The Effect Of Cervical Mobilization And Clinical Pilates in Cervicogenic Headache

Study Overview
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Brief Summary
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Cervicogenic headache (CH) arises from cervical region problems. Various physiotherapy methods such as manual therapy approaches and exercise training are used in the treatment of CH. The aim of our study is to investigate cervical mobilization and clinical Pilates exercises on pain, muscle stiffness, head and neck blood flow in CH. Including individuals diagnosed with CH in the study. Those to be included in the study will be divided into 3 groups by a simple method. Demographic information of the individuals, age, height, weight, Body Mass Index (BMI), gender, educational status, occupation, marital status, smoking, alcohol use will be recorded. In evaluations about pain before treatment; pain intensity, pain frequency, duration and characteristics will be evaluated with Visual Analog Scale (VAS). In addition, analgesic use (frequency, amount) in headache situations will be recorded. Migraine Disability Assessment Scale (MIDAS) will be used to determine the effect of headache on quality of life. Disability Index will be used in the assessment of functional desire, and Postur Screen mobile application will be used in the assessment of posture. Range of motion(ROM) of all neck joint movements will be evaluated by CROM goniometer, deep neck flexor muscle strength by Pressure Biofeedback Unit (PBU), sternocleidomastoid(SKM), suboccipital and upper trapezius muscle stiffness myotonometer, and head-neck artery flow volume will be evaluated by Doppler ultrasound. Cervical mobilization methods will be applied to the 1st group, clinical pilates applications to the 2nd group, clinical pilates with cervical mobilization will be applied to the 3rd group for 3 days / week for 6 weeks. All evaluations were completed again after the 3rd week and after the treatment. After the obtained results are obtained, the literature will be discussed.

Detailed Description
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The scope of the study, including patients over 18 years of age who applied to the Neurology outpatient clinic of Sani Konukoğlu Application and Research Hospital and presented with cervicogenic headache by a specialist. The sometimes headache frequency variable in the reference result was 5% Power analysis calculated 9 patients per group. It was decided to recruit 15 patients for the group. Inclusion criteria: CH was diagnosed, aged 18-65, had not received medical (except analgesic) treatment or physiotherapy for CH in the previous few months. Exclusion criteria: Individuals who have undergone CH surgery, history of serious heart or surgery, history of ongoing malignancy, diagnosed with epilepsy. Individuals for whom the Voluntary Consent form will be obtained will be randomly divided into groups using the minimalization method given age, gender and duration of illness.Patients will be asked not to use analgesics as much as possible during the treatment period. In the case of analgesic use, the amount and frequency will be recorded. The change in the frequency of analgesic use will also be used to evaluate the effectiveness of the applications.

Official Title
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The Effect Of Cervical Mobilization And Clinical Pilates Exercises On Pain, Muscle Hardness, Head-Neck Blood Flow in Cervicogenic Headache

Conditions
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Headache, Cervicogenic, Exercise, Therapeutics

Intervention / Treatment
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* Other: manuel therapy
* Other: exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosed with Cervicogenic Headache aged 18-65 did not receive medical (except analgesic) treatment or physiotherapy for bit Cervicogenic Headache in the previous few months Exclusion Criteria: Individuals who have undergone Cervicogenic Headache surgery have had a serious cardiac history or surgery a history of ongoing or previous malignancy a diagnosis of epilepsy.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: cervical mobilization<br>Cervical mobilization methods will be applied to 1st group for 3 days / week for 6 weeks. | Other: manuel therapy<br>* approaches will be applied for 3 days / week for 6 weeks.<br>* Other names: cervical mobilization;|
| Active Comparator: clinical pilates exercises<br>clinical pilates exercises will be applied to 2nd group,for 3 days / week for 6 weeks. | Other: exercises<br>* approaches will be applied for 3 days / week for 6 weeks.<br>* Other names: clinical pilates exercises;|
| Active Comparator: cervical mobilization and clinical pilates exercises<br>cervical mobilization and clinical pilates exercises will be applied to 3rd group,for 3 days / week for 6 weeks. | Other: manuel therapy<br>* approaches will be applied for 3 days / week for 6 weeks.<br>* Other names: cervical mobilization;Other: exercises<br>* approaches will be applied for 3 days / week for 6 weeks.<br>* Other names: clinical pilates exercises;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of headache | headache intensity by Visual Analogue Scale , headache frequency and analgesic intake | 6 week | 
| Change of muscle stiffness degree | SKM,suboccipital and upper trapezoidal muscle stiffness with Myoton Pro | 6 week | 
| Change of blood flow degree | head-neck artery flow Doppler Ultrasound (US) | 6 week | 
| change of posture | The PostureScreen Mobile® application | 6 week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| neck range of motion | range of motion by Cervical Range of Motion device | 6 week | 
| deep neck flexor muscle endurance | muscle endurance by Pressure Biofeedback Unit | 6 week | 
| headache life quality | Migraine Disability Assessment Scale for headache on quality of life. | 6 week | 
| neck functional status | Neck Disability Index for functional status | 6 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Blood flow, Cervicogenic Headache,, Pilates based exercises, Cervical mobilization, posture, muscle stifness