Effects of Shi Style Cervical Mobilization Versus SNAGS in Patients With Cervicogenic Headache
NCT Number: NCT06459726
Status: RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Cervicogenic Headache
Interventions: OTHER: shi style mobilization|OTHER: SNAGS
Sponsor: Riphah International University
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 40
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: SINGLE (OUTCOMES_ASSESSOR)|Primary Purpose: TREATMENT
Start Date: 2024-05-07
Completion Date: 2024-08-30
Locations: Jinnah Hospital Lahore, Lahore, Punjab, 54000, Pakistan

Summary:
Cervicogenic headache (CGH) manifests as unilateral neck pain referred from the neck's soft tissues or bony structures. The aim of this study will be to compare the effectiveness of Shi style cervical mobilization versus Sustained Natural Apophyseal Glides on pain, strength and functional disability in patients with Cervicogenic Headache.

Primary Outcome Measures: NPRS, Changes from base Line Numeric Pain rating scale is a scale for pain starting from 0-10. where 0 indicate no pain and 10 indicate severe pain Changes from base Line Numeric Pain rating scale is a scale for pain starting from 0-10. where 0 indicate no pain and 10 indicate severe pain The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical Changes from base Line Numeric Pain rating scale is a scale for pain starting from 0-10. where 0 indicate no pain and 10 indicate severe pain Changes from base Line Numeric Pain rating scale is a scale for pain starting from 0-10. where 0 indicate no pain and 10 indicate severe pain The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain)., 6th week|Deep Neck flexors strength by pressure Biofeedback, Subjects will be positioned in supine lying, and the air unit of pressure biofeedback will be placed at the posterior aspect of the cervical spine just below the occiput and inflated to a baseline of 20 mmHg. They will be instructed to perform the cranio-cervical flexion movement such that the pressure rose to 22 mmHg and will hold this position for 10 seconds. A rest of 30 seconds will be provided, and the whole procedure will be repeated for 24, 26, 28, and 30 mmHg. Final reading will be taken when the subject is not able to hold the specific pressure for 10 seconds. Before the test, subjects will be given enough time to practice and examiner will observe for any substitution movements during the test. Test will be considered poor if subjects could not hold the position at 26 mmHg, 6th week|Dizziness Handicap Inventory, The primary outcome will be the score on the Dizziness Handicap Inventory (DHI). The DHI Is a highly reliable and responsive tool. This questionnaire is validated and shows a high test-retest reliability (ICC = 0.98) he highest available score is 100, indicating the maximum level of self-perceived handicap (0-30 "low handicap", 30-60 "moderate handicap" and +60 "severe handicap")(32). The DHI consists of 25 items with 3 response levels that are categorized into subgroups as functional 36 points, emotional 36 points, and physical 28 points., 6th week|NDI, This questionnaire will be used to assess disability. It comprises of 10 items. Out of which 7 are related to daily living activities, 2of them related to pain and 1 related to concentration. Each item is scored from 0 to 5.. the lowest score of each item is 0 and the highest is 5, the higher the score the serious the dysfunction . The specific judgment is 0-20% indicates mild dysfunction, 21-40% indicates moderate dysfunction, 41-60% indicates severe dysfunction, 61-80% indicates extremely severe dysfunction, and 81-100% indicates complete dysfunction The Neck Disability Index exhibited excellent reliability (ICC ¼ 0.92; \[95 % CI: 0.46-0.97\]) validity (p \< 0.001) in this headache population(30). Total score is expressed as a percentage, with higher scores related to greater disability., 6th week|Quality of life SF36, SF-36 was used to assess participants' health-related quality of life. It contains 36 questions divided into eight dimensions including physical functioning (10 items), role limitations due to physical health problems (four items), social functioning (two items), bodily pain (two items), general mental health (five items), vitality (four items), role limitations due to emotional health problems (three items), general health perceptions (five items), and reported health transition (one item). The score for each question will be the weight sum of the questions in each dimension. Physical (physical health, role physical, bodily pain, general health) and mental component summary scores (vitality, social functioning, role-emotional, and emotional well-being) were calculated(37). A total score can range from 0 to 100, where a higher score indicates better health status Assessments will be performed before, during, and after intervention., 6th week