The Role Of Fascia And Breathing Exercises In The Treatment Of Cervicogenic Headache

NCT07518108 | Not Yet Recruiting

• 1 other identifier: MNINCE-2026-CGH01
• Study Type: interventional
• Target: 72
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to investigate the effect of specific exercise programs on individuals suffering from cervicogenic headaches, a type of headache originating from neck problems. While traditional physiotherapy is the standard approach, this research examines whether the addition of specific "fascia-focused" exercises or "breathing exercises" provides improved relief. Fascia is a thin, protective membrane layer surrounding every muscle and organ in the body. In this study, participants will be divided into three groups. All participants will receive standard neck exercises and posture training. One group will perform dynamic exercises targeting the body's connective tissue (fascia) to improve flexibility and coordination. Another group will practice specific breathing techniques to help reduce muscle tension and stress-related triggers. The exercises will be administered to participants for 12 weeks. It is expected that fascia exercises and breathing exercises will have positive effects on headaches as a result of the applied treatments.

Conditions

Cervicogenic Headache

Keywords

Thoracolumbar Fascia; Fascia Exercise; Breathing Exercise; Randomized Controlled Trial; Pain; Physical Therapy; Headache Impact Test; Cervicogenic Headache; Fascia thickness; Ultrasound imaging

Outcome Measures

Primary Outcomes (1)

• Change in Headache Impact Test (HIT-6) score from baseline to 12 weeks (post-intervention)

  The Headache Impact Test (HIT-6) is a validated 6-item questionnaire used to assess the impact of headache on daily life. Scores range from 36 to 78, with higher scores indicating greater headache-related disability.

  Baseline, 12 weeks (post-intervention)

Secondary Outcomes (7)

• Change in headache frequency recorded by headache diary from baseline to 12 weeks (post-intervention) and 24 weeks (follow-up)

  Baseline, 12 weeks (post-intervention), and 24 weeks (follow-up)

• Change in pain intensity measured by the Visual Analog Scale (VAS) from baseline to 12 weeks (post-intervention) and 24 weeks (follow-up)

  Baseline, 12 weeks (post-intervention), and 24 weeks (follow-up)

• Change in neck-related disability measured by the Neck Disability Index (NDI) from baseline to 12 weeks (post-intervention) and 24 weeks (follow-up)

  Baseline, 12 weeks (post-intervention), and 24 weeks (follow-up)

• Change in quality of life measured by the WHOQOL-BREF from baseline to 12 weeks (post-intervention) and 24 weeks (follow-up)

  Baseline, 12 weeks (post-intervention), and 24 weeks (follow-up)

• Change in Headache Impact Test (HIT-6) score from baseline to 24 weeks (follow-up)

  Baseline, 24 weeks (follow-up)

Study Arms (3)

Conventional Treatment Group

ACTIVE COMPARATOR

Participants in this group will receive conventional treatment consisting of postural education, cervical range of motion exercises, and stretching and strengthening exercises targeting the cervical and surrounding musculature.

Other: Conventional treatment

Breathing Exercise Group

EXPERIMENTAL

The breathing exercise program will consist of techniques focusing on diaphragmatic breathing and respiratory control. This intervention aims to improve breathing patterns, enhance respiratory efficiency, and reduce accessory muscle overactivity. Exercises will be performed under supervision throughout the intervention period. This approach may contribute to the reduction of headache symptoms by improving respiratory function and reducing muscular tension.

Other: Breathing Exercise

Thoracolumbar Fascia Exercise Group

EXPERIMENTAL

Participants in this group will undergo a structured, specifically designed, supervised thoracolumbar fascia-focused exercise program aimed at improving fascial mobility, neuromuscular control, and load transfer across the trunk and spine, which may contribute to the reduction of headache symptoms.

Other: Thoracolumbar Fascia Exercise

Interventions

Thoracolumbar Fascia Exercise OTHER

The exercise program will consist of mobility, activation, and stabilization exercises targeting the thoracolumbar fascia. The intervention is designed to improve fascial mobility, enhance force transmission, and optimize neuromuscular coordination of the trunk. Exercises will be performed under supervision, consisting of three sessions per week for twelve weeks.

Thoracolumbar Fascia Exercise Group

Breathing Exercise OTHER

The breathing exercise program will consist of techniques focusing on diaphragmatic breathing and breath control. This intervention aims to improve breathing patterns, increase respiratory efficiency, and reduce overactivity of accessory muscles. The exercises will be performed under supervision, three sessions per week for twelve weeks.

Breathing Exercise Group

Conventional treatment OTHER

Participants in this group will receive a single initial session of conventional treatment, including postural education, cervical range of motion exercises, and stretching and strengthening exercises targeting the cervical and surrounding musculature. Following this session, participants will be prescribed a structured home exercise program to be performed independently for 12 weeks without supervised sessions. Participants will be asked to adhere to the home program throughout the intervention period. Outcome assessments will be conducted at baseline, 12 weeks (post-intervention), and 24 weeks (follow-up).

Also known as: Control

Conventional Treatment Group

Eligibility Criteria

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

You may qualify if:

• Adults aged 18-60 years
• Diagnosis of cervicogenic headache according to the International Classification of Headache Disorders, 3rd edition (ICHD-3)
• Headache duration of at least 3 months
• Presence of headache associated with cervical movement limitation or provoked by neck movement
• Pain intensity of ≥3 on the Visual Analog Scale (VAS) at baseline
• Ability to understand and comply with the study procedures
• Willingness to participate and provision of written informed consent

You may not qualify if:

• Presence of other primary headache disorders (e.g., migraine, tension-type headache, cluster headache)
• Diagnosis of rheumatologic diseases (e.g., rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus)
• Serious cervical spine pathologies (e.g., cervical myelopathy, spinal stenosis)
• Presence of neurological deficits or central nervous system disorders
• Received physical therapy for the cervical region within the past 3 months
• Severe psychiatric disorders or cognitive impairment that may interfere with participation
• Pregnancy
• Cardiopulmonary conditions contraindicating exercise
• Musculoskeletal disorders that may interfere with exercise adherence

Sponsors & Collaborators

• Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital: lead

Study Sites (1)

Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital

Istanbul, Istanbul, 34785, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Post-Traumatic Headache; Pain

Interventions

Breathing Exercises

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Mind-Body Therapies; Complementary Therapies; Therapeutics; Exercise Movement Techniques; Physical Therapy Modalities

Central Study Contacts

Merve N CAN, MD

CONTACT

+905309421498; mervenur9830@gmail.com

Pelin YILDIRIM, MD

CONTACT

+905323801078; drpeliny@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Outcome assessments will be performed by an assessor blinded to group allocation. Due to the nature of the interventions, participants and therapists cannot be blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This study is designed as a three-arm, parallel-group randomized controlled trial. Participants will be randomly assigned to one of the following groups using a computer-generated randomization sequence: a thoracolumbar fascia-focused exercise group, a breathing exercise group, or a control group receiving conventional treatment. All interventions will be administered over a defined treatment period, and outcome measures will be assessed at baseline, post-intervention, and at follow-up.

Study Record Dates

• First Submitted: April 1, 2026
• First Posted: April 8, 2026
• Study Start: April 20, 2026
• Primary Completion (Estimated): August 30, 2026
• Study Completion (Estimated): October 30, 2026
• Last Updated: April 22, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)