IMMEDIATE AND SHORT-TERM EFFECT OF COMBINING SUBOCCIPITAL MYOFASCIAL RELEASE WITH MAITLAND MOBILIZATION ON CERVICOGENIC HEADACHE
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 57
- 试验地点
- 1
- 主要终点
- headache intensity
研究概览
简要总结
This study aims to investigate immediate and short-term effect of combining suboccipital myofascial release with Maitland mobilization techniques on headache intensity, duration, and frequency, CFRT, upper cervical ROM, general neck mobility, and PPT of upper trapezius and suboccipital muscles.
详细描述
Cervicogenic headache (CGH) was firstly defined by Ottar Sjaastad a Norwegian neurologist in 1980 as subtype of headache that is irritated by cervical spine movement . CHG is not a primary cause of headache, yet it is a specific type of headache that is caused by different structural abnormalities of the upper neck region leading to neck pain . Headache generally was documented as a high prevalent condition among people. It was classified into three main different types including migraine, tension type and CGH . CGH is common among patients that is responsible for 15-20% of all headache types .
The underlying pathophysiological mechanism of CGH includes any structural abnormality or irritation of the three upper cervical segments (c1, c2 and c3) and muscles supplied by their nerves which consequently led to unilateral referred pain around anatomical bone structures of head, occipital, frontal and temporal regions . Upper cervical pain is the main characteristic of CGH that is presented in 80 percent of the cases . CGH originate from musculoskeletal component disorders such as spine or muscles or disc and another component that aggravates neck pain and mainly arises from upper cervical and atlantooccipital joint that refers symptoms to head or temporal area .
Management of CGH includes pharmacological and non-pharmacological treatment. Regarding the pharmacological treatment, it may relieve pain efficiently, yet, it has many side effects on both short and long term. On the other side, non-pharmacological therapy has positive effects on both pain and function with minimal side effects. It includes manual therapy such as massage, spinal manipulation, and myofascial release, ROM exercises, stretching exercises, strengthening exercise and mobilization techniques aiming at pain relief and curing headache.
The effect of manual therapy had been suggested to be due to modifying sensitivity of the trigeminocervical nucleus . Additionally, myofascial release as a type of manual therapy is observed to relieve pain that is caused by restriction of soft tissue and reduce tissue load that improves eventually ROM (Tavakkoli et al., 2024). Specifically, the myofascial release for the suboccipital region aims at reliving stress and increasing elasticity of suboccipital muscles that were shortened or spasmed due to long and bad body habits such as forward head posture.
The effect of suboccipital release has been documented in different studies according to a systematic review . It improves pain and ROM in patients with CGH. It is used as an immediate pain killer in suboccipital region and improve ROM along cervical and disability of neck during functional activities through correct forward head abnormality.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 20 Years 至 40 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Each patient will be included in our study if only he/she meets all of the following criteria:
- •Age between 20- 40 year.
- •No physiotherapy intervention at least for the last three months (Mohamed et al., 2019).
- •Neck pain elicited and disturbed by neck movement or maintained position pain produced by pressure over upper cervical (Dunning et al.,2021).
- •Limited neck motion with flexion and rotation test less than or equal 32 degree on both right and left side (Dunning et al.,2021).
- •Patients suffered from intermittent headaches of varying duration and pain level at least once every week through the last 3 months (Hall et al., 2010; Khalil., et al 2019).
- •The patient will be excluded if he /she meets one of the following criteria:
- •Physical therapy intervention during last three months (Mohamed et al., 2019).
- •Primary headaches such as migraine or tension type headache (Mohammadi et al.,2021).
- •Cervical radiculopathy, history of neck trauma and previous surgery at neck or shoulder, spondylosis (Mohammadi et al.,2021).
- •Vertebrobasilar insufficiency or vestibular dysfunctions (Mohamed et al., 2019).
- •Any degenerative vertebral lesion (Shabbir et al., 2021).
- •Concomitant medical diagnosis of any primary headache (tension type or migraine) (Shabbir et al., 2021).
排除标准
- 未提供
结局指标
主要结局
headache intensity
时间窗: Time Frame: before treatment and one week after treatment
headache intensity Description: headache intensity which represent the primary outcome by using numerical analogue scale for measure intensity before treatment and one week post treatment
次要结局
- Headache Frequency Headache Duration Cervical Flexion Rotation Test Neck Mobility Assessment Pressure Pain Threshold(Headache Frequency and headache duration before and one week after treatment. Cervical Flexion Rotation Test and Mobility Assessment and Pressure Pain Threshold measurement before and after and one week post treatment)
研究者
Mohamed Alaa Mahmoud Ahmed
Msc candidate, orthopedic physical therapy department , cairo university
Cairo University