Effects of Sustained Natural Appophyseal Glide Versus Rocababo 6x6 Program in Subjects With Cervicogenic Headache.

NCT05865808 | Completed

• 1 other identifier: REC/RCR & AHS/23/0121
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to investigate the effects of TMJ directed treatment approach using the Rocabado 6x6 program in patients with cervicogenic headache on the intensity of headache, function of the neck, and quality of life and compare its effectiveness with headache SNAGs which have been proven very effective in treatment of cervicogenic headache.

Conditions

Cervicogenic Headache

Keywords

cervical spine; neurological disorder; post-traumatic disorder; secondary headache

Outcome Measures

Primary Outcomes (1)

• Neck Disability Index

  Neck Disability Index will be used examine neck pain intensity and cervicogenic headache symptoms.Consists of 10 sections each section is scored on a 0 to 5 rating scale, in which zero means 'No pain' and 5 means 'Worst imaginable pain'. Changes from Baseline to 8 weeks.

  8th week

Secondary Outcomes (3)

• Headache Impact Test-6 SCALE

  8th week

• Flexion Rotation Test

  8th week

• Numeric Pain Rating Scale

  8th week

Study Arms (2)

Cervical spine mobilization

EXPERIMENTAL

Subjects in this group will be treated with headache SNAGs

Other: cervical spine mobilization

Rocabado 6x6 exercises

ACTIVE COMPARATOR

Rocabado 6x6 program includes 6 types of exercises which are- rest position of the tongue, TMJ rotation control, upper cervical distraction, axial extension of cervical spine, shoulder girdle retraction, and rhythmic stabilization technique.

Other: Rocabado 6x6

Interventions

cervical spine mobilization OTHER

headache SNAGs, 10 repetitions holding for 10 seconds in each glide with a rest time of 30 seconds in between. Eight weeks of treatment session will be provided and assessment of the improvement in cervicogenic headache will done at baseline, after 04, 06 and at the end of 8 week.

Cervical spine mobilization

Rocabado 6x6 OTHER

The Rocabado 6x6 program includes 6 types of exercises which are- rest position of the tongue, TMJ rotation control, upper cervical distraction, axial extension of cervical spine, shoulder girdle retraction, and rhythmic stabilization technique, which are to be performed 6 times in a day with 6 repetitions of each exercise in each session,

Rocabado 6x6 exercises

Eligibility Criteria

• Age: 20 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age 20-60 years.
• Unilateral headache that do not shift side with ipsilateral neck pain/stiffness.
• Headache for past 3 months at least once per week.
• Positive flexion rotation test.

You may not qualify if:

• Subjects with other type of headache.
• Specific disorders and congenital conditions of cervical spine.
• PT or chiropractic treatment in past 3 months.
• Severe pain, traumatic injury, occlusal splints or any surgery in TMJ area

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Zia Hospital

Lahore, Punjab Province, Pakistan

Location

Related Publications (13)

• Paquin JP, Tousignant-Laflamme Y, Dumas JP. Effects of SNAG mobilization combined with a self-SNAG home-exercise for the treatment of cervicogenic headache: a pilot study. J Man Manip Ther. 2021 Aug;29(4):244-254. doi: 10.1080/10669817.2020.1864960. Epub 2021 Feb 5.

  PMID: 33541242 BACKGROUND

• Verma S, Tripathi M, Chandra PS. Cervicogenic Headache: Current Perspectives. Neurol India. 2021 Mar-Apr;69(Supplement):S194-S198. doi: 10.4103/0028-3886.315992.

  PMID: 34003165 BACKGROUND

• Cardoso R, Seixas A, Rodrigues S, Moreira-Silva I, Ventura N, Azevedo J, Monsignori F. 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. Arch Physiother. 2022 Sep 1;12(1):20. doi: 10.1186/s40945-022-00144-3.

  PMID: 36045409 BACKGROUND

• Rani M, Kaur J. Effectiveness of different physiotherapy interventions in the management of cervicogenic headache: a pilot randomized controlled trial. J Man Manip Ther. 2022 Apr;30(2):96-104. doi: 10.1080/10669817.2021.1962687. Epub 2021 Aug 10.

