Additional Effects of Sternocleidomastoid Release With SNAGS in the Management of Cervicogenic Headache

NCT ID: NCT06534606

Last Updated: 2024-08-02

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 38 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-06-10
• Study Completion Date: 2024-12-30

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.

Conditions

Cervicogenic Headache

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

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.

Group Type: ACTIVE_COMPARATOR

Electrotherapy and physical agents

Intervention Type: PROCEDURE

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

Intervention Type: PROCEDURE

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.

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.

Group Type: EXPERIMENTAL

Electrotherapy and physical agents

Intervention Type: PROCEDURE

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

Intervention Type: PROCEDURE

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

Intervention Type: PROCEDURE

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.

Interventions

Electrotherapy and physical agents

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.

Intervention Type: PROCEDURE

Headache SNAGs

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 Type: PROCEDURE

Sternocleidomastoid Release

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 Type: PROCEDURE

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 45 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Foundation University Islamabad

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Foundation University College of Physical Therapy

Rawalpindi, Punjab Province, Pakistan

Countries

Pakistan

Other Identifiers

FUI/CTR/2024/17

Identifier Type: -

Identifier Source: org_study_id