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Short- and medium-term effects of manual therapy on the upper cervical spine combined with exercise vs isolated exercise in patients with cervicogenic headache. A randomized controlled trial

Journal: International Journal of Osteopathic Medicine Date: 2022/03, 43(1):Pages: 5-15. doi: Subito , type of study: randomized controlled trial

Full text    (https://www.sciencedirect.com/science/article/pii/S1746068922000219)

Keywords:

cervicogenic headache [9]
exercise [94]
manual therapy [139]
upper cervical spine [3]
neck pain [132]
randomized controlled trial [710]

Abstract:

Background Cervicogenic headache is defined as a unilateral headache associated with a lack of range of motion. The effect of manual therapy applied to the upper cervical spine combined with cervical exercises in this patient population is currently unknown. Objective To determine if adding manual therapy to an exercise and home-exercise program is more effective by reducing symptoms and improving function in the short- and mid-term than just applying exercises in patients with cervicogenic headache. Methods Randomized controlled trial. 40 participants with cervicogenic headache were recruited (20 = Manual Therapy + Exercise and 20 = Exercise). Each group received four 20-min sessions weekly and a home exercise regime. Upper cervical flexion and flexion-rotation test, HIT-6, headache intensity, craniocervical flexion test, pain pressure thresholds, GROC-scale, and adherence to self-treatment were measured at the beginning and end of the intervention, and again at 3-(short-term) and 6-month (mid-term) follow-ups. Results The Manual Therapy + Exercise group showed a statistically significant improvement in all short- and mid-term variables (p < .05) compared to the exercise group except for the variable pain pressure thresholds first metacarpal joint right and left short-term and adherence to self-treatment short-term. Conclusion Four 20-min sessions of manual therapy and an exercise protocol along with a home exercise regime is more effective in the short and mid-term than an exercise protocol and a home exercise regime for patients with cervicogenic headache.


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