Additional Effects of Sternocleidomastoid Release With SNAGS in the Management of Cervicogenic Headache

NCT06534606 | Active Not Recruiting

• 1 other identifier: FUI/CTR/2024/17
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

Cervicogenic headache is a common type of headache in adults which causes disability and difficulty in everyday activities. According to the latest International Headache Society model, cervicogenic headache (CGH) is a secondary headache having C1-C2 dysfunction. SNAGs are highly effective in the treatment approach for these patients. Sternocleidomastoid muscle receive overactive tension from forward neck posture, increasing muscular fatigue and tone of muscles. This tension in SCM causes referred pain in the head and neck region. SNAGs are very effective but musculoskeletal impairments especially the tightness of sternocleidomastoid muscle still persist and can exacerbate symptoms. Manual therapy targeted to the SCM muscle may be effective for reducing headache and neck pain intensity and increasing performance of deep cervical flexors. Findings of this study will aid the therapists in choosing which technique to use while treating the patients. This will save therapist's time and effort as they will not be using the less effective treatment protocol. Furthermore, patient's time and investment will be used in the right direction.

Conditions

Cervicogenic Headache

Outcome Measures

Primary Outcomes (4)

• Pain intensity

  Pain will be measured on the basis of Numeric Pain Rating Scale score.

  2 weeks

• Range of motion

  Cervical rotation will be measured through CROM device

  2 weeks

• Headache Disability

  Headache Disability Index will be used

  2 weeks

• Cervical Proprioception

  Joint Position Error Test will be used

  2 weeks

Study Arms (2)

Conventional physical therapy Group

ACTIVE COMPARATOR

Both Group A and Group B will receive this conventional physical therapy protocol for cervicogenic headache. * Moist heat therapy: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks. * TENS application: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks. In addition to this, they will receive Headache SNAGs (Sustained Natural Apophyseal Glides) 5 sets of 10 repetitions. Each repetition will be given with a 10 second hold. • Frequency: 3 times a week for 2 weeks. 6 sessions in total.

Procedure: Electrotherapy and physical agents; Procedure: Headache SNAGs

Conventional physical therapy with sternocleidomastoid release

EXPERIMENTAL

Both Group A and Group B will receive this conventional physical therapy protocol for cervicogenic headache. * Moist heat therapy: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks. * TENS application: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks. Headache SNAGs: In addition to the conventional physical therapy protocol, they will receive Headache SNAGs (Sustained Natural Apophyseal Glides) 5 sets of 10 repetitions. Each repetition will be given with a 10 second hold. * Frequency: 3 times a week for 2 weeks. 6 sessions in total. Sternocleidomastoid Release: Group B will also receive Sternocleidomastoid release in addition with headache SNAGs. Release to the sternocleidomastoid muscle will be given once per session for 5-8 minutes. * Frequency: 3 times a week for 2 weeks. 6 sessions in total.

Procedure: Electrotherapy and physical agents; Procedure: Headache SNAGs; Procedure: Sternocleidomastoid Release

Interventions

Electrotherapy and physical agents PROCEDURE

Moist heat therapy: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks. • TENS application: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks.

Conventional physical therapy Group; Conventional physical therapy with sternocleidomastoid release

Headache SNAGs PROCEDURE

Headache SNAGs (Sustained Natural Apophyseal Glides) 5 sets of 10 repetitions. Each repetition will be given with a 10 second hold. • Frequency: 3 times a week for 2 weeks. 6 sessions in total.

Conventional physical therapy Group; Conventional physical therapy with sternocleidomastoid release

Sternocleidomastoid Release PROCEDURE

Sternocleidomastoid Release: Group B will also receive Sternocleidomastoid release in addition with headache SNAGs. Release to the sternocleidomastoid muscle will be given once per session for 5-8 minutes.Frequency: 3 times a week for 2 weeks. 6 sessions in total.

Conventional physical therapy with sternocleidomastoid release

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Age group: 18-45 years old
• Both males and females
• Unilateral headache with no shift of side
• C1-C2 Dysfunction
• Positive flexion rotation test (Rotation restriction is greater than 10 degrees)
• Headache at least once a month in the last 3 months
• Headache with at least 4 score in NPRS (Sign and Symptoms of Neck Involvement)
• Headache with restriction of ROM in the neck
• Headache precipitated by:
• Sustained neck movements, and awkward head positioning. External Pressure over upper cervical or occipital region
• Headache Characteristics:
• Moderate-severe, non-throbbing pain, usually starting in the neck.
• Episodes of varying duration, or: fluctuating, continuous pain

You may not qualify if:

• Headache of non-cervical origin
• Diagnosed Cases of:Cervical spondylosis,Cervical radiculopathy/ nerve root involvement/ disc herniation,Cervical instability/ fracture,Vertebrobasilar insufficiency ,Cervical spine surgery,Cervical spondylolisthesis,Spinal infection or tumors,Osteoporosis,History of trauma,Rheumatoid Arthritis,Inflammatory Arthritis

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Foundation University College of Physical Therapy

Rawalpindi, Punjab Province, 46000, Pakistan

Location

MeSH Terms

Conditions

Post-Traumatic Headache

Interventions

Electric Stimulation Therapy

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Therapeutics; Physical Therapy Modalities; Rehabilitation

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This is a randomized controlled trial having two groups. One group will receive SNAGs and the second will receive Sternocleidomastoid Release along with SNAGS. Both groups will be recruited concurrently.

Study Record Dates

• First Submitted: July 30, 2024
• First Posted: August 2, 2024
• Study Start: June 10, 2024
• Primary Completion: December 10, 2024
• Study Completion: December 30, 2024
• Last Updated: August 2, 2024

Record last verified: 2024-07

Locations

PA (1)