Effectiveness of Dural Tube Myofascial Release on Suboccipital Muscle Thickness, Cervical Flexion-Rotation Range & Clinical Metrics For Cervicogenic Headache: Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 34
- 试验地点
- 1
- 主要终点
- 1. Suboccipital Muscle thickness assessment using ultrasonography
研究概览
简要总结
Cervicogenic headache (CGH) is commonly linked to physical impairments in the joints, muscles and neural structures of the cervical region, particularly the upper spine. Due to the referral of pain from the neck, CGH is frequently misdiagnosed and overlooked in individuals experiencing neck pain, leading to inadequate treatment. Physiotherapy is a safe and effective alternative, employing manual therapy techniques and highlighting the fascial concept to tackle neuro-musculoskeletal conditions linked to cervicogenic headaches.
Various systematic reviews favour the use of sustained natural apophyseal glides (SNAGs) as a part of non-pharmacological management of cervicogenic headache. The clinical practice guidelines suggest that SNAGs and low load cervical exercises can be considered as a standard line of management for cervicogenic headache. However the potential effect of SNAGS and low load exercises on cervical muscle dysfunction visualized based on cervical muscle thickness in relation to the myodural bridge or dura using ultrasonography is seldom studied, there is also lack of supporting evidence considering the carry over effect of these techniques on the clinical metrics of cervicogenic headache.
Application of Myofascial release (MFR) techniques like trigger point therapy and suboccipital release in reducing the intensity of CGH has been researched with positive outcomes. However none of these techniques targeted the dural tube that is a potential factor for CGH, that would have an impact on muscle thickness connecting the dural tube.
Considering the dural tube being a major contributing factor for CGH which is linked through fascia of suboccipital muscles, the potential effect of fascial techniques like dural tube MFR that are specifically targeting the bridge and dura on clinical metrics (intensity, frequency, duration & severity) and muscle thickness is unknown and not explored. Thus it was hypothetized to determine and compare the effect of dural tube myofascial release with Sham release along with standard physical therapy care on suboccipital muscle thickness, cervical flexion-rotation range and clinical metric of headache in individuals with cervicogenic headache.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 盲法
- Participant and Investigator Blinded
入排标准
- 年龄范围
- 18.00 Year(s) 至 50.00 Year(s)（—）
- 性别
- All
入选标准
- •Individuals diagnosed with CGH based on the CHISG with a mandatory presentation of unilaterality of the head pain without side-shift associated with the neck pain and positive flexion-rotation test less then 33 degrees.31 2.All gender individuals aged 18-50 years.
- •3.Willingness to participate in the intervention while continuing to follow up for 12 weeks.
排除标准
- •1.Primary headache according to ICHD.9 2.Exhibiting any red flags for manual therapy15 like spinal infection, vertebral tumors or fracture, cervical instability, metabolic diseases, rheumatoid arthritis, osteoporosis, dizziness or visual disturbance symptoms, skin inflammatory condition, ulcers or wounds around treatment area.
- •3.Any medical or surgical conditions that prevents the participants from going in prone position as it is required for the intervention.
- •4.Taking prescribed analgesics or physiotherapy or any other allied therapies for the treatment of headache/ cervical pain/ or any other condition within 1 month.
- •Radiating pain in the upper extremity/neurological deficits to the upper extremities or known cases of cervical disc condition, arthritis of the cervical spine.
- •6.History of central nervous system involvement and vestibular dysfunction.
- •7.History of prior surgery to the head or neck.
- •8.Pregnancy.
结局指标
主要结局
1. Suboccipital Muscle thickness assessment using ultrasonography
时间窗: Baseline and Post intervention (4 weeks)
2. Flexion Rotation Test
时间窗: Baseline and Post intervention (4 weeks)
次要结局
- 1. Intensity, Duration and Frequency(2. Quality of life)
研究者
Aarti Welling
KLE Institute of Physiotherapy