Impact of Adding Jones Technique to Mulligan Therapy in Patients With Cervicogenic Headache

Not Applicable

Not yet recruiting

• Conditions: Cervicogenic Headache

• Registration Number: NCT07047313
• Lead Sponsor: Cairo University

Brief Summary

this study will be conducted to investigate impact of adding jones technique to mulligan therapy in patients with cervicogenic headache

Detailed Description

Cervicogenic headache (CeH) is a secondary headache attributed to dysfunctions of the cervical spine (international headache society. CGH is a non-throbbing, unilateral, side locked headache that originates in the cervical spine and gradually spreads to the occipital, temporal and orbital areas. It is associated with neck pain or stiffness and is often aggravated by sustained neck postures, repeated neck movements or physical activity. A survey published in 2003 found that strain-counterstrain was the forth most commonly used manipulative technique among providers of osteopathy in the US. The most common explanation for the effects of strain-counterstrain is that it influences aberrant neuromuscular activity mediated by muscle spindles, local circulation and inflammatory reactions. Clinical research into the effects of strain-counterstrain has only begun to emerge in recent years . The Mulligan manoeuvre is one of the best manipulations. Unlike traditional mobilization, which relies solely on the therapist, Mulligan posited that by exerting pressure on the spinous processes in a weight-bearing stance, the facet joints would undergo a synchronized sliding motion in a parallel manner. At the same time, It requires the patient to move actively in order to achieve the perfect therapeutic effect ,The Mulligan maneuver is highly efective in the manipulative treatment of CEH A systematic review have demonstrated the efficacy of the Mulligan maneuvre for CEH on clinical pain scales and cervical range of motion after treatment

Study Timeline

• Status Verified: 2025-06
• Study First Submitted: 2025-06-24
• Study First Submitted QC: 2025-06-24
• Last Update Submitted: 2025-06-24
• Study Start: 2025-06-30
• Study First Posted: 2025-07-02
• Last Update Posted: 2025-07-02
• Primary Completion: 2026-01-30
• Study Completion: 2026-01-30

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 90

Inclusion Criteria

• 20 to 60 years old patient with unilaterally of the head pain
• pain triggered by external pressure over the upper cervical joints (c1-c3)
• pain elicited by the neck movements, and/or sustained awkward positions with reduced neck ROM
• headache intensity pain score of at least 20mm on the Visual analogue scale (VAS)
• headache frequency of at least once a week for at least 3 months
• minimum neck disability index score of 10 points or greater

Exclusion Criteria

• Migraine, tension- type headache, tumor, osteoporosis, fracture, rheumatoid arthritis and metabolic diseases.
• Prolonged history of steroid use.
• Resting blood pressure greater than 140/90 mmhg.
• cervical spinal stenosis, diminished sensation and central nervous system involvement,
• previous head or neck surgery or whiplash injury history within the last 6 weeks

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
pain intesnity	up to four weeks	visual analogue scale will be used to asses pain intensity which patient will be instructed to put point on line from no pain to tolerable pain. The scale consists of a line, usually 100 mm long, ranging from no pain or discomfort (zero) , to the worst pain that could possibly feel .
headache disability	up to four weeks	The Headache spesific Disability Questionnaire was used to assess headcahe disability. it is a self-administered scale with 9 items that assesses pain intensity, work or school disruptions, and the effect on recreational activities in individuals with headache complaints. Higher scores reflect greater impairment.

Secondary Outcome Measures

Name	Time	Method
neck disability	up to four weeks	will be measured by Arabic neck disability index. It contains ten category/classes. Each category contains six choices (zero-five).Score from zero to four no disability, from five to 15 this is mild, From 15 to 24 this is moderate, from 25 to 34 this is severe, more than 34 this is a complete disability
pressure pain threshold	up to four weeks	pressure pain threshold pressure pain threshold will be assessed by commander algometer
cervical range of motion	up to four weeks	range of motion will be measured by inclinometer CROM. The CROM (deluxe version - Performance Attainment Associates, Roseville, MN, USA) measures the cervical range of motion5- for fexion, extension, lateral fexion, and rotation using separate inclinometers. These inclinometers are attached to a frame similar to that for eyeglasses one in the sagittal plane for fexion - extension, second in the frontal plane for lateral fexion and a third in the horizontal plane for rotation.
headache frequency	up to four weeks	the number of days the subjects feel headache (headache frequency).
medication intake	up to four weeks	from the patients' diary in the last week , medications intake will be recorded as follow: 1) not at all; 2) once a week; 3) once every couple of days; 4) once or twice a day; or 5) three or more times a day
headache duration	up to four weeks	the total hours of headache (headache duration).