McKenzie Method of Mechanical Diagnosis and Therapy for Management of Cervicogenic Headache: A Prospective Case Series

NCT ID: NCT05212844

Last Updated: 2022-01-28

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

UNKNOWN

Total Enrollment

20 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-12-17

Study Completion Date

2022-07-31

Brief Summary

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The goal of this study is to examine the effectiveness the Mechanical Diagnosis and Therapy (MDT) approach for the management patients with neck related headache that are referred to a hospital based out-patient physical therapy clinic.

Background: Headache conditions are among the most common complaints causing people to seek medical care. An estimated 14 billion dollars are spent annually on treating headaches. Neck related headache is characterized by pain which comes from the cervical spine (neck) and could be referred to the head and/or face. CGH is frequently managed clinically utilizing an MDT approach however to date there is limited research available examining the effectiveness of this intervention type in a population with CGH.

Detailed Description

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Objective: The goal of this case-series is to examine the effectiveness the Mechanical Diagnosis and Therapy (MDT) approach for the management patients with cervicogenic headache referred to a hospital based out-patient physical therapy clinic.

Design: Prospective consecutive case series.

Background: Headache conditions are among the most common complaints causing people to seek medical care. An estimated 14 billion dollars are spent annually on treating headaches. Cervicogenic headache (CGH) is described as a secondary type of headache characterized by pain which emanates from the cervical spine and is potentially referred to one or more regions of the head and/or face. CGH is frequently managed clinically utilizing an MDT approach however to date there is limited research available examining the effectiveness of this intervention type in a population with CGH.

Study Selection Criteria: Convenience sampling will be utilized. Subjects diagnosed with CGH and meeting inclusion criteria will be recruited from a population of patients referred by their physician to a hospital based out-patient physical therapy clinic for treatment.

Procedures: Subjects meeting inclusion criteria will be evaluated, classified, and receive interventions based on the MDT approach. Outcome measures utilized will include the Neck Disability Index (NDI), Numeric Pain Rating Scale (NRS), and Headache Disability Index (HDI) will be completed at baseline, visit 5, and visit 10 or discharge, whichever comes first.

Data Management: Descriptive statistics will be used to describe sample characteristics. A repeated measures ANOVA will be utilized to identify changes in group means.

Key Words: Cervicogenic Headache, Mechanical Diagnosis and Treatment.

Conditions

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Cervicogenic Headache

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Interventions

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Musculoskeletal Physical Therapy

Therapeutic exercise and manual physical therapy based on the individual response to end range repeated movements.

Intervention Type PROCEDURE

Other Intervention Names

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Mechanical Diagnosis and Treatment

Eligibility Criteria

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Inclusion Criteria

* Age 19-70
* During the physical therapy examination, it is found that movements, static positions, or postures affect the patient headache symptoms.
* Pain presents as unilateral or bilateral head/neck pain and/or stiffness
* Headache frequency at least 1x/week
* Headache symptoms are present for at least 3 months
* Dizziness and/or tinnitus affected by neck movements or positions
* Patient has been previously screened for their headache symptoms by their MD

Exclusion Criteria

* Headache is determined to be of non-cervical origin including migraine, cluster headache, tension-type headache
* Malignancy/infection
* Cranial or cervical vascular disorder
* Substance use or withdrawal
* Acute Post cervical surgery
* Psychosis/psychiatric disorder/post-traumatic stress disorder
* Received nerve block or Botox injections during therapy
* Vertigo with nystagmus is present
* Involved in litigation related to headache complaints
Minimum Eligible Age

19 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tufts University

OTHER

Sponsor Role collaborator

D'Youville College

OTHER

Sponsor Role collaborator

Faith Regional Health Services

OTHER

Sponsor Role lead

Responsible Party

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Lan Lin Pu

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ronal Schenk, PhD

Role: STUDY_DIRECTOR

Tufts University

Locations

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Faith Regional Rehabilitation Therapies

Norfolk, Nebraska, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Ronald Schenk, PhD

Role: CONTACT

716-566-8756

Eric Miller, DSc

Role: CONTACT

716-912-9046

Facility Contacts

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Lin Pu, PT

Role: primary

402-644-7396

References

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Hu XH, Markson LE, Lipton RB, Stewart WF, Berger ML. Burden of migraine in the United States: disability and economic costs. Arch Intern Med. 1999 Apr 26;159(8):813-8. doi: 10.1001/archinte.159.8.813.

Reference Type BACKGROUND
PMID: 10219926 (View on PubMed)

Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24 Suppl 1:9-160. doi: 10.1111/j.1468-2982.2003.00824.x. No abstract available.

Reference Type BACKGROUND
PMID: 14979299 (View on PubMed)

Jull G, Barrett C, Magee R, Ho P. Further clinical clarification of the muscle dysfunction in cervical headache. Cephalalgia. 1999 Apr;19(3):179-85. doi: 10.1046/j.1468-2982.1999.1903179.x.

Reference Type BACKGROUND
PMID: 10234466 (View on PubMed)

Jull G, Kristjansson E, Dall'Alba P. Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients. Man Ther. 2004 May;9(2):89-94. doi: 10.1016/S1356-689X(03)00086-9.

Reference Type BACKGROUND
PMID: 15040968 (View on PubMed)

Nilsson N. A randomized controlled trial of the effect of spinal manipulation in the treatment of cervicogenic headache. J Manipulative Physiol Ther. 1995 Sep;18(7):435-40.

Reference Type BACKGROUND
PMID: 8568424 (View on PubMed)

Page P. Cervicogenic headaches: an evidence-led approach to clinical management. Int J Sports Phys Ther. 2011 Sep;6(3):254-66.

Reference Type BACKGROUND
PMID: 22034615 (View on PubMed)

Other Identifiers

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081468

Identifier Type: -

Identifier Source: org_study_id

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