Mulligan SNAG Versus Active Release Technique in Cervicogenic Headache.
- Conditions
- Cervicogenic Headache
- Registration Number
- NCT07132047
- Lead Sponsor
- University of Lahore
- Brief Summary
This study is designed to compare two different manual therapy approaches for individuals with cervicogenic headaches, a type of headache that originates from the neck. Participants will be randomly assigned to one of two groups.
The first group will receive Mulligan mobilization using sustained natural apophyseal glides (SNAG) along with a home program of Mobilization self-SNAG exercises.
The second group will receive the Active Release Technique (ART) combined with a home program of stretching and strengthening exercises for the neck and shoulder muscles. Each participant will attend treatment sessions three times per week for four weeks. Pain levels, headache impact, and neck function will be evaluated at the start, after four weeks of treatment, and again at eight weeks to determine which method provides better outcomes.
- Detailed Description
Cervicogenic headache is a form of secondary headache caused by dysfunction in the cervical spine. It is often associated with neck pain, restricted mobility, and limitations in daily activities. Manual therapy, combined with targeted exercises, is frequently used in rehabilitation to reduce pain and improve neck function. This randomized controlled trial aims to compare the effectiveness of Mulligan mobilization with sustained natural apophyseal glides (SNAG) versus the Active Release Technique (ART) in the treatment of cervicogenic headache.
Group A - Mulligan Mobilization SNAG and Home Exercise:
Participants in this group will receive the Headache SNAG technique, which involves a gentle, sustained postero-anterior glide of the second cervical vertebra for 10 to 30 seconds to help reduce headache intensity. If relief is noted, up to six repetitions may be performed. In addition, each participant will be prescribed a home program consisting of C1-C2 self-SNAG rotation using a towel to apply pressure on the posterior arch of C1 during active cervical rotation. The exercise will be completed twice daily, with 10 repetitions per session. Written instructions will be given to ensure correct performance and better compliance.
Group B - Active Release Technique and Home Exercise Program:
Participants allocated to this group will receive the Active Release Technique (ART), a hands-on treatment aimed at releasing tight muscles and improving soft tissue mobility. During ART, controlled pressure is applied to specific muscles while the neck is moved to restore normal function and reduce discomfort. Target muscles include the pectoralis major, upper trapezius, levator scapulae, rhomboids, deep neck flexors, and serratus anterior.
The intervention will also include a structured exercise program designed to stretch and strengthen the neck and shoulder muscles, reduce tension, and enhance posture. Stretches will consist of sitting chair stretch, Brugger's stretch, wall angles, and doorway stretches. Strengthening activities such as the Kibler squeeze and head/neck retractions will also be incorporated. The home program will begin with gentle neck stretches, such as tilting the head toward one shoulder and holding the position for 20-30 seconds, repeating three times on each side. Chin tucks will be performed by gently retracting the chin without tilting the head, holding for 5 seconds, and repeating 10 times for 2-3 sets. These exercises aim to relieve muscle tightness, improve alignment, and help alleviate headache symptoms.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 72
-
* Aged between 20-50 years
- Both Male and females
- Individuals diagnosed with neck pain accompanied by headaches.
- Individuals with Unilateral or Bilateral cervicogenic headache.
- Headache at least 3 times during the last 3 months.
-
* History of inflammatory disorders (e.g Rheumatoid Arthritis).
- History of trauma to the cervical region.
- History of Neurological conditions (myelopathy, radiculopathy or disc problems).
- Taking medications for headache.
- Pregnancy.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Neck Disability Index (NDI) score Baseline, 4 weeks, and 8 weeks after start of intervention The purpose of the Neck Disability Index (NDI) questionnaire is to gather data on how your neck pain has impacted your capacity to function in daily life. The NDI is divided into ten categories, each of which is rated from 0 to 5, where 5 represents "worst imaginable pain" and 0 represents "no pain". The sum of the points determines the final score, with 0 denoting no activity constraints and 50, or 100%, denoting entire activity limitations.
- Secondary Outcome Measures
Name Time Method Numeric Pain Rating Scale (NPRS) score. Baseline, 4 weeks, and 8 weeks after start of intervention In the segmented numerical version of the NPRS, a respondent chooses a whole number (0-10 integers) that most accurately represents the level of pain they are experiencing. A horizontal bar or line is the standard format. It takes less than a minute to finish the NPRS. Greater pain intensity is indicated by higher scores, which range from 0 to 10.
Headache Disability Index (HDI) score Baseline, 4 weeks, and 8 weeks after start of intervention The Henry Ford Hospital Headache Disability Inventory/Index (HDI) was created to measure how headaches affect day to day functioning. A 25-item headache questionnaire that was developed from the case history answers of individuals who had headaches was divided into functional and emotional subscales to evaluate how headaches and their management affected daily activities.
Trial Locations
- Locations (1)
The University Of Lahore Teaching Hospital
🇵🇰Lahore, Pakistan
The University Of Lahore Teaching Hospital🇵🇰Lahore, Pakistan