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Spinal manipulation versus cervical stretching and strengthening in the treatment of tension-type headaches with forward head posture: a randomized clinical trial

Phase 4
Conditions
Musculoskeletal Diseases
Registration Number
PACTR201904920882014
Lead Sponsor
niversity of Johannesburg
Brief Summary

Intra-group analysis for the NDI, pressure algometer and the CVA found statistically significant post-treatment differences in all treatment groups (p < 0.001). The spinal manipulation group showed the greatest percentage improvement regarding the subjective data NDI (49.54%) and pressure algometer (133.80%). The soft tissue group showed the greatest percentage improvement regarding the objective CVA (24.93%). There was no statistical evidence of an additive effect of when the two treatment approaches were used simultaneously

Detailed Description

Not available

Recruitment & Eligibility

Status
Complete
Sex
All
Target Recruitment
30
Inclusion Criteria

In order to be included into the study, participants needed to comply with the following criteria:

•Symptomatic males and females who have a forward head posture. Patients are considered to have a forward head posture when their head and cervical spine leans anteriorly to the plumb line that passes the lateral malleolus in sagittal view.9
•Participants between the ages of 18 and 50 years. These are the individuals who are most susceptible to developing a forward head posture due to continual studying positions, work positions and sleeping positions.10
Participants had to be suffering from tension-type headaches. The diagnostic criteria for tension-type headaches, according to the International Headache Society are:11

A)At least 10 previous headache episodes fulfilling criteria B through D.
B)Headaches lasting anywhere from 30 minutes to seven days.
C)At least two of the following characteristics:
- A pressing or tightening (non-pulsating) quality around the head;
- Mild to moderate intensity;
- Bilateral location; and
- No aggravation from walking stairs or similar routine activities.
D)Absence of the following:
- Nausea or vomiting; and
- Phonophobia and photophobia; one may be present but not both.

Exclusion Criteria

Participants were excluded if they presented with the following:
•Any known congenital anomalies that can result in a forward head posture e.g. wedge vertebrae.
•Contraindication to cervical spine manipulative therapy.
•History of cervical spine surgery.
•Participants demonstrating a forward head posture but are asymptomatic for headaches.
•Red flags of headaches

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
The primary outcome of this study was to compare the effectiveness of two different treatment approaches on the same condition. It was found that all three groups showed a clinical improvement but that spinal manipulations was more effective with pain relief and the soft tissue protocol was more effective with correcting posture.
Secondary Outcome Measures
NameTimeMethod
A secondary outcome was to determine if a combination of the two would have an additive effect, this was found not to be the case.
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