  PMID: 34374330 BACKGROUND

• Coskun Benlidayi I MD, Guzel R MD, Tatli U PhD, Salimov F PhD, Keceli O PhD. The relationship between neck pain and cervical alignment in patients with temporomandibular disorders. Cranio. 2020 May;38(3):174-179. doi: 10.1080/08869634.2018.1498181. Epub 2018 Jul 26.

  PMID: 30048225 BACKGROUND

• Ghodrati M, Mosallanezhad Z, Shati M, Noroozi M, Moghadam AN, Rostami M, Nourbakhsh MR. Adding Temporomandibular joint treatments to routine physiotherapy for patients with non-specific chronic neck pain: A randomized clinical study. J Bodyw Mov Ther. 2020 Apr;24(2):202-212. doi: 10.1016/j.jbmt.2019.11.004. Epub 2019 Nov 22.

  PMID: 32507146 BACKGROUND

• Kang JH. Effects on migraine, neck pain, and head and neck posture, of temporomandibular disorder treatment: Study of a retrospective cohort. Arch Oral Biol. 2020 Jun;114:104718. doi: 10.1016/j.archoralbio.2020.104718. Epub 2020 Apr 18.

  PMID: 32334135 BACKGROUND

• Greenbaum T, Dvir Z, Emodi-Perlman A, Reiter S, Rubin P, Winocur E. The association between specific temporomandibular disorders and cervicogenic headache. Musculoskelet Sci Pract. 2021 Apr;52:102321. doi: 10.1016/j.msksp.2021.102321. Epub 2021 Jan 12.

  PMID: 33482538 BACKGROUND

• Craciun MD, Geman O, Leuciuc FV, Holubiac IS, Gheorghita D, Filip F. Effectiveness of Physiotherapy in the Treatment of Temporomandibular Joint Dysfunction and the Relationship with Cervical Spine. Biomedicines. 2022 Nov 17;10(11):2962. doi: 10.3390/biomedicines10112962.

  PMID: 36428529 BACKGROUND

• Pundkar S, Patil D, Naqvi W. A Comparative Study on Effectiveness of Rocabado Approach and Conventional Physiotherapy on Pain, ROM and QOL in Patients with TMJ Dysfunction. 2021.

  BACKGROUND

• Corum M. Evaluation of Cervical Dysfunctions in Temporomandibular Disorders. Medical Journal of Bakirkoy. 2021;17(1).

  BACKGROUND

• La Touche R, Martinez Garcia S, Serrano Garcia B, Proy Acosta A, Adraos Juarez D, Fernandez Perez JJ, Angulo-Diaz-Parreno S, Cuenca-Martinez F, Paris-Alemany A, Suso-Marti L. Effect of Manual Therapy and Therapeutic Exercise Applied to the Cervical Region on Pain and Pressure Pain Sensitivity in Patients with Temporomandibular Disorders: A Systematic Review and Meta-analysis. Pain Med. 2020 Oct 1;21(10):2373-2384. doi: 10.1093/pm/pnaa021.

  PMID: 32181811 BACKGROUND

• Murtza S, Noor R, Bashir MS, Ikram M. Effects of sustained natural apophyseal glides versus rocabado 6 x 6 program in subjects with cervicogenic headache. BMC Musculoskelet Disord. 2024 Feb 22;25(1):169. doi: 10.1186/s12891-024-07290-8.

  PMID: 38389050 DERIVED

MeSH Terms

Conditions

Post-Traumatic Headache; Nervous System Diseases

Condition Hierarchy (Ancestors)

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

Study Officials

• Rabiya Noor, phd

  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: May 4, 2023
• First Posted: May 19, 2023
• Study Start: May 1, 2023
• Primary Completion: August 1, 2023
• Study Completion: August 1, 2023
• Last Updated: December 27, 2023

Record last verified: 2023-12

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)