgia. 1999 Apr;19(3):179-85. doi: 10.1046/j.1468-2982.1999.1903179.x.

  PMID: 10234466 BACKGROUND

• 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.

  PMID: 31037013 BACKGROUND

• Umar M, Naeem A, Badshah M, Zaidi S. A randomized control trial to review the effectiveness of cervical mobilization combined with stretching exercises in cervicogenic headache. J Public Health Biolo Sci. 2012;1(1):09-13.

  BACKGROUND

• Jamil M, Janjua U. Comparison of cervicogenic headache between housewives and working women. Rawal Medical Journal. 2020 Jan;45(1):77-9.

  BACKGROUND

• Umar M, Badshah M, Maryam M, Naeem A, Rehman L, Ahmed M. Prevalence Of Different Types Of Headache In Medical Students Of Rawalpindi & Islamabad. International Journal of Rehabilitation Sciences (IJRS). 2018 Mar 15;4(01):15-9.

  BACKGROUND

• Coelho M, Ela N, Garvin A, Cox C, Sloan W, Palaima M, et al. The effectiveness of manipulation and mobilization on pain and disability in individuals with cervicogenic and tension-type headaches: a systematic review and meta-analysis. Physical Therapy Reviews. 2019;24(1-2):29-43

  BACKGROUND

• Rani M, Kulandaivelan S, Bansal A, Pawalia A. Physical therapy intervention for cervicogenic headache: an overview of systematic reviews. European Journal of Physiotherapy. 2019:1-7

  BACKGROUND

• Rasul HNU, Dustagir A, Malik AN. Role of Mobilization to Improve Cervicogenic Headache

  BACKGROUND

MeSH Terms

Conditions

Post-Traumatic Headache

Condition Hierarchy (Ancestors)

Headache Disorders, Secondary; Headache Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Study Officials

• Dr Saira Waqqar, PP-DPT, MHPE

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Assignment

Study Record Dates

• First Submitted: August 18, 2020
• First Posted: August 20, 2020
• Study Start: May 4, 2019
• Primary Completion: December 15, 2020
• Study Completion: December 15, 2020
• Last Updated: December 17, 2020

Record last verified: 2020-12

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)