Spinal Mobilization Versus Myofacial Release Techniques On Pain And Disability In Patients With Tension Type Headache
Condition: Tension Type Headache
MeSH terms: Tension-Type Headache; Headache
Study type: Interventional

Summary: 
      The most frequent kind of primary headache is tension headache, often known as stress
      headache or tension-type headache (TTH). The pain usually affects both sides of the head and
      might extend from the lower back of the head, the neck, the eyes, or other muscle groups in
      the body. Nearly 90 percent of all headaches are tension-type headaches causing a
      debilitating effect on job productibility and overall quality of life. The aim of the study
      will be to compare the effects of spinal mobilizations comprising Mulligan's headache SNAGs
      and Maitland's PA glide with the myofascial release technique on pain and disability in
      patients with tension-type headache.
    

Detailed description: 
      A Randomized Clinical Trial will be conducted at FMH Physiotherapy Clinic, NUR International
      Physical Therapy clinic and Boston Physiotherapy Clinic Lahore through consecutive sampling
      technique on 34 patients which will be allocated using simple random sampling through sealed
      opaque envelopes into Group A and Group B. Group A will be treated with Spinal Mobilizations
      comprising Mulligan's headache SNAGs and Maitland's PA glide and Group B will be treated with
      Myofascial release technique. Outcome measures tools will be conducted through NPRS, Headache
      disability Index, Headache impact test (HIT-6). Data will be analyzed using SPSS software
      version 25. After assessing normality of data by Shapiro-wilk test, it will be decided either
      parametric or non-parametric test will be used within a group or between two groups
    

Intervention name(s): Spinal Mobilizations; Myofascial Release Technique
Intervention type(s): Other; Other
Intervention description(s): Headache SNAG: A posteroanterior mobilization of the second cervical vertebrae is sustained for 10 to 30 s with the aim to reduce headache intensity at the time of application. (6)
Maitland's C1-C7 PA Glide: A posteroanterior (PA) mobilization of the first till seventh cervical vertebra is achieved by applying a force on to a vertebral segment in a posteroanterior direction (Back to front).
The patients will receive Spinal Mobilizations consisting of 1 set of 6 repetitions once daily thrice per week for four weeks. Pre and post intervention values will be taken on 1st day and after 4 weeks; Suboccipital Inhibition Technique: While the patient will be in the supine position, the physician sitting at the top end of the table will place the fingers of both hands on the patient's suboccipital region. Flexi-perpendicular long fingers exerting an inhibitory pressure on the muscle insertions of the neck extensors in the occiput, perpendicularly to muscle fibers, while the thumbs counterbalance the head against rotation. A deep and progressive pressure would be applied perpendicular to the fibers until a decrease in muscle tone would be detected. This deep and progressive pressure would be maintained for a total of 10 min until release of suboccipital tissues is achieved.
The patients will receive myofascial release with the frequency of 1 set and 10 repetitions once a day three times per week for four weeks. Pre and post intervention values will be taken on 1st day and after 4 weeks.
Other intervention name(s): Headache SNAG, Maitland's C1-C7 PA Glide; Suboccipital Inhibition Technique
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Tension Type Headache