Manual Therapy and Exercise in Patients With Cervicogenic Headache

NCT ID: NCT01580280

Last Updated: 2014-11-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

112 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-04-30

Study Completion Date

2014-08-31

Brief Summary

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Hypothesis: The group of cervicogenic headache patients receiving upper cervical and upper thoracic thrust manipulation will demonstrate significant and clinically important changes in outcomes when compared to the mobilization and exercise group.

Detailed Description

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Patients with cervicogenic headache will be randomized to receive 6-8 sessions over 2-4 weeks of either: (1) upper cervical and upper thoracic thrust manipulation, or (2) upper cervical and upper thoracic non-thrust mobilization and range of motion, strength and postural exercises.

Conditions

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Cervicogenic Headache

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Thrust manipulation

Group Type EXPERIMENTAL

Thrust Manipulation

Intervention Type OTHER

Upper cervical and upper thoracic thrust manipulation for 6-8 sessions over 2-4 weeks.

Non-thrust mobilization and exercise

Group Type ACTIVE_COMPARATOR

Non-thrust Mobilization and Exercise

Intervention Type OTHER

Upper cervical and upper thoracic non-thrust mobilization and exercise for 6-8 sessions over 2-4 weeks.

Interventions

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Thrust Manipulation

Upper cervical and upper thoracic thrust manipulation for 6-8 sessions over 2-4 weeks.

Intervention Type OTHER

Non-thrust Mobilization and Exercise

Upper cervical and upper thoracic non-thrust mobilization and exercise for 6-8 sessions over 2-4 weeks.

Intervention Type OTHER

Other Intervention Names

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High-velocity low-amplitude thrust manipulation of the spine Non-thrust mobilization to cervical and thoracic spines Cervical range of motion, strength, and postural exercises

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of cervicogenic headache as defined by Cervicogenic Headache International Study Group criteria
* Headache frequency of at least one per week for a minimum of 3 months
* Minimum pain score (NPRS) of 2/10 and minimum disability score (NDI) of 10/50

Exclusion Criteria

* Bilateral headaches
* Presence of any of the following atherosclerotic risk factors: hypertension, diabetes, heart disease, stroke, transient ischemic attack, peripheral vascular disease, smoking, hypercholesterolemia or hyperlipidemia
* Red flags noted in the patient's Neck Medical Screening Questionnaire (i.e. tumor, fracture, metabolic diseases, RA, osteoporosis, prolonged history of steroid use, etc.)
* History of whiplash injury within the last 6 weeks
* Diagnosis of cervical spinal stenosis
* Bilateral upper extremity symptoms
* Evidence of central nervous system involvement, to include hyperreflexia, sensory disturbances in the hand, intrinsic muscle wasting of the hands, unsteadiness during walking, nystagmus, loss of visual acuity, impaired sensation of the face, altered taste, the presence of pathological reflexes (i.e. positive Hoffman's and/or Babinski reflexes)
* Two or more positive neurologic signs consistent with nerve root compression, including any two of the following:

* Muscle weakness involving a major muscle group of the upper extremity.
* Diminished upper extremity deep tendon reflex of the biceps, brachioradialis, triceps or superficial flexors
* Diminished or absent sensation to pinprick in any upper extremity dermatome
* Prior surgery to the neck or thoracic spine.
* Involvement in litigation or worker's compensation regarding their neck pain and/or headaches.
* Physical therapy or chiropractic treatment for neck pain or headache in the 3 months before baseline examination.
* Any condition that might contraindicate spinal manipulative therapy
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Long Island University

OTHER

Sponsor Role collaborator

Alabama Physical Therapy & Acupuncture

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marshall Hagins, PT, PhD

Role: STUDY_CHAIR

Long Island University

Locations

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Alabama Physical Therapy & Acupuncture

Montgomery, Alabama, United States

Site Status

Countries

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United States

References

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Dunning JR, Cleland JA, Waldrop MA, Arnot CF, Young IA, Turner M, Sigurdsson G. Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial. J Orthop Sports Phys Ther. 2012 Jan;42(1):5-18. doi: 10.2519/jospt.2012.3894. Epub 2011 Sep 30.

Reference Type BACKGROUND
PMID: 21979312 (View on PubMed)

Dunning JR, Butts R, Mourad F, Young I, Fernandez-de-Las Penas C, Hagins M, Stanislawski T, Donley J, Buck D, Hooks TR, Cleland JA. Upper cervical and upper thoracic manipulation versus mobilization and exercise in patients with cervicogenic headache: a multi-center randomized clinical trial. BMC Musculoskelet Disord. 2016 Feb 6;17:64. doi: 10.1186/s12891-016-0912-3.

Reference Type DERIVED
PMID: 26852024 (View on PubMed)

Other Identifiers

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12/01-006

Identifier Type: -

Identifier Source: org_study_id