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Effectiveness of cervical spine manipulation and prescribed exercise in reduction of cervicogenic headache pain and frequency: A single case study experimental design

Journal: International Journal of Osteopathic Medicine Date: 2005/09, 8(3):Pages: 106-113. doi: Subito , type of study: case report

Full text    (http://www.sciencedirect.com/science/article/pii/S174606890500057X)

Keywords:

case report [514]
cervicogenic headache [9]
headache [127]
OMT [2951]
osteopathic manipulative treatment [2973]
spinal manipulation [74]

Abstract:

Introduction Patients commonly present to osteopaths with a complaint of headache. There is a clear rationale for osteopathic manipulative treatment in management of headaches that involve cervical spine dysfunction such as cervicogenic headache. Recent evidence suggests that deficits in muscle performance of the deep neck flexor muscles may be linked to cervicogenic headache, and that specific exercise prescription may play an important treatment role. Evidence also suggests that combining both manipulative treatment and specific exercise may be an effective treatment approach. Methods A prospective case study utilising an A–B–C design was used to evaluate the effectiveness of osteopathic treatment and specific exercise of the deep cervical flexor muscles in reducing cervicogenic headache pain and frequency in a 26-year-old female, with a 16-year history of cervicogenic headache. The diagnosis of cervicogenic headache was based upon clinical examination, medical history and fulfilment of cervicogenic headache diagnostic criteria. The study consisted of a three-week baseline data collection phase, a three-week osteopathic manipulative treatment phase and a three-week home based exercise phase. Outcome measures included the quadruple visual analogue scale, a headache diary, and data recorded from a pressure biofeedback device. Osteopathic treatment involved high velocity low amplitude (HVLA) thrust techniques and a low load exercise programme targeting the deep cervical flexor musculature. Results Visual analysis of plotted outcome measure data indicated a reduction in both intensity of headache pain and frequency. Conclusions The findings of this single case study are limited in their generalisability, but are consistent with the results of other similar studies investigating cervicogenic headache using similar interventions.


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