Effects of Workstation Ergonomics and Physiotherapy in Cervicogenic Headache.
Condition: Cervicogenic Headache
MeSH terms: Post-Traumatic Headache; Headache
Study type: Interventional
Phase: Phase 2

Summary: 
      Cervicogenic headache (CgH) is a distinct form of headache and accounts for 17.8% of all
      headaches and the prevalence rate is between 0.4% and 20%. A guide to health and safety in
      the office handbook by common wealth of Australia (2008) suggested the ergonomic guidance and
      interventions for preventing and treating musculoskeletal disorder (MSD) injuries in the
      office workers. Also, It has been estimated that 34% of US citizens receive some sort of
      physiotherapy for CgH each year. However, no studies have compared and investigated the
      combined and individual effects of workstation ergonomics, physiotherapy and patient
      education for improving cervicogenic headache and work ability in office workers.
    

Detailed description: 
      Cervicogenic headache (CgH) is a distinct form of headache and accounts for 17.8% of all
      headaches and the prevalence rate is between 0.4% and 20%. A guide to health and safety in
      the office handbook by common wealth of Australia (2008) suggested the ergonomic guidance and
      interventions for preventing and treating musculoskeletal disorder (MSD) injuries in the
      office workers. Also, It has been estimated that 34% of US citizens receive some sort of
      physiotherapy for CgH each year. However, no studies have compared and investigated the
      combined and individual effects of workstation ergonomics, physiotherapy and patient
      education for improving cervicogenic headache and work ability in office workers.

      Therefore, our study objective was intended to compare and investigate the combined and
      individual effects of workstation ergonomics, physiotherapy and patient education in
      improving cervicogenic headache and work ability in office workers. This randomized clinical
      trial hypothesized that there is a difference in primary and secondary outcome measures
      between workstation ergonomics, physiotherapy and patient education for improving
      cervicogenic headache and work ability in office workers.
    

Intervention name(s): Ergonomic modifications; Physiotherapy; Ergonomic modifications and Physiotherapy; Patient education
Intervention type(s): Biological; Biological; Biological; Biological
Intervention description(s): A blinded therapist used an observation-based ergonomics assessment check list for office workers to check the status of office environment, which usually took 40 - 45 minutes to complete. It consists of 5 domains (7 items related to office chair, 9 items related to office desk, 8 items related to keyboard and mouse, 5 items related to computer screen, 3 items related to telephone and 5 items related to the office environment -) and it has a good reliability and validity. After assessment required modifications were done in the chair, desk, keyboard, mouse, computer screen, telephone and the office environment. Ergonomic education and instructions were also given on an individual basis as per the report of the assessment.; First of all, hydro collator pack was applied over the neck region for 10 minutes to relax the muscles of the neck region. Then the therapist located the sites of abnormal changes in each vertebra and then cervical manipulation was given. To perform the C1-C2 cervical spine manipulation (CSM) the participant was instructed to lie in a face-up position with upper and lower extremities kept aside relaxed. The head was kept in a neutral position and the treating therapist stands at the patient's head side and holds the chin of the patient with the right side hand. The therapist left hand holds the posterior aspect of the head and does two to three free rotatory movements. Afterwards, the therapist did HVLAT technique in either the right or left direction based upon the symptoms informed by the patient.; A blinded therapist used an observation-based ergonomics assessment check list for office workers to check the status of office environment, which usually took 40 - 45 minutes to complete. After assessment required modifications were done in the chair, desk, keyboard, mouse, computer screen, telephone and the office environment.
First of all, hydro collator pack was applied over the neck region for 10 minutes to relax the muscles of the neck region. Then the therapist located the sites of abnormal changes in each vertebra and then cervical manipulation was given.; Participants in the CNG group received the patient education through an experienced physiotherapist and each session lasting for 30 minutes for 4 weeks. According to each individual patients' abilities the therapist educated them to improve the health literacy regarding the condition. The therapist educated them about the benefits of self-care activities, maintaining good posture, stay active and doing active movements and stretching muscles for preventing the health related musculoskeletal injuries at the workstation. Also, life style modifications were taught to the patients to prevent further deterioration of the condition.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The study includes ergonomic modifications group (EMG; n=24), physiotherapy group (PTG; n=24), and ergonomic modifications combined with physiotherapy group (EPG; n=24) and, control group (CNG; n=24)
Masking: Single (Outcomes Assessor)
Primary purpose: Health Services Research
Keywords: Workstation; Ergonomics; Physiotherapy; Randomized control trial; Office workers