Efficacy of Lumbar Motor Control Training in Treatment Of Patients With Cervicogenic Headache

NCT ID: NCT05952115

Last Updated: 2023-07-19

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 52 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-07-16
• Study Completion Date: 2023-10-16

Brief Summary

this study will be conducted to investigate the effect of lumbar motor control training exercise on headache frequency, duration, intensity and neck functional disability in cervicogenic headache patients

Detailed Description

Cervicogenic Headache is a referred pain spreading from cervical structures supplied by the upper cervical spinal nerve roots (C1-C3), this referred pain that starts from the posterior aspect of the head and neck is usually found to be unilateral, and it also can spread to the frontal, temporal and orbital aspects of the head.The patient frequently reports having a terrible headache, having less neck range of motion, performing less well at work, and having trouble focusing, that may linger for hours. The convergence of primary sensory afferents from cervical nerve roots C1 to C3 with the afferents from the occiput and trigeminal nerve causes the underlying pathology. Because of this, the Suboccipital muscles particularly, which cervical roots C1 innervates to C3, are potential risk structures. Treatment options include posture correction, cervical and upper thoracic strengthening exercises, facet joint manipulation, ultrasound therapy, laser therapy, trigger release therapy, and cervical joint mobilization.famous exercise known as "Motor control exercise" attempts to improve the coordination and effectiveness of the muscles that support and govern the spine. It can also improve coordination between the deep neck flexors and superficial neck flexors and between core muscles of the lumbar region. fifty two patients will be randomly assigned to two equal groups; experimental group will receive lumbar motor control and cervical stabilization exercises and control group will receive cervical stabilization exercises only.

Conditions

Cervicogenic Headache

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

lumbar motor control exercises

patients will receive lumbar motor control and cervical stabilization exercises three times a week for four weeks

Group Type: EXPERIMENTAL

lumbar motor control exercises

Intervention Type: OTHER

the patients will receive lumbar motor control exercises in the form of three exercises (Abdominal draw in maneuver, side-bridge, and quadruped) and the level of difficulty increased each week. For all exercises, the number of repetitions stayed the same, but the difficulty increased each week, and we progressed to the advanced level of each of the three exercises.

This training achieves co-contraction of the local/deep stabilizing muscles (Transversus abdominis and multifidus) and strengthening the global/large spinal stabilizers (erector spinae and obliques).

Cervical stabilization exercises

Intervention Type: OTHER

The exercise program consisted of an axial elongation exercise, cranio-cervical flexion exercise, cervical extension exercise, and cervical-scapulothoracic strengthening exercise. The exercise program progressed based on the exercise tolerance of the patients by increasing the repetition of the exercise (10 reps to 15 reps to 20 reps). And for the resistive exercise, the participants change to an elastic band with greater resistance (progress to the next color resistance band). Exercises were performed for 20 min/session, and an exercise log recording the date and repetition of the exercises was maintained by the therapist for each participant.

cervical stabilization exercises

the patients will receive cervical stabilization exercises three times a week for four weeks

Group Type: ACTIVE_COMPARATOR

Cervical stabilization exercises

Intervention Type: OTHER

The exercise program consisted of an axial elongation exercise, cranio-cervical flexion exercise, cervical extension exercise, and cervical-scapulothoracic strengthening exercise. The exercise program progressed based on the exercise tolerance of the patients by increasing the repetition of the exercise (10 reps to 15 reps to 20 reps). And for the resistive exercise, the participants change to an elastic band with greater resistance (progress to the next color resistance band). Exercises were performed for 20 min/session, and an exercise log recording the date and repetition of the exercises was maintained by the therapist for each participant.

Interventions

lumbar motor control exercises

the patients will receive lumbar motor control exercises in the form of three exercises (Abdominal draw in maneuver, side-bridge, and quadruped) and the level of difficulty increased each week. For all exercises, the number of repetitions stayed the same, but the difficulty increased each week, and we progressed to the advanced level of each of the three exercises.

This training achieves co-contraction of the local/deep stabilizing muscles (Transversus abdominis and multifidus) and strengthening the global/large spinal stabilizers (erector spinae and obliques).

Intervention Type: OTHER

Cervical stabilization exercises

The exercise program consisted of an axial elongation exercise, cranio-cervical flexion exercise, cervical extension exercise, and cervical-scapulothoracic strengthening exercise. The exercise program progressed based on the exercise tolerance of the patients by increasing the repetition of the exercise (10 reps to 15 reps to 20 reps). And for the resistive exercise, the participants change to an elastic band with greater resistance (progress to the next color resistance band). Exercises were performed for 20 min/session, and an exercise log recording the date and repetition of the exercises was maintained by the therapist for each participant.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• The age of the subjects ranged from 20-40 years old, both genders.
• Patients with chronic mechanical neck pain with frequent cervicogenic headaches persisting for more than 3 months.
• Positive flexion rotation test.
• Unilateral head pain without side shift or bilateral head pain with dominant side headache associated with neck pain and aggravated by neck movement and/or sustained awkward head positioning
• Joint tenderness in at least one of the upper three cervical joints or the occipital region as detected by manual palpation.
• Intensity of headache is moderate to severe.
• Abnormal performance in CCFT < = 26 mmHg
• Body mass index range from 18 to 25 km/m2

Exclusion Criteria

• Fracture or previous surgery on the vertebral column.
• Spinal stenosis.
• Disc prolapsed.
• TMJ dysfunction.
• Headache with autonomic involvement, dizziness, or visual disturbance.
• Congenital condition of the cervical spine.
• Neck pain of less than three months

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Hagar Abd_El basset Ismail Marzok

principle investigator hagar Abd El basset Ismail Marzouk

Responsibility Role: PRINCIPAL_INVESTIGATOR

Other Identifiers

P.T.REC/012/003835

Identifier Type: -

Identifier Source: org_study_id