Instrument Based Fascial Abrasion Versus Myofascial Release Technique in Cervicogenic Headache Patients
Condition: Cervicogenic Headache
MeSH terms: Post-Traumatic Headache; Headache
Study type: Interventional

Summary: 
      Study will be randomized clinical trial. Data will be collected from non probability
      consecutive sampling technique. Total 44 participants from Rafiqa Hospital and District
      Headquarter (DHQ) Sargodha will be selected and randomly allocated to two different groups
      i.e Group A and Group B. Group A will be treated with Instrument assisted Fascial Abrasion
      and Conventional Therapy for 5 minutes, 6 sessions (3 sessions per week) (12) while Group B
      will be treated with Myofascial Release Technique and Conventional Therapy for 2 to 3
      minutes, 5-7 repetitions and 3 sessions per week on alternate days were given for 6 weeks.
      NPRS, MOS-36, NDI will be used as outcome measuring tool before and after treatment. Data
      will be analyzed by using Statistical package for social sciences 25.
    

Detailed description: 
      Cervicogenic headache is a symptomatic headache characterized by chronic, hemi cranial pain
      syndrome in which pain sensations originates in cervical spine and soft tissues of the neck
      and basically referred to head. Cervicogenic headache originates in the upper cervical
      region, and the headache mechanism involves nociceptive structures such as the upper cervical
      spinal nerves, ganglia, disks, facet joints, muscles, and ligaments. Consequently, the
      anatomical structures innervated by cervical roots C1-C3 are potential sources of
      Cervicogenic headache.

      Myofascial Release (MFR) is a therapeutic technique that uses gentle pressure and stretching
      (in both forms of direct and indirect approaches) with the intention of restoring decrease
      pain, optimizing length and facilitating the release of fascial restrictions caused by
      injury, stress, repetitive use, etc. There are some studies about MFR and its effects which
      include: increase extensibilities of soft tissues, increase ROM, improves joint biomechanics,
      increases temperature of fascia, increases blood circulation to the muscles and decreases
      pain and muscles tone significantly.

      Although; a lot of remedies such as physiotherapy, electrotherapy, exercises therapy and
      spinal mobilization are used for cervicogenic headache, but sub-occipital MFR for
      Cervicogenic headache has not been studied specifically. Another technique used for
      cervicogenic headache includes Fascial Abrasion Technique tool that is a revolutionary tool
      that can quickly and effectively loosen muscle tissue/fascia. It improves range and quality
      of movement.
    

Intervention name(s): Instrument based Fascial abrasion technique; Myofascial release technique
Intervention type(s): Other; Other
Intervention description(s): Participants were in a comfortable position during treatment. Emollient (anti-allergic) was applied to prevent skin irritation prior to Fascial Abrasion application. Each session included 1 minute of sweeping (longitudinal strokes performed parallel to the muscle fibers similar to compression with oscillations) directly over the Myofascial trigger points, 2 minutes of fanning (one end of the instrument was held in place & the other end moved through a semicircular pattern similar to petrissage) and concluded with 1 min of sweeping. Fascial Abrasion tool was washed in alcohol-based sanitizer before and after every treatment session and all norms of COVID-19 precautions were maintained. Myofascial trigger points were marked with a 1×1 cm piece of tape/under wrap to confirm consistency of subsequent treatments.; All participants will get Conventional therapy i.e heating pad for 10 minutes. For the application of technique, the patient position will be supine lying with head fully supported on therapist hands and therapist places 3 middle fingers just inferior to the nucle line, lifts the finger tips towards the ceiling while resting the head on the table and then therapist applied a gentle upward pull. This procedure done for 2-3 minutes, 5-7 repetitions, 3 sessions per week on alternate days given for 6 weeks.
Other intervention name(s): Instrument based soft tissue release technique; Soft tissue release technique
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Neck and head pain