Additional Effects of Sternocleidomastoid Release With SNAGS in the Management of Cervicogenic Headache
Trial Snapshot
- Phase
- Not Applicable
- Status
- Active, not recruiting
- Enrollment
- 38
- Locations
- 1
- Primary Endpoint
- Headache Disability
Study Overview
Brief Summary
Cervicogenic headache is a common type of headache in adults which causes disability and difficulty in everyday activities. According to the latest International Headache Society model, cervicogenic headache (CGH) is a secondary headache having C1-C2 dysfunction. SNAGs are highly effective in the treatment approach for these patients. Sternocleidomastoid muscle receive overactive tension from forward neck posture, increasing muscular fatigue and tone of muscles. This tension in SCM causes referred pain in the head and neck region. SNAGs are very effective but musculoskeletal impairments especially the tightness of sternocleidomastoid muscle still persist and can exacerbate symptoms. Manual therapy targeted to the SCM muscle may be effective for reducing headache and neck pain intensity and increasing performance of deep cervical flexors. Findings of this study will aid the therapists in choosing which technique to use while treating the patients. This will save therapist's time and effort as they will not be using the less effective treatment protocol. Furthermore, patient's time and investment will be used in the right direction.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 45 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Age group: 18-45 years old
- •Both males and females
- •Unilateral headache with no shift of side
- •C1-C2 Dysfunction
- •Positive flexion rotation test (Rotation restriction is greater than 10 degrees)
- •Headache at least once a month in the last 3 months
- •Headache with at least 4 score in NPRS (Sign and Symptoms of Neck Involvement)
- •Headache with restriction of ROM in the neck
- •Headache precipitated by:
- •Sustained neck movements, and awkward head positioning. External Pressure over upper cervical or occipital region
- •Headache Characteristics:
- •Moderate-severe, non-throbbing pain, usually starting in the neck.
- •Episodes of varying duration, or: fluctuating, continuous pain
Exclusion Criteria
- •Headache of non-cervical origin
- •Diagnosed Cases of:Cervical spondylosis,Cervical radiculopathy/ nerve root involvement/ disc herniation,Cervical instability/ fracture,Vertebrobasilar insufficiency ,Cervical spine surgery,Cervical spondylolisthesis,Spinal infection or tumors,Osteoporosis,History of trauma,Rheumatoid Arthritis,Inflammatory Arthritis
Arms & Interventions
Conventional physical therapy Group
Both Group A and Group B will receive this conventional physical therapy protocol for cervicogenic headache.
- Moist heat therapy: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks.
- TENS application: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks.
In addition to this, they will receive Headache SNAGs (Sustained Natural Apophyseal Glides) 5 sets of 10 repetitions. Each repetition will be given with a 10 second hold.
• Frequency: 3 times a week for 2 weeks. 6 sessions in total.
Intervention: Electrotherapy and physical agents (Procedure)
Conventional physical therapy Group
Both Group A and Group B will receive this conventional physical therapy protocol for cervicogenic headache.
- Moist heat therapy: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks.
- TENS application: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks.
In addition to this, they will receive Headache SNAGs (Sustained Natural Apophyseal Glides) 5 sets of 10 repetitions. Each repetition will be given with a 10 second hold.
• Frequency: 3 times a week for 2 weeks. 6 sessions in total.
Intervention: Headache SNAGs (Procedure)
Conventional physical therapy with sternocleidomastoid release
Both Group A and Group B will receive this conventional physical therapy protocol for cervicogenic headache.
- Moist heat therapy: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks.
- TENS application: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks.
Headache SNAGs: In addition to the conventional physical therapy protocol, they will receive Headache SNAGs (Sustained Natural Apophyseal Glides) 5 sets of 10 repetitions. Each repetition will be given with a 10 second hold.
- Frequency: 3 times a week for 2 weeks. 6 sessions in total. Sternocleidomastoid Release: Group B will also receive Sternocleidomastoid release in addition with headache SNAGs. Release to the sternocleidomastoid muscle will be given once per session for 5-8 minutes.
- Frequency: 3 times a week for 2 weeks. 6 sessions in total.
Intervention: Electrotherapy and physical agents (Procedure)
Conventional physical therapy with sternocleidomastoid release
Both Group A and Group B will receive this conventional physical therapy protocol for cervicogenic headache.
- Moist heat therapy: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks.
- TENS application: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks.
Headache SNAGs: In addition to the conventional physical therapy protocol, they will receive Headache SNAGs (Sustained Natural Apophyseal Glides) 5 sets of 10 repetitions. Each repetition will be given with a 10 second hold.
- Frequency: 3 times a week for 2 weeks. 6 sessions in total. Sternocleidomastoid Release: Group B will also receive Sternocleidomastoid release in addition with headache SNAGs. Release to the sternocleidomastoid muscle will be given once per session for 5-8 minutes.
- Frequency: 3 times a week for 2 weeks. 6 sessions in total.
Intervention: Headache SNAGs (Procedure)
Conventional physical therapy with sternocleidomastoid release
Both Group A and Group B will receive this conventional physical therapy protocol for cervicogenic headache.
- Moist heat therapy: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks.
- TENS application: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks.
Headache SNAGs: In addition to the conventional physical therapy protocol, they will receive Headache SNAGs (Sustained Natural Apophyseal Glides) 5 sets of 10 repetitions. Each repetition will be given with a 10 second hold.
- Frequency: 3 times a week for 2 weeks. 6 sessions in total. Sternocleidomastoid Release: Group B will also receive Sternocleidomastoid release in addition with headache SNAGs. Release to the sternocleidomastoid muscle will be given once per session for 5-8 minutes.
- Frequency: 3 times a week for 2 weeks. 6 sessions in total.
Intervention: Sternocleidomastoid Release (Procedure)
Outcomes
Primary Outcomes
Headache Disability
Time Frame: 2 weeks
Headache Disability Index will be used
Range of motion
Time Frame: 2 weeks
Cervical rotation will be measured through CROM device
Cervical Proprioception
Time Frame: 2 weeks
Joint Position Error Test will be used
Pain intensity
Time Frame: 2 weeks
Pain will be measured on the basis of Numeric Pain Rating Scale score.
Secondary Outcomes
No secondary outcomes reported