Comparison of Myofascial Release and Mulligan Concept Techniques in Patients With Cervicogenic Headache

NCT06690411 | Completed DMC

• 1 other identifier: E-10840098-202.3.02-4329
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

The International Headache Society classifies cervicogenic headache as a secondary headache caused by a disorder of the cervical spine and its components. Mulligan Concept (SNAG) is a gentle manual therapy that can be applied to the neck area. The myofascial release technique is also a massage-type manual therapy technique that is widely used in physiotherapy to relieve pain and tension in the relevant muscle group. This clinical trial aims to investigate the effectiveness of the Mulligan Concept and myofascial release technique in patients with cervicogenic headaches. The main questions it aims to answer are:

• Undergo the evaluations mentioned above before and after interventions
• Undergo Mulligan Concept applications or the myofascial release technique 3 times a week for 4 weeks
• Keep a diary of their symptoms and the number of times they use a drug

Conditions

Cervicogenic Headache; Cervicogenic Headaches

Keywords

Cervicogenic headache; Mulligan SNAG; Myofascial Release; Physiotherapy; Headache; Manual Therapy

Outcome Measures

Primary Outcomes (2)

• Headache Impact Test-6

  Headache Impact Test-6 (HIT-6) evaluates the effects of headaches on daily living activities. HIT-6 shows good internal consistency, retest reliability, validity and responsiveness. A total score of 36 is the best in terms of headache, and 78 is the worst. In this study, HIT-6 will be used to evaluate how headache affects individuals' daily living activities.

  10 minutes

• Hand Grip Strength Measurement

  To the best of our knowledge, no previous study has evaluated the effect of headache on handgrip strength. However, studies have shown a negative correlation between neck pain and handgrip strength. The Jamar Hand Dynamometer is the gold standard tool for handgrip strength assessment in clinical and research settings with its validity and reliability. In this study, Jamar dynamometer will be used to evaluate the hand grip strength of patients on the affected side.

  1 minute

Secondary Outcomes (6)

• Muscle Tone Measurement

  5 minutes

• Cervical Range of Motion Measurement

  5 minutes

• Pain Pressure Threshold Measurement

  5 minutes

• Neck Disability Index

  10 minutes

• Diary

  3 minutes a day

Study Arms (2)

Myofascial Release Group

EXPERIMENTAL

Twenty participants who will be randomized into the myofascial release group will undergo the myofascial release technique by an experienced physiotherapist 3 times a week for 4 weeks.

Other: Myofascial Release Technique

Mulligan SNAG group

EXPERIMENTAL

Twenty participants who will be randomized into the Mulligan SNAG group will undergo the Mulligan SNAG technique by an experienced physiotherapist 3 times a week for 4 weeks.

Other: Mulligan Concept

Interventions

Mulligan Concept OTHER

The participants of the Mulligan SNAG group will undergo the Mulligan SNAG technique. Mulligan's SNAG technique is a gentle manual therapy method. This technique is based on the correction of the joint position. There are 3 techniques specified for headache; Headache SNAG, Reverse Headache SNAG, and C1-C2 SNAG.

Mulligan SNAG group

Myofascial Release Technique OTHER

Myofascial therapy can be described as massage-type manual therapy. The participants of the Myofascial Release Group will undergo the myofascial release technique.

Myofascial Release Group

Eligibility Criteria

• Age: 25 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Having been diagnosed with cervicogenic headache according to the International Classification of Headache Disorder-III diagnostic criteria
• Having been diagnosed with cervicogenic headache for more than 3 months
• Having a headache accompanying neck pain
• Having restricted neck joint movement according to the Flexion-Rotation Test
• Having pain between 3 and 8 according to the Visual Analog Scale
• Being between 25-60 years of age
• Agreeing to participate in the study voluntarily

You may not qualify if:

• Previous cervical surgery
• Previous cervical trauma
• Having received diagnosis-related physiotherapy in the last 6 months
• Diagnosis of tumor or cancer
• Having other types of headache
• Serious cardiovascular, cerebrovascular, hematological, metabolic, neurological or mental disease
• Being pregnant or breastfeeding
• Having red flags for manual therapy
• Dizziness with headache, visual disturbance
• Congenital cervical disorder
• Rheumatoid arthritis, cervical spondylolisthesis, cervical instability, infection

Sponsors & Collaborators

• Istanbul Kent University: collaborator
• Istanbul Medipol University Hospital: lead

Study Sites (1)

Sefakoy Medipol University Hospital

Istanbul, Istanbul, 34295, Turkey (Türkiye)

Location

Related Publications (3)

• Correll S, Field J, Hutchinson H, Mickevicius G, Fitzsimmons A, Smoot B. RELIABILITY AND VALIDITY OF THE HALO DIGITAL GONIOMETER FOR SHOULDER RANGE OF MOTION IN HEALTHY SUBJECTS. Int J Sports Phys Ther. 2018 Aug;13(4):707-714.

  PMID: 30140564 BACKGROUND

• Corum M, Aydin T, Medin Ceylan C, Kesiktas FN. The comparative effects of spinal manipulation, myofascial release and exercise in tension-type headache patients with neck pain: A randomized controlled trial. Complement Ther Clin Pract. 2021 May;43:101319. doi: 10.1016/j.ctcp.2021.101319. Epub 2021 Jan 24.

  PMID: 33517104 BACKGROUND

• Liang Z, Thomas L, Jull G, Treleaven J. The Neck Disability Index Reflects Allodynia and Headache Disability but Not Cervical Musculoskeletal Dysfunction in Migraine. Phys Ther. 2022 May 5;102(5):pzac027. doi: 10.1093/ptj/pzac027.

  PMID: 35230421 BACKGROUND

MeSH Terms

Conditions

Post-Traumatic Headache; Headache

Interventions

Myofascial Release Therapy

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Massage; Therapy, Soft Tissue; Musculoskeletal Manipulations; Complementary Therapies; Therapeutics; Physical Therapy Modalities; Rehabilitation

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The researcher who makes the evaluations will not know which treatment the individuals received, in other words, will be blind to the groups.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer, Assoc. Dr.

Model Details: This study will be a single blind-randomized clinical trial. The researcher who makes the evaluations will not know which treatment the individuals received, in other words, will be blind to the groups.

Study Record Dates

• First Submitted: November 13, 2024
• First Posted: November 15, 2024
• Study Start: November 13, 2024
• Primary Completion: February 1, 2026
• Study Completion: February 18, 2026
• Last Updated: March 25, 2026

Record last verified: 2025-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)