Effects of SNAGS Along With Thoracic Postural Correction Techniques in Patients With Chronic Cervicogenic Headache

NCT04993950 | Completed

• 1 other identifier: REC/01008 Urooj Sajjad
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to find out the effects of Mulligan SNAGs along with thoracic postural correction techniques on patients with chronic cervicogenic headache. Patients suffering from cervicogenic headache are often associated with muscle imbalance. This study will be significant in determining the effects of SNAGs along with thoracic postural correction techniques to improve pain, level of disability and functional status in patients of cervicogenic headache. It will be Randomized controlled trial study design Data will be collected from Lady reading Hospital Peshawar Purposive sampling, group randomization using lottery method will be used in this study.

Conditions

Cervicogenic Headache

Keywords

cervicogenic headache, thoracic posture correction, SNAGS

Outcome Measures

Primary Outcomes (4)

• Visual Analog scale (VAS)

  The VAS is a 10- cm graduated line. Each participant will self-assess the intensity of her pain. Patients in each group will be instructed to point to the position on the line between the faces to indicate how much pain they are currently feeling. The far-left end indicates "no pain" and the far right end indicates worst pain ever

  four weeks

• Neck Disability Index (NDI)

  The NDI can be scored as a raw score or doubled and expressed as a percent. Each section is scored on a 0 to 5 rating scale, in which zero means 'No pain' and 5 means 'Worst imaginable pain.

  for four weeks

• Headache Impact Test

  Headache Impact Test is a tool used to measure the impact headaches have on your ability to function on the job, at school, at home and in social situations. Your score shows you the effect that headaches have on normal daily life and your ability to function.

  for four weeks

• Cervical ROM --Universal Goniometer

  A large universal goniometer having a stationary arm and a moving arm of 12 inch and full circle body will be used for measuring cervical range of motion.

  four weeks

Study Arms (2)

sustained natural apophyseal glides

EXPERIMENTAL

SNAGS will be applied in flexion, extension and rotation for a few seconds with 3 repetitions on the first day and 10 repetitions from the next visit.

Other: sustained natural apophyseal glides; Other: SNAGS with thoracic postural correction techniques

SNAGS with thoracic postural correction techniques

ACTIVE COMPARATOR

active as well as therapist-facilitated stretches.thoracic extension in sitting, Wall angle stretch and Corner stretch, while the therapist-facilitated stretches will be seated mid-thoracic stretch and prone mid thoracic stretch. Stretches will be maintained for 15-20 seconds with 10 repetitions of each stretch per session

Other: sustained natural apophyseal glides; Other: SNAGS with thoracic postural correction techniques

Interventions

sustained natural apophyseal glides OTHER

SNAGS will be applied in flexion, extension and rotation for a few seconds with 3 repetitions on the first day and 10 repetitions from the next visit.

SNAGS with thoracic postural correction techniques; sustained natural apophyseal glides

SNAGS with thoracic postural correction techniques OTHER

thoracic extension in sitting, Wall angle stretch and Corner stretch, while the therapist-facilitated stretches will be seated mid-thoracic stretch and prone mid thoracic stretch. Stretches will be maintained for 15-20 seconds with 10 repetitions of each stretch per session

SNAGS with thoracic postural correction techniques; sustained natural apophyseal glides

Eligibility Criteria

• Age: 30 Years - 60 Years
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients having headache for the last three months
• Patients having unilateral neck pain along with stiffness.
• A headache that is more frequent periorbitally, spreading to the temporal and ocular region and in the low occipital and less frequent in the frontal, parietal and facial region.
• Pain that is usually elicited by applying external pressure on at least 1 of the upper cervical joints (C0-C3) and moderate to severe non throbbing pain

You may not qualify if:

• Other types of headaches
• Congenital conditions of the cervical spine
• Disc herniation
• Cervical Fractures
• Degenerating disease of the cervical spine.
• Patients with contraindications to mobilization techniques and those with dizziness due to vertebrobasilar insufficiency or vestibular dysfunctions

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Lady reading Hospital

Peshawar, KPK, 25000, Pakistan

Location

Related Publications (9)

• Racicki S, Gerwin S, Diclaudio S, Reinmann S, Donaldson M. Conservative physical therapy management for the treatment of cervicogenic headache: a systematic review. J Man Manip Ther. 2013 May;21(2):113-24. doi: 10.1179/2042618612Y.0000000025.

  PMID: 24421621 BACKGROUND

• Chaibi A, Russell MB. Manual therapies for cervicogenic headache: a systematic review. J Headache Pain. 2012 Jul;13(5):351-9. doi: 10.1007/s10194-012-0436-7. Epub 2012 Mar 30.

  PMID: 22460941 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 BACKGROUND

• Fernandez-de-Las-Penas C, Courtney CA. Clinical reasoning for manual therapy management of tension type and cervicogenic headache. J Man Manip Ther. 2014 Feb;22(1):44-50. doi: 10.1179/2042618613Y.0000000050.

  PMID: 24976747 BACKGROUND

• McDowell JM, Johnson GM, Hetherington BH. Mulligan Concept manual therapy: standardizing annotation. Man Ther. 2014 Oct;19(5):499-503. doi: 10.1016/j.math.2013.12.006. Epub 2014 Jan 10.

  PMID: 24491791 BACKGROUND

• McDonnell MK, Sahrmann SA, Van Dillen L. A specific exercise program and modification of postural alignment for treatment of cervicogenic headache: a case report. J Orthop Sports Phys Ther. 2005 Jan;35(1):3-15. doi: 10.2519/jospt.2005.35.1.3.

  PMID: 15754599 BACKGROUND

• Tul Ain SQ, Shakil Ur Rehman S, Maryam M, Kiani SK. Effects of Sustained Natural Apophyseal Glides with and without thoracic posture correction techniques on mechanical back pain: a randomized control trial. J Pak Med Assoc. 2019 Nov;69(11):1584-1587. doi: 10.5455/JPMA.274875..

  PMID: 31740859 BACKGROUND

• 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 BACKGROUND

• Vernon H. The Neck Disability Index: state-of-the-art, 1991-2008. J Manipulative Physiol Ther. 2008 Sep;31(7):491-502. doi: 10.1016/j.jmpt.2008.08.006.

  PMID: 18803999 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

• Maria Khalid, MSOMPT

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 5, 2021
• First Posted: August 6, 2021
• Study Start: February 20, 2022
• Primary Completion: August 1, 2022
• Study Completion: August 20, 2022
• Last Updated: September 19, 2022

Record last verified: 2022-09

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)