The Role Of Fascia And Breathing Exercises In The Treatment Of Cervicogenic Headache: A Randomized Controlled Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Active, not recruiting
- Sponsor
- Enrollment
- 72
- Locations
- 1
- Primary Endpoint
- Change in Headache Impact Test (HIT-6) score from baseline to 12 weeks (post-intervention)
Study Overview
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.
Detailed Description
This study is designed as a prospective, three-arm, randomized controlled trial to evaluate the effectiveness of different exercise-based interventions in individuals with cervicogenic headache (CGH). CGH is a secondary headache resulting from dysfunction of the cervical spine and related structures, typically characterized by neck pain and restricted cervical mobility.
Participants diagnosed with CGH according to the International Classification of Headache Disorders (ICHD-3) criteria will be recruited from a physical therapy and rehabilitation clinic setting. Following informed consent, eligible participants will be randomly assigned to one of three study arms.
All participants will receive a standard physiotherapy program consisting of patient education and therapeutic exercises targeting cervical function. In addition to the basic protocol, intervention groups will receive either exercises that activate the thoracolumbar fascia or specific breathing exercises.
The primary outcome measure is the Headache Impact Test-6 (HIT-6). In addition, pain intensity, functional status, quality of life, and psychological status will be assessed using validated clinical instruments. Thoracolumbar fascia thickness will be evaluated using ultrasonography at predefined time points using a standardized measurement protocol to assess structural changes associated with the interventions.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Outcomes Assessor)
Masking Description
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.
Eligibility Criteria
- Ages
- 18 Years to 60 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •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
Exclusion Criteria
- •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
Arms & Interventions
Thoracolumbar Fascia Exercise Group
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.
Intervention: Thoracolumbar Fascia Exercise (Other)
Conventional Treatment Group
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.
Intervention: Conventional treatment (Other)
Breathing Exercise Group
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.
Intervention: Breathing Exercise (Other)
Outcomes
Primary Outcomes
Change in Headache Impact Test (HIT-6) score from baseline to 12 weeks (post-intervention)
Time Frame: Baseline, 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.
Secondary Outcomes
- 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))
- Changes in depression scores as measured by the Hospital Anxiety and Depression Scale (HADS)(Baseline, 12 weeks (post-intervention), and 24 weeks (follow-up))
- Change in thoracolumbar fascia thickness measured by ultrasound(Baseline, 12 weeks (post-intervention), and 24 weeks (follow-up))