Effect of Myofascial Release Technique Alone or Combined With Exercises on Cervical Cobb Angle, Sleep Quality, and Psychological Factors in Patients With Cervicogenic Headache

NCT ID: NCT07168512

Last Updated: 2025-09-11

Basic Information

• Recruitment Status: ENROLLING_BY_INVITATION
• Clinical Phase: NA
• Total Enrollment: 100 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-09-04
• Study Completion Date: 2026-04-03

Brief Summary

This study will investigate whether myofascial release therapy alone or in combination with therapeutic exercises can improve cervical spine alignment, measured by cervical Cobb angle on X-ray, in patients with cervicogenic headache. The research will also examine potential effects on sleep quality and psychological factors."

Conditions

Effect of Physiotherapy on Cobb Angle in Patients With Cervicogenic Headache

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: SINGLE

Study Groups

One group will receive exercises

The intervention will include targeted neck strengthening and endurance exercises combined with the application of hot packs

Group Type: EXPERIMENTAL

Exercises (Endurance and strengthening)

Intervention Type: OTHER

Neck Strengthening and Endurance Exercises with Hot Packs

Preparation: A moist hot pack will be applied for 10-15 minutes to the cervical region before exercise to reduce stiffness and enhance tissue extensibility.

Exercise program:

Deep cervical flexor training: Chin tucks in supine and sitting, progressing to sustained isometric holds.

Extensor and scapular stabilizer training: Prone head lifts and shoulder retraction exercises with light resistance.

Endurance training: Low-load, high-repetition exercises focusing on maintaining cervical posture against gravity.

Progression: Intensity and duration will gradually increase, emphasizing endurance over maximal strength to correct postural deficits.

Frequency: 40 minutes per session, 3 times per week for 6 weeks

Rationale: The combined use of heat and targeted exercises improves neuromuscular control, enhances cervical stability, and supports better cervical curvature correction. Myofascial Release Technique

Exercises and Myofascial release technique

The intervention will include targeted neck strengthening and endurance exercises combined with the application of hot packs in addition to myofasical release technique

Group Type: EXPERIMENTAL

Exercises (Endurance and strengthening)

Intervention Type: OTHER

Neck Strengthening and Endurance Exercises with Hot Packs

Preparation: A moist hot pack will be applied for 10-15 minutes to the cervical region before exercise to reduce stiffness and enhance tissue extensibility.

Exercise program:

Deep cervical flexor training: Chin tucks in supine and sitting, progressing to sustained isometric holds.

Extensor and scapular stabilizer training: Prone head lifts and shoulder retraction exercises with light resistance.

Endurance training: Low-load, high-repetition exercises focusing on maintaining cervical posture against gravity.

Progression: Intensity and duration will gradually increase, emphasizing endurance over maximal strength to correct postural deficits.

Frequency: 40 minutes per session, 3 times per week for 6 weeks

Rationale: The combined use of heat and targeted exercises improves neuromuscular control, enhances cervical stability, and supports better cervical curvature correction. Myofascial Release Technique

Myofascial release technique

Intervention Type: OTHER

Myofascial Release Technique

Target areas: Suboccipital muscles, upper trapezius, levator scapulae, and deep cervical fascia.

Method: A physiotherapist will perform gentle, sustained manual pressure and low-load, long-duration stretching on restricted cervical and upper thoracic fascia to reduce tension and improve soft tissue mobility.

Duration and frequency: Each session will include 30'to 50 minutes of myofascial release, delivered 3 times per week for the study period for 6 weeks.

Rationale: This technique aims to decrease myofascial restrictions contributing to abnormal cervical alignment and pain, thereby facilitating improved posture and muscle activation.

Control

control ; only advices

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Exercises (Endurance and strengthening)

Neck Strengthening and Endurance Exercises with Hot Packs

Preparation: A moist hot pack will be applied for 10-15 minutes to the cervical region before exercise to reduce stiffness and enhance tissue extensibility.

Exercise program:

Deep cervical flexor training: Chin tucks in supine and sitting, progressing to sustained isometric holds.

Extensor and scapular stabilizer training: Prone head lifts and shoulder retraction exercises with light resistance.

Endurance training: Low-load, high-repetition exercises focusing on maintaining cervical posture against gravity.

Progression: Intensity and duration will gradually increase, emphasizing endurance over maximal strength to correct postural deficits.

Frequency: 40 minutes per session, 3 times per week for 6 weeks

Rationale: The combined use of heat and targeted exercises improves neuromuscular control, enhances cervical stability, and supports better cervical curvature correction. Myofascial Release Technique

Intervention Type: OTHER

Myofascial release technique

Myofascial Release Technique

Target areas: Suboccipital muscles, upper trapezius, levator scapulae, and deep cervical fascia.

Method: A physiotherapist will perform gentle, sustained manual pressure and low-load, long-duration stretching on restricted cervical and upper thoracic fascia to reduce tension and improve soft tissue mobility.

Duration and frequency: Each session will include 30'to 50 minutes of myofascial release, delivered 3 times per week for the study period for 6 weeks.

Rationale: This technique aims to decrease myofascial restrictions contributing to abnormal cervical alignment and pain, thereby facilitating improved posture and muscle activation.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age 20-55 years.
• Clinical diagnosis of cervicogenic headache according to International Classification of Headache Disorders (ICHD-3) criteria (headache attributed to cervical disorder).

Exclusion Criteria

• History of major cervical spine pathology such as fracture, dislocation, congenital malformation, tumor, infection, or inflammatory arthritis (e.g., rheumatoid arthritis, ankylosing spondylitis).
• Previous cervical spine surgery or fusion at any level.
• Red flag symptoms indicating serious pathology (e.g., progressive neurological deficit, unexplained weight loss, fever, history of cancer).
• Systemic or neurological disorders that may affect neck function or headache (e.g., multiple sclerosis, Parkinson's disease).
• Severe osteoporosis or metabolic bone disease that contraindicates cervical X-ray imaging.
• Vascular disorders such as vertebrobasilar insufficiency or carotid artery disease.
• Pregnancy or breastfeeding (due to radiation exposure during cervical radiography).
• Unstable psychiatric conditions (e.g., severe depression, psychosis) that may interfere with participation or adherence.
• Recent physiotherapy or manual therapy targeting the cervical region within the past 6 weeks, or planned during the study outside the protocol.
• Use of botulinum toxin or steroid injections to the neck or head region in the past 6 months.
• Contraindications to manual therapy or exercise (e.g., acute cervical disc herniation, severe myelopathy, unstable cardiovascular disease).
• Inability to understand study procedures, comply with treatment sessions, or provide informed consent.
• Symptoms of migraine, tension-type headache (TTH), or any other headache apart from cervicogenic headache.

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Al-Azhar University

OTHER

Sponsor Role: lead

Responsible Party

Mosab ALdabbas

mosab aldabbas

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Naser Medical Complex

Gaza, Gaza Strip, Palestinian Territories

Ministry of Health

Gaza, , Palestinian Territories

Countries

Palestinian Territories

References

Cervical Cobb angle, sleep quality and psychological factors in patients with chronic neck pain with and without cervicogenic headache

Reference Type: BACKGROUND

Related Links

https://sheets.new

Related Info

Other Identifiers

Al Azhar university, Palestine

Identifier Type: -

Identifier Source: org_study_id