Comparison of Maitland Oscillatory Mobilizations With Kaltenborn Sustained Stretch Mobilizations in Cervicogenic Headache Patients

Study Overview
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Brief Summary
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Cervicogenic headache is a common headache that causes disability and affects everyday activities. Headache related disorders are the second most common reason for years lived with disability all over the world. According to the latest International Headache Society model, cervicogenicheadache (CGH) is a secondary headache having C1-C2 dysfunction. There is marked limitation in cervical ROM specially rotation. Treatment indicated involves use of electrotherapy and thermal modalities. In addition, use of different manual therapy techniques are advocated to eliminate the root cause i.e. C1-C2 dysfunction. Maitland mobilizations for cervical spine have been found to be effective in treating CGH patients. Maitland mobilizations uses oscillatory mobilizations and has four grades. Kaltenborn, on the other hand, applies sustained stretches and has 3 grades.So, the study will be focusing on comparing the effectiveness of these two mobilizations on cervicogenic headache patients.

Official Title
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Comparison of Maitland Oscillatory Mobilizations With Kaltenborn Sustained Stretch Mobilizations in Cervicogenic Headache Patients

Conditions
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Cervicogenic Headache

Intervention / Treatment
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* Procedure: Maitland Oscillatory Mobilization
* Procedure: Kaltenborn Sustained Stretch Mobilization
* Procedure: Conventional therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18-45 years Both males and females Unilateral headache with no shift of side C1-C2 dysfunction Headache with neck stiffness Headache at least once a month in the last 3 months Positive flexion rotation test (Rotation restriction is greater than 10 degrees) Headache with a score of at least 4 in the Numeric pain rating scale Exclusion Criteria: Cervical spondylosis Headache of non-cervical origin Dizziness or visual disturbance Cervical radiculopathy/ nerve root involvement/ disc herniation Cervical instability/ fracture Vertebrobasilar insufficiency Thoracic outlet syndrome Cervical spine surgery Cervical spondylolisthesis Spinal infection or tumors Osteoporosis History of trauma Metabolic disorders Rheumatoid Arthritis Inflammatory Arthritis

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 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
Interventional Model Description: This is a randomized controlled trial having two groups. One group will receive conventional physical therapy along with Maitland oscillatory mobilizations and the second will receive Kaltenborn sustained stretch mobilizations with conventional physical therapy. Both groups will be recruited concurrently.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Maitland + Conventional PT Group<br>Participants of this group will receive the conventional physical therapy protocol mentioned above. In addition to this, they will receive Maitland oscillatory mobilizations. 3 sets of 15 repetitions. Each set is of 30 seconds and each repetition is given in 2 seconds. Frequency: 3 times a week for 2 weeks. 6 sessions in total. Mobilizations will be performed in Grade 1 initially and then progressed to Grade 2 and 3. Techniques used are postero-anterior unilateral vertebral pressure and Maitland rotation. | Procedure: Maitland Oscillatory Mobilization<br>* Maitland Posteroanterior unilateral vertebral pressure and Maitland cervical rotation technique will be used.3 sets of 15 repetitions. Each set is of 30 seconds and each repetition is given for 2 seconds.<br>Procedure: Conventional therapy<br>* Moist heat, TENS, Neck Muscle Stretching, Neck muscle isometrics<br>|
| Experimental: Kaltenborn + Conventional PT Group<br>Participants of this Group will receive the conventional physical therapy protocol mentioned above. In addition to this, they will receive Kaltenborn sustained stretch mobilizations. 3 sets of 15 repetitions for 3 seconds. Frequency: 3 times a week for 2 weeks. 6 sessions in total. Mobilizations will be performed in Grade 1 and then progressed to 2 and 3. Kaltenborn technique used will be atlas-axis rotation. | Procedure: Kaltenborn Sustained Stretch Mobilization<br>* Kaltenborn sustained stretch mobilizations. 3 sets of 15 repetitions for 3 seconds. Frequency: 3 times a week for 2 weeks. 6 sessions in total. Mobilizations will be performed in Grade 1 and then progressed to 2 and 3. Kaltenborn technique used will be atlas-axis rotation<br>Procedure: Conventional therapy<br>* Moist heat, TENS, Neck Muscle Stretching, Neck muscle isometrics<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity | Pain will be measured on the basis of Numeric Pain Rating Scale score. | 2 weeks | 
| Cervical range of motion | Cervical rotation will be measured through CROM device | 2 weeks |