Effects of Cervical Manual Therapy on Cervicogenic Headache
Condition: Unilateral Headache; Musculoskeletal Neck Pain
MeSH terms: Post-Traumatic Headache; Headache; Neck Pain
Study type: Interventional

Summary: 
      The effects of cervical spine manual therapy, including mobilization and manipulation, on
      cervical spine range of motion, joint position sense, and balance is unknown among
      individuals with cervicogenic headache. Previous studies have indicated improved frequency of
      headache, decreased perceived disability, and demonstrated improved neuromuscular function
      following upper cervical manipulation. Other authors report improved cervical spine range of
      motion, joint position sense, and balance following cervical spine manual therapy for
      individuals with cervicogenic dizziness. Through an experimental design, this study aims to
      determine the effects of cervical spine manual therapy on variables such as cervical spine
      range motion, joint position sense, and balance among individuals with headache of a cervical
      spine origin.
    

Detailed description: 
      A convenience sample will be utilized to obtain subjects who suffer from cervicogenic
      headaches, as defined by the International Headache Classification. Subjects will be given an
      online medical screening questionnaire to differentiate and screen additional types of
      headache symptoms (migraine, cluster, tension-type, for example) and identify possible
      contraindications for manual therapy treatment techniques and exclude individuals if
      necessary. Subjects will be randomized into one of three groups (upper cervical mobilization,
      upper cervical manipulation, or control) and be tested with the Cervical Flexion Rotation
      Test, Joint Position Error testing, and sensorimotor balance testing via NeuroCom Balance
      Master. Subjects with cervicogenic headaches will receive their assigned intervention and
      dependent variables will be reassessed immediately, as well as 4-weeks after initial
      intervention. Individuals in either intervention group (mobilization or manipulation) will
      also complete a specific home-exercise program, which has been reported to improve upper
      cervical range of motion, to the C1/2 segment.
    

Intervention name(s): Cervical Spine Mobilization; Cervical Spine Manipulation
Intervention type(s): Procedure; Procedure
Intervention description(s): C1/2 graded mobilizations (Grade III/IV) provided to C1/2 segment on ipsilateral side of unilateral headache. Mobilizations will be completed for 3 sets of 30 seconds.; C1/2 manipulation (Grade V) provided to C1/2 segment on ipsilateral side of unilateral headache. The goal of the manipulation technique is to elicit an audible cavitation. If no cavitation is achieved upon the first attempt, a second and final attempt will be completed. No more than two attempts will be utilized per each subject in this allocated group.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Pre-test, Post-test, control group design 3 groups - mobilization, manipulation, control
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Cervicogenic Headache; Manual Therapy; Joint Position Sense; Balance